Patterns of Colorectal Cancer Test Use, Including CT Colonography, in the 2010 National Health Interview Survey

BACKGROUND: Recommended colorectal cancer (CRC) screening tests for adults ages 50 to 75 years include home fecal occult blood tests (FOBT), sigmoidoscopy with FOBT, and colonoscopy. A newer test, computed tomographic (CT) colonography, has been recommended by some, but not all, national organizations. METHODS: We analyzed 2010 National Health Interview Survey data, including new CT colonography questions, from respondents ages 50 to 75 years (N = 8,952). We (i) assessed prevalence of CRC test use overall, by test type, and by sociodemographic and health care access factors and (ii) assessed reported reasons for not having a CRC test. RESULTS: The age-standardized percentage of respondents reporting FOBT, sigmoidoscopy, or colonoscopy within recommended time intervals was 58.3% 95% confidence interval (CI), 57.0-59.6. Colonoscopy was the most commonly reported test within past 10 years: 54.6% (95% CI, 53.2-55.9). Home FOBT and sigmoidoscopy with FOBT were less frequently used FOBT within past year: 8.8% (95% CI, 8.1-9.6); sigmoidoscopy within past 5 years with FOBT within past 3 years: 1.3% (95% CI, 1.0-1.6). CT colonography was rare: 1.3% (95% CI, 1.0-1.7). Increasing age, education, income, having health care insurance, and having a usual source of health care were associated with higher CRC test use. Test use within recommended time intervals was particularly low among individuals ages 50 to 64 years without health care insurance 21.2% (95% CI, 18.3-24.4). The most common reason for nonuse was "no reason or never thought about it." CONCLUSIONS: About 40% of Americans ages 50 to 75 years do not meet the recommendations for having CRC screening tests. IMPACT: Expanded health care coverage and greater awareness of CRC screening are needed to further decrease CRC mortality.