The U.S. Preventive Services Task Force (USPSTF) and the American College of Physicians recommend screening for average-risk adults, ages 50-75, using one of the following options:
- Annual, at-home stool tests: fecal immunochemical test (FIT), or high sensitivity guaiac-based fecal occult blood test (gFOBT)
- Flexible sigmoidoscopy every five years
- Colonoscopy every 10 years
The USPSTF states, “[N]o head-to-head studies demonstrated that any of the recommended screening strategies are more effective than others.” The National Colorectal Cancer Roundtable and the American Cancer Society have a call to action for recommending screenings to patients: The best test is the one that gets done.
Colorectal Cancer Screening in Massachusetts
The statewide screening rate in Massachusetts is 74.6%, but there are disparities in screening rates across ethnicities and regions. The rates among Hispanics (55.7%) and black, non-Hispanics, (67.6%) are lower than the rate among whites (76.2%). The use of FOBT/FIT is low, statewide, and is an opportunity to increase overall screening rates.
Research shows that patients have a significantly higher test completion rate when they are offered the option of a FOBT/FIT or colonoscopy.
Colonoscopy has long been seen as the gold standard for colorectal cancer screening. But many patients face barriers to colonoscopies, including transportation, language, and lack of time. Any of these barriers can lead to inadequate prep, and ultimately, incomplete or missed exams. Discussing options for colorectal cancer screening can help match patients to the screening test they are most likely to complete, which leads to more patients getting screened.
Resources for Providers
The National Colorectal Cancer Roundtable has a suite of resources for primary care practices to advance colorectal cancer screening:
- How to Increase Colorectal Cancer Screening Rates in Practice: A Primary Care Clinician’s Evidenced- Based Toolbox and Guide
- Colorectal Cancer Screening Clinician’s Guide: Cancer Screening Action Plan - an abridged version of the Toolbox and Guide
- The New FOBT/FIT Clinician’s Reference Resource
- Online CME Course: Efficacy of FIT-FOBT for Colorectal Cancer Screening
Resources for Patients
Patients can visit the Colon Cancer Screening Saves Lives web page for more information about at home screening options.
You can download or order the following free patient materials about colorectal cancer screening from the Massachusetts Health Promotion Clearinghouse.