Skip directly to searchSkip directly to the site navigationSkip directly to the page's main content
Skip directly to searchSkip directly to the site navigationSkip directly to this page's context menuSkip directly to the page's main content
State of Alaska

Health Indicator Report of Cancer Screening - Colorectal - Adults (Ages 50-75)

Even though the exact cause of most colorectal cancers is not known, it is possible to prevent many cases. Prevention and early detection are possible through screening because most colorectal cancers develop from polyps (precancerous tissue growths). Early detection screening tests for colorectal cancer can help find polyps, which can be easily removed, thereby lowering a person's cancer risk. Colorectal cancers are more successfully treated when detected early. Screening tests can detect colon polyps before they become cancerous, as well as early stage colorectal cancers. Beginning at age 50, people of average risk with no symptoms should get colorectal cancer screening. The various screening tests have different recommended yearly intervals.^1^[[br]] [[br]] ---- {{class .SmallerFont 1. American Cancer Society, Colorectal Cancer. [http://www.cancer.org/acs/groups/content/@nho/documents/document/colorectalcancer.pdf]. Published January 2016. Accessed September 7, 2016. }}

Data Sources

  • Alaska Data: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System], Alaska Department of Health and Social Services, DPH, Section of Chronic Disease Prevention and Health Promotion
  • U.S. Data: National Center for Chronic Disease Prevention and Health Promotion, Behavioral Risk Factor Surveillance System (BRFSS)

Data Interpretation Issues

The suite of colorectal cancer screening measures have been asked in even-numbered years since 2008.

Definition

Percentage of adults aged 50-75 years who reported having a fecal occult blood test (FOBT) within 1 year, or a sigmoidoscopy within the 5 years and with a FOBT within 3 years, or a colonoscopy within the past 10 years. This is assessed on the [http://www.cdc.gov/brfss/ Behavioral Risk Factor Surveillance System (BRFSS)] by 5 questions according to three criteria. First, "Yes" to the question: "A blood stool test is a test that may use a special kit at home to determine whether the stool contains blood. Have you ever had this test using a home kit?" with a response of "Within the past year (anytime less than 12 months ago)" to "How long has it been since you had your last blood stool test using a home kit?" Second, a response of "Within the past 3 years (2 years but less than 3 years ago)" to the FOBT questions in conjunctions with a response of "Yes" to the question: "Sigmoidoscopy and colonoscopy are exams in which a tube is inserted in the rectum to view the colon for signs of cancer or other health problems. Have you ever had either of these exams?" and a response of "Sigmoidoscopy" to the question "For a SIGMOIDOSCOPY, a flexible tube is inserted into the rectum to look for problems. A COLONOSCOPY is similar, but uses a longer tube, and you are usually given medication through a needle in your arm to make you sleepy and told to have someone else drive you home after the test. Was your MOST RECENT exam a sigmoidoscopy or a colonoscopy?" along with a response of within the past 5 years or less to the question on "How long has it been since you had your last sigmoidoscopy or colonoscopy?" Or lastly, having a colonoscopy within the past 10 years.

Numerator

Weighted number of adults aged 50-75 years who responded affirmatively on the BRFSS to one of three criteria: 1) A blood stool test within the past year; 2) a blood stool testing within the past 3 years and a sigmoidoscopy within the past 5 years; or 3) having a colonoscopy within the past 10 years.

Denominator

Weighted number of adults aged 50-75 years with complete and valid responses on the BRFSS to the colorectal cancer screening questions, excluding those who answered "Don't know / Not sure" or "Refused".

Healthy People Objective: Increase the proportion of adults who receive a colorectal cancer screening based on the most recent guidelines

U.S. Target: 70.5 percent

How Are We Doing?

In 2016, 65.9% of Alaska adults aged 50-75 years met the colorectal cancer screening guidelines. The rate was 61.4% among Alaska Native adults aged 50-75 years. The screening rate for Alaska Native adults in 2016 was significant higher than the rate of 47.2% in 2008. Screening rates were significantly higher among those aged 65-75 years, greater than a high school education, or at the middle/high poverty level. The lowest screening rates were recorded in the Y-K Delta region, with 43.3% for all Alaskans and 39.5% among Alaska Native people aged 50-75 years. Colorectal cancer screening results for those aged 50-75 from the BRFSS are initially presented for all Alaskans and Alaska Native people for all available years. Subsequent analyses by demographic subpopulations (i.e., sex, age, race/ethnicity, ethnicity, marital status, education, employment status, income, and poverty status) are limited to 2008 and later when all three criteria are available. Crosstabulations were also conducted for three-year averages by body mass index, current smoking, sexual orientation, disability, and number of Adverse Childhood Experiences. Only the table showing significant differences by current smoking status is displayed. Results of the other comparisons are available upon request. Colorectal cancer screening rates for those aged 50-75 by regions of Alaska are presented for all Alaskans and Alaska Native people for the 4-year average of surveys conducted between 2008-2014: 1) 7 Alaska Public Health Regions, 2) 5 Metropolitan and Micropolitan Statistics Areas and rural remainder, 3) 10 behavioral health assessment regions based upon aggregations of 20,000 population, 4) 29 boroughs and census areas, and 5) 12 tribal health organization regions.

What Is Being Done?

In collaboration with partners statewide, the Alaska Comprehensive Cancer Control Partnership supports an active committee on colorectal cancer. This group, the Alaska Colorectal Cancer Partnership, includes partners in the tribal health system, private hospitals and providers, non-profit organizations, community health organizations and cancer survivorship and advocacy groups. Activities include: addressing access to colorectal cancer screening; support of patient navigators in tribal, private and public health systems; training in family history to assist those with inherited risk; and increasing colorectal cancer screening rates through public education (small media). Additional information on current efforts to address prevention and control of colorectal cancer in Alaska are available at [http://dhss.alaska.gov/dph/Chronic/Pages/Cancer/comprehensive.aspx] and [http://www.alaskacolonhealth.org/]. Within the Alaska Native community, innovative efforts have been used to reduce disparities in colorectal cancer, which is the second leading cause of cancer death among Alaska Native people.^2^ Three pilot programs were instrumental in increase colorectal cancer screening among Alaska Native rural populations: 1) training rural mid-level health providers in flexible sigmoidoscopy and provision of itinerant endoscopy services at rural tribal health facilities, 2) creation of a first-degree relative database for colorectal cancer to identify and screen individuals at highest risk, and 3) supporting and implementing screening navigation services.[[br]] [[br]] ---- {{class .SmallerFont 2. Redwood D, Provost E, Perdue E, et al. The last frontier: innovative efforts to reduce colorectal cancer disparities among the remote Alaska Native population. Gastrointest Endosc. 2012 Mar;75(3):474-80. doi: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4523058/ 10.1016/j.gie.2011.12.031]. }}

Evidence-based Practices

WHAT WORKS Cancer Prevention and Control: Cancer Screening.^3^ Reducing out of pocket costs is one of the ways to increase colorectal cancer screening along with group education and client reminders. "How to Increase Colorectal Cancer Screening Rates in Practice: A Primary Care Clinician's Evidence-Based Toolbox and Guide 2008"^4^ listed 4 essentials for increasing colorectal cancer screening rates: [[br]]1. Every practice should have an office policy on CRC screening. [[br]]2. An office policy to assess individual risk, identify local health resources, access insurance coverage, and consider patient preference needs to be implemented.[[br]]3. An office reminder system with patient education and cues for action in association with prompts for physicians.[[br]]4. An effective communication system of stage-based communication, informed decisions with aids, and staff involvement. Clinical Advisor. Cancer screening rates are short of the goal.^5^ There are declining screening rates for all three screenable cancers. Women with a higher education and income exceed the Healthy People 2020 goals and adults without insurance have the lowest screening rates. The National Colorectal Cancer Roundtable also provides tools and resources to facilitate colorectal cancer screen.^6^ A summary of evidence-based interventions and screening recommendations for Comprehensive Cancer Control Programs was produced in 2009.^7^[[br]] [[br]] ---- {{class .SmallerFont 3. WHAT WORKS Cancer Prevention and Control: Cancer Screening. The Community Guide. [https://www.thecommunityguide.org/about/What-Works-Cancer-Screening-insert.pdf]. Published August 2012. Accessed September 7, 2016. 4. Sarfaty M. How to Increase Colorectal Cancer Screening Rates in Practice: A Primary Care Clinician's Evidence-Based Toolbox and Guide 2008. [http://www.cancer.org/acs/groups/content/documents/document/acspc-024588.pdf]. Accessed August 22, 2016. 5. Clinical Advisor. Cancer screening rates are short of the goal. [http://www.clinicaladvisor.com/newsline/colorectal-breast-cervical-cancer-screening-rates-drop/article/418000/]. Accessed September 7, 2016. 6. CRC Clinician's Guide | National Colorectal Cancer Roundtable. [http://nccrt.org/about/provider-education/crc-clinician-guide/]. Accessed August 22, 2016. 7. Townsend JS, Richardson LC, Steele CB, White DE. Evidence-based interventions and screening recommendations for colorectal cancer in comprehensive cancer control plans: a content analysis. Prev Chronic Dis 2009;6(4):A127. [http://www.cdc.gov/pcd/issues/2009/ oct/08_0223.htm]. Accessed August 22, 2016. }}
Page Content Updated On 03/01/2018, Published on 03/01/2018
The information provided above is from the Alaska Department of Health and Social Services' Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health (Ak-IBIS) web site (http://ibis.dhss.alaska.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Fri, 25 May 2018 from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health web site: http://ibis.dhss.alaska.gov ".

Content updated: Thu, 1 Mar 2018 13:26:48 AKST
The information provided above is from the Alaska Department of Health and Social Services' Center for Health Data and Statistics AK-IBIS web site (http://ibis.dhss.alaska.gov/). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Fri, 25 May 2018 20:11:10 from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Indicator-Based Information System for Public Health Web site: http://ibis.dhss.alaska.gov/ ".

Content updated: Thu, 1 Mar 2018 13:26:48 AKST