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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. }}

Notes

Ethnicity is defined independent of race. It is based upon responses to the question, "Are you Hispanic, Latino/a, or Spanish origin?" Responses of "Don't Know/Not Sure" or "Refused" are excluded.

Data Source

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

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 2018, 61.4% of Alaska adults aged 50-75 years met the colorectal cancer screening guidelines. The rate was 67.6% among Alaska Native adults aged 50-75 years. The screening rate for Alaska Native adults in 2016 was significant higher than the rate of 47.6% in 2008. Screening rates were lower among those aged 50-64 (54.8%) compared to those 65 to 75 (76.5%), and also lower among those eligible for Medicaid (49.9%) compared to those ineligible (65.0%). Screening rates increased along with increasing levels of income and education. 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 Medicaid eligibility) 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, and sexual orientation. 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) 11 behavioral health assessment regions based upon aggregations of 20,000 population, and 3) 12 tribal health organization regions.

What Is Being Done?

In collaboration with partners statewide, the Alaska Cancer Partnership supports activities such as: 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). 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^ [[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

The [https://www.thecommunityguide.org/ Guide to Community Preventive Services] is a resource to help choose programs and policies to improve health and prevent disease in communities. The Community Guide for Cancer Screening recommends client reminders, small media, group education, reducing structural barriers, and reducing client out-of-pocket costs to increase cancer screening.^3^ [[br]] [[br]] ---- {{class .SmallerFont 3. The Community Guide: Cancer.[https://www.thecommunityguide.org/topic/cancer]. Accessed September 23, 2019. }}
Page Content Updated On 09/26/2019, Published on 09/26/2019
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, 18 October 2019 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: Mon, 30 Sep 2019 08:30:48 AKDT
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, 18 October 2019 12:53:51 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: Mon, 30 Sep 2019 08:30:48 AKDT