Use Of Colorectal Cancer Screening Tests Research Articles

Up-to-Date Breast, Cervical, and Colorectal Cancer Screening Test Use in the United States, 2021.

We examined national estimates of breast, cervical, and colorectal cancer (CRC) screening test use and compared them with Healthy People 2030 national targets. Test use in 2021 was compared with prepandemic estimates. In 2022, we used 2021 National Health Interview Survey (NHIS) data to estimate proportions of adults up to date with US Preventive Services Task Force recommendations for breast (women aged 50-74 y), cervical (women aged 21-65 y), and CRC screening (adults aged 50-75 y) across sociodemographic and health care access variables. We compared age-standardized estimates from the 2021 and 2019 NHIS. Percentages of adults up to date in 2021 were 75.7% (95% CI, 74.4%-76.9%), 75.2% (95% CI, 73.9%-76.4%), and 72.2% (95% CI, 71.2%-73.2%) for breast, cervical, and CRC screening, respectively. Estimates were below 50% among those without a wellness check in 3 years (all screening types), among those without a usual source of care or insurance (aged <65 y) (breast and CRC screening), and among those residing in the US for less than 10 years (CRC screening). Percentages of adults who were up to date with breast and cervical cancer screening and colonoscopy were similar in 2019 and 2021. Fecal occult blood/fecal immunochemical test (FOBT/FIT) use was modestly higher in 2021 (P < .001). In 2021, approximately 1 in 4 adults of screening age were not up to date with breast, cervical, and CRC screening recommendations, and Healthy People 2030 national targets were not met. Disparities existed across several characteristics, particularly those related to health care access. Breast, cervical, and colonoscopy test use within recommended screening intervals approximated prepandemic levels. FOBT/FIT estimates were modestly higher in 2021.

Utilization of access to colorectal cancer screening modalities in low-income populations after medicaid expansion.

Colorectal cancer (CRC) remains a relevant public health problem. Current research suggests that racial, economic and geographic disparities impact access. Despite the expansion of Medicaid eligibility as a key component of the Affordable Care Act (ACA), there is a dearth of information on the utilization of newly gained access to CRC screening by low-income individuals. This study investigates the impact of the ACA's Medicaid expansion on utilization of the various CRC screening modalities by low-income participants. Our working hypothesis is that Medicaid expansion will increase access and utilization of CRC screening by low-income participants. To investigate the impact of the Affordable Care Act and in particular the effect of Medicaid expansion on access and utilization of CRC screening modalities by Medicaid state expansion status across the United States. This was a quasi-experimental study design using data from the Behavioral Risk Factor Surveillance System, a large health system survey for participants across the United States and with over 2.8 million responses. The period of the study was from 2011 to 2016 which was dichotomized as pre-ACA Medicaid expansion (2011-2013) and post-ACA Medicaid expansion (2014-2016). The change in utilization of access to CRC screening strategies between the expansion periods were analyzed as the dependent variables. Secondary analyses included stratification of the access by ethnicity/race, income, and education status. A greater increase in utilization of access to CRC screening was observed in Medicaid expansion states than in non-expansion states [+2.9%; 95% confidence interval (95%CI): 2.12, 3.69]. Low-income participants showed a +4.02% (95%CI: 2.96, 5.07) change between the expansion periods compared with higher income groups +3.19% (1.70, 4.67). Non-Hispanic Whites and Hispanics [+3.01% (95%CI: 2.16, 3.85) vs +5.51% (95%CI: 2.81, 8.20)] showed a statistically significant increase in utilization of access but not in Non-Hispanic Blacks, or Multiracial. There was an increase in utilization across all educational levels. This was significant among those who reported having a high school graduate degree or more +4.26 % (95%CI: 3.16, 5.35) compared to some high school or less +1.59% (95%CI: -1.37, 4.55). Medicaid expansion under the Affordable Care Act led to an overall increase in self-reported use of CRC screening tests by adults aged 50-64 years in the United States. This finding was consistent across all low-income populations, but not all races or levels of education.

Spatial mapping of colorectal cancer screening uptake and associated factors.

Over the past decades, it has been understood that the availability of screening tests has contributed to a steady decline in incidence of colorectal cancer (CRC). However, it is also seen that there is a geographic disparity in the use of such tests across small areas. The aim of this study is to examine small-area level barrier factors that may impact CRC screening uptake and to delineate coldspot (low uptake of screening) counties in Florida. Data on the percentages of county-level CRC screening uptakes in 2016 and county-level barrier factors for screening were obtained from the Florida Department of Health, Division of Public Health Statistics & Performance Management. Bayesian spatial beta models were used to produce posterior probability of deceedance to identify coldspots for CRC screening rates. Unadjusted screening rates using sigmoidoscopy or colonoscopy test ranged from 56.8 to 85%. Bayesian spatial beta models were fitted to the proportion data. At an ecological level, we found that an increasing rate of CRC screening uptake for either of the test types (colon/rectum exam, stool-based test) was strongly associated with a higher health insurance coverage, and lower percentage of population that speak English less than very well (immigration) at county level. Eleven coldspot counties out of 67 total were also identified. This study suggests that health insurance disparities in the use of CRC screening tests are an important factor that may need more attention for resource allocation and health policy targeting small areas with low uptake of screening.

Breast, cervical, and colorectal cancer screening test use in the US territories of Guam, Puerto Rico, and the US Virgin Islands

BackgroundThe United States Preventive Services Task Force (USPSTF) recommends breast, cervical, and colorectal cancer screening among eligible adults, but information on screening use in the US territories is limited. MethodsTo estimate the proportion of adults up-to-date with breast, cervical, and colorectal cancer screening based on USPSTF recommendations, we analyzed Behavioral Risk Factor Surveillance System data from 2016, 2018, and 2020 for the 50 US states and DC (US) and US territories of Guam and Puerto Rico and from 2016 for the US Virgin Islands. Age-standardized weighted proportions for up-to-date cancer screening were examined overall and by select characteristics for each jurisdiction. ResultsOverall, 67.2% (95% CI: 60.6–73.3) of women aged 50–74 years in the US Virgin Islands, 74.8% (70.9–78.3) in Guam, 83.4% (81.7–84.9) in Puerto Rico, and 78.3% (77.9–78.6) in the US were up-to-date with breast cancer screening. For cervical cancer screening, 71.1% (67.6–74.3) of women aged 21–65 years in Guam, 81.3% (74.6–86.5) in the US Virgin Islands, 83.0% (81.7–84.3) in Puerto Rico, and 84.5% (84.3–84.8) in the US were up-to-date. For colorectal cancer screening, 45.2% (40.0–50.5) of adults aged 50–75 years in the US Virgin Islands, 47.3% (43.6–51.0) in Guam, 61.2% (59.5–62.8) in Puerto Rico, and 69.0% (68.7–69.3) in the US were up-to-date. Adults without health care coverage reported low test use for all three cancers in all jurisdictions. In most jurisdictions, test use was lower among adults with less than a high school degree and an annual household income of < $25,000. ConclusionCancer screening test use varied between the US territories, highlighting the importance of understanding and addressing territory-specific barriers. Test use was lower among groups without health care coverage and with lower income and education levels, suggesting the need for targeted evidence-based interventions.

Multilevel small area estimation for county-level prevalence of colorectal cancer screening test use in the United States using 2018 data

Purpose—National screening estimates mask county-level variations. We aimed to generate county-level colorectal cancer (CRC) screening prevalence estimates for 2018 among adults aged 50–75 years and identify counties with low screening prevalence. Methods—We combined individual-level county data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS) (n = 204,947) with the 2018 American Community Survey county poverty data as a covariate, and the 2018 U.S. Census county population count data to generate county-level prevalence estimates for being current with any CRC screening test, colonoscopy, and home stool blood test. Because BRFSS is a state-based survey, and because some counties did not have samples for analysis, we used correlation coefficients to test internal consistency between model-based and BRFSS state estimates. Results—Correlation coefficients tests were ≥0.97. Model-based national prevalence for any test was 69.9% (95% CI, 69.5% –70.4%) suggesting 30% are not current with screening test use. State mean estimates ranged from 62.1% in Alaska and Wyoming to 76.6% in Maine and Massachusetts. County mean estimates ranged from 42.2% in Alaska to 80.0% in Florida and Rhode Island. Most tests were performed with colonoscopy. Conclusions—Estimates across all U.S. counties showed large variations. Estimates may be informative for planning by states and local screening programs.

Utilization of a Colorectal Cancer Screening Test Among Individuals With Average Risk

Colorectal cancer (CRC) screening reduces CRC incidence and mortality. It is important to examine screening patterns over time, including after the introduction of new screening modalities. To compare use of CRC screening tests before and after the availability of the multitarget stool DNA (mt-sDNA) test, given that endorsed options have changed. This longitudinal cohort study used administrative claims data to examine CRC screening use in 2 discrete periods: before (August 1, 2011, to July 31, 2014) and after (August 1, 2016, to July 31, 2019) the mt-sDNA test became available. The MarketScan Commercial and Medicare Supplemental databases were queried for individuals aged 45 to 75 years between August 1, 2011, and July 31, 2019, with average risk of CRC and with continuous enrollment in the databases from August 1, 2001, to July 31, 2019. The proportion of individuals up to date or not due for CRC screening during each measurement year and the type of screening test used among individuals due for screening. Data were reported overall and among individuals aged 45 to 49 or 50 years and older on August 1, 2011. A total of 97 776 individuals with average risk were identified. Individuals had a mean (SD) age of 50.8 (3.5) years, and 54 227 (55.5%) were women. The proportion of individuals with average risk aged 50 to 75 years with commercial or Medicare supplemental insurance who were up to date with CRC screening increased from 50.4% in 2011 (30 605 of 60 770) to 69.7% in 2019 (42 367 of 60 770). Among individuals due for screening and screened, the use of high-sensitivity fecal occult blood test (FOBT) decreased between 2011 (1088 of 6241 eligible individuals [17.7%]) and 2019 (195 of 2943 eligible individuals [6.6%]), and the use of mt-sDNA increased between 2016 (58 of 3014 eligible individuals [1.9%]) and 2019 (418 of 2943 eligible individuals [14.2%]). No consistent trends were observed with fecal immunochemical test (FIT) or screening colonoscopy. Computed tomography colonography, double-contrast barium enema, and flexible sigmoidoscopy were rarely performed. In this cohort study, the proportion of individuals with average risk who were up to date with CRC screening increased between 2011 and 2019 but remained suboptimal. There were no substantial changes in the use of the colonoscopy or FIT; however, there was an increase in the adoption of mt-sDNA and a decrease in the use of FOBT during the study period.

Screening for Colorectal Cancer in the United States: Correlates and Time Trends by Type of Test.

It is strongly recommended that adults aged 50-75 years be screened for colorectal cancer. Recommended screening options include colonoscopy, sigmoidoscopy, CT colonography, guaiac fecal occult blood testing (FOBT), fecal immunochemical testing (FIT), or the more recently introduced FIT-DNA (FIT in combination with a stool DNA test). Colorectal cancer screening programs can benefit from knowledge of patterns of use by test type and within population subgroups. Using 2018 National Health Interview Survey (NHIS) data, we examined colorectal cancer screening test use for adults aged 50-75 years (N = 10,595). We also examined time trends in colorectal cancer screening test use from 2010-2018. In 2018, an estimated 66.9% of U.S. adults aged 50-75 years had a colorectal cancer screening test within recommended time intervals. However, the prevalence was less than 50% among those aged 50-54 years, those without a usual source of health care, those with no doctor visits in the past year, and those who were uninsured. The test types most commonly used within recommended time intervals were colonoscopy within 10 years (61.1%), FOBT or FIT in the past year (8.8%), and FIT-DNA within 3 years (2.7%). After age-standardization to the 2010 census population, the percentage up-to-date with CRC screening increased from 61.2% in 2015 to 65.3% in 2018, driven by increased use of stool testing, including FIT-DNA. These results show some progress, driven by a modest increase in stool testing. However, colorectal cancer testing remains low in many population subgroups. These results can inform efforts to achieve population colorectal cancer screening goals.

Vital Signs: Colorectal Cancer Screening Test Use - United States, 2018.

BackgroundColorectal cancer (CRC) is the second leading cause of cancer death in the United States of cancers that affect both men and women. Despite strong evidence that screening for CRC reduces incidence and mortality, CRC screening prevalence is below the national target. This report describes current CRC screening prevalence by age, various demographic factors, and state.MethodsData from the 2018 Behavioral Risk Factor Surveillance System survey were analyzed to estimate the percentages of adults aged 50–75 years who reported CRC screening consistent with the United States Preventive Services Task Force recommendation.ResultsIn 2018, 68.8% of adults were up to date with CRC screening. The percentage up to date was 79.2% among respondents aged 65–75 years and 63.3% among those aged 50–64 years. CRC screening prevalence was lowest among persons aged 50–54 years (50.0%) and increased with age. Among respondents aged 50–64 years, CRC screening prevalence was lowest among persons without health insurance (32.6%) and highest among those with reported annual household income of ≥$75,000 (70.8%). Among respondents aged 65–75 years, CRC screening prevalence was lowest among those without a regular health care provider (45.6%), and highest among those with reported annual household income ≥$75,000 (87.1%). Among states, CRC screening prevalence was highest in Massachusetts (76.5%) and lowest in Wyoming (57.8%).DiscussionCRC screening prevalence is lower among adults aged 50–64 years, although most reported having a health care provider and health insurance. Concerted efforts are needed to inform persons aged <50 years about the benefit of screening so that screening can start at age 50 years.

AWARENESS OF MEDICAL STUDENTS IN SULAIMANI UNIVERSITY ABOUT COLORECTAL CANCER SCREENING

Background &#x0D; Colorectal cancer (CRC) is one of most common cancers. Deaths from colorectal cancer have decreased with the use of CRC screening tests. Screening can find colorectal cancer early, when there is a greater chance that treatment will be most effective and lead to a cure.&#x0D; Objective&#x0D; To identify and compare knowledge and attitude among medical students of colleges of medicine, dentistry and pharmacy /Sulaimani University regarding CRC screening.&#x0D; Materials and Methods &#x0D; A cross sectional study was conducted from (20th–21st November), 2016 included 310 medical students regarding their knowledge and attitude about CRC and its screening. Questionnaires were distributed among them then data were collected and analyzed by SSPS 20th version. Chi square was used to get the association, P-value ≤ 0.05 was considered statistically significant.&#x0D; Results&#x0D; 310 students included in this study, only 44.8% of them considered CRC to be a high-risk condition for public health. However, the majority of participants identified CRC-related symptoms (&gt; 60%), and acknowledged its screening to be of great value in reducing CRC incidence and mortality (45.8%). Nearly 47 % had received information regarding CRC screening and 67.7% believed that there is alack or shortage of trained professionals conducting screening, with a significant association regarding P value (0.017). Students of college of medicine had the highest frequency of correct answers and positive attitudes among the 3 colleges.&#x0D; Conclusion&#x0D; Although most medical students had positive attitudes regarding cancer screening, this study showed important deficits in knowledge. Medical students in Sulaimani University need to be better informed about CRC and its screening.

Trends in Colorectal Cancer Screening of African Americans Aged 45-49

Introduction: Colorectal cancer (CRC) is the second leading cause of cancer death in the United States. African Americans have a higher incidence of and mortality from CRC compared to other ethnic groups. Screening tests have proven efficacy to reduce CRC incidence and mortality. The American College of Gastroenterology in 2008 and American Society for Gastrointestinal Endoscopy in 2014 recommended screening of African Americans beginning at age 45 years. This study assessed the rate of CRC screening test use in African Americans between the ages of 45-49 years from 2005 to 2015. Methods: Individuals between the ages of 45-49 years were identified in Cancer Control Supplement of National Health Interview Survey (NHIS) conducted in 2005, 2010 and 2015. The NHIS is a national in-person household survey conducted by the US Census Bureau on the civilian population. Respondent history of colonoscopy, stool testing, sigmoidoscopy, CT colonography and demographic information was analyzed using SAS version 9.4 (SAS Institute Inc, Cary, NC, USA). A P value <0.05 was considered significant. Results: A total of 7434 individuals were identified age 45-49 years with 1115 African Americans in this cohort. Only 210 African American respondents had at least one screening test for CRC (18.8%). Screening test use in 2015 was lower among African Americans (20.2%) than Whites (21.4%) (see Table 1). African Americans receiving screening tests were more likely to be above the poverty threshold (79.3% vs 70.9%; P<0.01), college educated (48.0% vs 21%; P<0.01), and insured (88.8% vs 80.2%; P<0.01). No gender differences were observed in African American screening test use.Table: Table. Rate of CRC Screening Test Use by Race and YearConclusion: Screening test use in African Americans is similar to Whites in the 45-49 age cohort suggesting limited implementation of early screening guidelines. Race and socioeconomic barriers to healthcare contribute to disparities in CRC screening test use. Poor adherence to CRC screening in African Americans in the setting of persistent differences in national recommendations emphasizes the need for ongoing public health advocacy, communication to primary care providers/patients and additional prospective research.

Cancer Screening Test Use - United States, 2015.

Healthy People 2020 (HP2020) includes objectives to increase screening for breast, cervical, and colorectal cancer (1) as recommended by the U.S. Preventive Services Task Force (USPSTF).* Progress toward meeting these objectives is monitored by measuring cancer screening test use against national targets using data from the National Health Interview Survey (NHIS) (1). Analysis of 2015 NHIS data indicated that screening test use remains substantially below HP2020 targets for selected cancer screening tests. Although colorectal cancer screening test use increased from 2000 to 2015, no improvements in test use were observed for breast and cervical cancer screening. Disparities exist in screening test use by race/ethnicity, socioeconomic status, and health care access indicators. Increased measures to implement evidence-based interventions and conduct targeted outreach are needed if the HP2020 targets for cancer screening are to be achieved and the disparities in screening test use are to be reduced.

Colorectal cancer screening: Estimated future colonoscopy need and current volume and capacity

In 2014, a national campaign was launched to increase colorectal cancer (CRC) screening rates in the United States to 80% by 2018; it is unknown whether there is sufficient colonoscopy capacity to reach this goal. This study estimated the number of colonoscopies needed to screen 80% of the eligible population with fecal immunochemical testing (FIT) or colonoscopy and determined whether there was sufficient colonoscopy capacity to meet the need. The Microsimulation Screening Analysis-Colon model was used to simulate CRC screening test use in the United States (2014-2040); the implementation of a national screening program in 2014 with FIT or colonoscopy with 80% participation was assumed. The 2012 Survey of Endoscopic Capacity (SECAP) estimated the number of colonoscopies that were performed and the number that could be performed. If a national screening program started in 2014, by 2024, approximately 47 million FIT procedures and 5.1 million colonoscopies would be needed annually to screen the eligible population with a program using FIT as the primary screening test; approximately 11 to 13 million colonoscopies would be needed annually to screen the eligible population with a colonoscopy-only screening program. According to the SECAP survey, an estimated 15 million colonoscopies were performed in 2012, and an additional 10.5 million colonoscopies could be performed. The estimated colonoscopy capacity is sufficient to screen 80% of the eligible US population with FIT, colonoscopy, or a mix of tests. Future analyses should take into account the geographic distribution of colonoscopy capacity. Cancer 2016;122:2479-86. © 2016 American Cancer Society.

Use of Evidence-Based Interventions to Address Disparities in Colorectal Cancer Screening.

Colorectal cancer (CRC) is the second leading cause of cancer death among cancers that affect both men and women. Despite strong evidence of their effectiveness, CRC screening tests are underused. Racial/ethnic minority groups, persons without insurance, those with lower educational attainment, and those with lower household income levels have lower rates of CRC screening. Since 2009, CDC's Colorectal Cancer Control Program (CRCCP) has supported state health departments and tribal organizations in implementing evidence-based interventions (EBIs) to increase use of CRC screening tests among their populations. This report highlights the successful implementation of EBIs to address disparities by two CRCCP grantees: the Alaska Native Tribal Health Consortium (ANTHC) and Washington State's Breast, Cervical, and Colon Health Program (BCCHP). ANTHC partnered with regional tribal health organizations in the Alaska Tribal Health System to implement provider and client reminders and use patient navigators to increase CRC screening rates among Alaska Native populations. BCCHP identified patient care coordinators in each clinic who coordinated staff training on CRC screening and integrated client and provider reminder systems. In both the Alaska and Washington programs, instituting provider reminder systems, client reminder systems, or both was facilitated by use of electronic health record systems. Using multicomponent interventions in a single clinical site or facility can support more organized screening programs and potentially result in greater increases in screening rates than relying on a single strategy. Organized screening systems have an explicit policy for screening, a defined target population, a team responsible for implementation of the screening program, and a quality assurance structure. Although CRC screening rates in the United States have increased steadily over the past decade, this increase has not been seen equally across all populations. Increasing the use of EBIs, such as those described in this report, in health care clinics and systems that serve populations with lower CRC screening rates could substantially increase CRC screening rates.

Colorectal cancer screening in first-degree relatives of colorectal cancer

Family history is one of the most important risk factors for developing colorectal cancer (CRC), and medical organizations recommend CRC screening in this population. However, the use of CRC screening is still low in our country. To investigate the use of CRC screening, knowledge about CRC and screening tests, and factors related to screening in a family-risk population. A total of 334 family-risk participants answered a questionnaire to assess the use of CRC screening tests, knowledge about CRC, risk perception, and barriers against screening. In total, 22% of participants had undergone at least one of the recommended tests for CRC screening. Furthermore, indication for screening was found in only 8% of participants. Use of CRC screening tests was significantly lower than mammography for breast cancer detection in women (20 vs. 82%, P<0.001) and use of serum prostate-specific antigen for prostate cancer detection in men (27 vs. 46%, P<0.001). Most participants (59%) knew that being elderly was a risk factor and only about half (47%) had knowledge about any of the recommended examinations. Only in about half of the cases (47%) was subjective risk perception higher than in the general population. In the logistic regression analysis, having more than one affected relative (odds ratio= 2.63, 95% confidence interval: 1.05-6.68; P=0.03) and a high subjective perception of risk (odds ratio= 2.87, 95% confidence interval: 1.10-7.46; P=0.03) were independent predictors for CRC screening. Less than 25% of the family-risk population has undergone a CRC screening test. Family history and subjective risk perception of CRC are the strongest predictors of CRC screening.

Primary care utilization and colorectal cancer outcomes among Medicare beneficiaries.

Primary medical care may improve colorectal cancer (CRC) outcomes through increased use of CRC screening tests and earlier diagnosis. We examined the association between primary care utilization and CRC screening, stage at diagnosis, CRC mortality, and all-cause mortality. We conducted a retrospective cohort study of patients, aged 67 to 85 years, diagnosed as having CRC between 1994 and 2005 in the Surveillance, Epidemiology, and End Results-Medicare-linked database. Association of the number of visits to primary care physicians (PCPs) in the 3- to 27-month period before the CRC diagnosis and CRC screening, early-stage diagnosis, CRC mortality, and all-cause mortality were examined using multivariable logistic regression and Cox proportional hazards models. The odds of CRC screening and early-stage diagnosis increased with increasing number of PCP visits (P<.001 for trend). Compared with persons having 0 or 1 PCP visit, patients with 5 to 10 visits had increased odds of ever receiving CRC screening at least 3 months before diagnosis (adjusted odds ratio, 2.60; 95% CI, 2.48-2.72) and early-stage diagnosis (1.35; 1.29-1.42). Persons with 5 to 10 visits had 16% lower CRC mortality (adjusted hazard ratio [AHR], 0.84; 95% CI, 0.80-0.88) and 6% lower all-cause mortality (0.94; 0.91-0.97) compared with persons with 0 or 1 visit. Medicare beneficiaries with CRC have better outcomes if they have greater utilization of primary care before diagnosis. Revitalization of primary care in the United States may help strengthen the national efforts to reduce the burden of CRC.

Colonoscopy and fecal occult blood test use in Germany: results from a large insurance-based cohort

Colonoscopy and guaiac-based fecal occult blood tests (FOBT) are recommended and offered for colorectal cancer (CRC) screening in Germany. We aimed to explore their utilization in a large insurance-based cohort. Claims data from between 2000 and 2008 were collected for 170493 individuals who were insured by a large health insurance plan in the federal state of Hesse, Germany. The percentages of individuals who had recently utilized CRC screening-related procedures were calculated. Additionally, multiple test use and identification of CRC screening providers were ascertained. Following the inception of the current CRC screening program in 2002, colonoscopy utilization rates varied only slightly and FOBT use decreased in individuals aged ≥50 years. At the end of 2008, the age-standardized percentages of individuals who had undergone colonoscopy within ≤10 years were 23% for men and 26% for women. The proportions of individuals who had used FOBT within ≤1 year were 14% for men and 22% for women. Patient education had been utilized by 38% of eligible persons and was increasingly followed by screening colonoscopy. For women, practices that specialized in gynecology were the main providers of FOBT (93%) and patient education (61%). This study provides new insights into the inter-related utilization of colonoscopy, FOBT, and patient education in Germany, and may be particularly informative for the design of strategies to increase CRC screening uptake. It indicates that sex differences in CRC screening test use could result to a large extent from general visits to different types of specialist physicians involved in the CRC screening process.

S1010 Validation of Utilizing an Administrative Database for Determination of Colorectal Cancer Screening Test use in a Safety-Net Health System

S1010 Validation of Utilizing an Administrative Database for Determination of Colorectal Cancer Screening Test use in a Safety-Net Health System

Increased Use of Colorectal Cancer Tests

Increased Use of Colorectal Cancer Tests