Research Article A Population-Based Study of Prevalence and Adherence Trends in Average Risk Colorectal Cancer Screening,

Background: Increasing colorectal cancer screening (CRCS) is important for attaining the Healthy People 2020 goal of reducingCRC-relatedmorbidity andmortality. Evaluating CRCS trends can help identify shifts in CRCS, and specific groups that might be targeted for CRCS. Methods: We utilized medical records to describe population-based adherence to average-risk CRCS guidelines from 1997 to 2008 in Olmsted County, MN. CRCS trends were analyzed overall and by gender, age, and adherence to screening mammography (women only). We also carried out an analysis to examine whether CRCS is being initiated at the recommended age of 50. Results: From 1997 to 2008, the size of the total eligible sample ranged from 20,585 to 21,468 people. CRCS increased from22 % to 65 % forwomen and from17 % to 59 % formen (P < 0.001 for both) between 1997 and 2008. CRCS among women current with mammography screening increased from 26 % to 74%, and this group was more likely to be adherent to CRCS than all other subgroups analyzed (P < 0.001).The mean ages of screening initiationwere stable throughout the study period,with amean age of 55 years among bothmen andwomen in 2008. Conclusion: Although overall CRCS tripled during the study period, there is still room for improvement. Impact: Working to decrease the age at first screening, exploration of gender differences in screening behavior, and targetingwomen adherent tomammography but not to CRCS seemwarranted.Cancer Epidemiol Biomarkers Prev; 21(2); 347–50. 2011 AACR