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Complete Health Indicator Report of Colorectal Cancer Screening

Definition

Estimated percentage of New Jersey adults ages 50-75 years who are current with colorectal cancer screening recommendations. An individual is considered current if they have had a take-home fecal immunochemical test (FIT) or high-sensitivity fecal occult blood test (FOBT) within the past year, and/or a flexible sigmoidoscopy within the past 5 years with a take-home FIT/FOBT within the past 3 years, and/or a colonoscopy within the past ten years.

Numerator

Number of New Jersey adults aged 50-75 years who reported that they are current with colorectal cancer screening recommendations.

Denominator

The total number of survey respondents aged 50-75 excluding those who answered "don't know" or "refused" to the numerator question.

Data Interpretation Issues

The question asked on the BRFSS about colorectal cancer screening has changed over time. In 1993 and 1995, survey respondents were asked whether they had ever had a proctoscopic exam and the length of time since the last exam. In 1997, respondents were asked whether they had ever had a sigmoidoscopy or proctoscopy and the length of time since the last exam. In 1999-2000 respondents were asked whether they had ever had a sigmoidoscopy or colonoscopy and the length of time since the last exam. From 2001 to present, data has been based on sigmoidoscopy or colonoscopy or fecal occult blood testing and the length of time since the last exam. Data from the New Jersey Risk Factor Survey are intended to represent non-institutionalized adults in households with telephones. Data are collected using a random sample of all possible telephone numbers. Prior to analysis, data are weighted to represent the population distribution of adults by age, sex, and "race"/ethnicity. As with all surveys, however, some residual bias may result from nonresponse (e.g., refusal to participate in the survey or to answer specific questions) and measurement error (e.g., social desirability or recall). Starting in 2011, BRFSS protocol requires that the NJBRFS incorporate a fixed quota of interviews from cell phone respondents along with a new weighting methodology called iterative proportional fitting or "raking". The new weighting methodology incorporates additional demographic information (such as education, race, and marital status) in the weighting process. These methodological changes were implemented to account for the underrepresentation of certain demographic groups in the land line sample (which resulted in part from the increasing number of U.S. households without land line phones). Comparisons between 2011 and prior years should therefore be made with caution. (More details about these changes can be found at [http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6122a3.htm].)

Why Is This Important?

The fecal occult blood test and sigmoidoscopy are important tools in the detection of various health conditions, especially cancer of the colon and rectum. Colorectal cancer is unfortunately relatively common, does not have symptoms in its early stages, and has a risk that increases with age. Regular colorectal cancer screening is one of the most effective means by which colorectal cancer can be prevented or found early, when treatment is easier. Such screening helps people stay healthy and protects lives. The majority of diagnoses of this type of cancer occur in people who are over the age of 50. As a result, most people are advised to begin receiving these screening tests at age 50. Screening for hidden blood in the stool, using the fecal occult blood test, results in the detection of colorectal cancer at relatively high rates. Additionally, widespread use of this non-invasive, annual test has been shown to decrease both incidence and mortality in randomized controlled trials. By contrast, sigmoidoscopy is a minimally invasive test which uses a tiny video camera to examine the structure of the rectum and the lower part of the colon to find any abnormal areas. A sigmoidoscopy is usually performed only once every 5 years, depending on one's personal risk for colorectal cancer, but is also proven to decrease colorectal cancer incidence and mortality. Although this is a more involved procedure, sigmoidoscopy does have an enhanced ability, when compared to the fecal occult blood test, to find both cancer and colorectal polyps. Polyps are small growths which can over time become cancer, if left in place. Any polyps that are discovered can immediately be extracted through the medical device used for a sigmoidoscopy to prevent possible progression to cancer or to better assess whether or not any cancer is currently present.

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
State Target: 70.2 percent

Other Objectives

'''Healthy New Jersey 2020 Objective CA-15''': Increase the proportion of adults aged 50 to 75 years who receive a colorectal cancer screening based on the most recent guidelines to 70.2% for the total population, 72.1% among Whites, 71.5% among Blacks, 69.2% among Hispanics, and 62.6% among Asians.

How Are We Doing?

In 2017, approximately 67 percent of New Jersey adults aged 50-75 reported being current with colorectal cancer screening recommendations.

What Is Being Done?

A fecal occult blood test and sigmoidoscopy are recommended by the Comprehensive Cancer Control Plan 2008-2012. The Comprehensive Cancer Control Plan 2008-2012 has been developed by the Task Force on Cancer Prevention, Early Detection and Treatment in New Jersey which aims to reduce the incidence, illness, and death due to cancer among New Jersey residents.

Available Services

NJDOH has many programs and partnerships related to cancer resources, cancer information and cancer prevention. [http://nj.gov/health/cancer/]

Health Program Information

For cancer resources and initiatives: [http://www.nj.gov/health/ces/public/resources/occp.shtml]


Related Indicators

Health Care System Factors

Since June 2016, the USPSTF^1^ has recommended screening for colorectal cancer starting at age 50 years and continuing until age 75 years. Other health care system factors associated with colorectal cancer screening include '''health insurance status''' ([https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6608696/ Freund et al., 2019]), having a '''usual source of primary care''', and '''visiting a doctor in the past 12 months''' ([https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6093265/ Hall et al., 2018]). Note: [https://www-doh.state.nj.us/doh-shad/query/builder/njbrfs/ColScrPSTF/ColScrPSTFAA11_.html Custom data views] of the estimated prevalence of adherence to colorectal cancer screening guidelines among New Jersey adults by selected '''sociodemographic and other characteristics''' (including '''health insurance status''', '''having a usual source of primary care''', and '''visiting a doctor in the past 12 months''') can be generated using the New Jersey Behavioral Risk Factor Survey interactive query module. 1. United States Preventive Services Task Force. [https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/colorectal-cancer-screening2 Colorectal Cancer: Screening] [Last reviewed: 1/27/20]

Related Health Care System Factors Indicators:


Risk Factors

Factors that are negatively associated with self-report of colorectal cancer screening according to current guidelines include having less than a '''high school education''', having an '''annual income''' of less than 139% of poverty level, and being '''non-Hispanic Asian'''. ([https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6093265/ Hall et al., 2018]) Note: [https://www-doh.state.nj.us/doh-shad/query/builder/njbrfs/ColScrPSTF/ColScrPSTFAA11_.html Custom data views] of the estimated prevalence of adherence to colorectal cancer screening guidelines among New Jersey adults by selected '''sociodemographic and other characteristics''' (including '''education''', '''income''', and '''race/ethnicity''') can be generated using the New Jersey Behavioral Risk Factor Survey interactive query module.

Related Risk Factors Indicators:


Health Status Outcomes

According to the NCI, use of the guaiac-based fecal occult blood test as a screening intervention decreases '''colorectal cancer mortality''' by about 15% to 30%, use of sigmoidoscopy decreases '''colorectal cancer mortality''' by about 20% to 30% and '''colorectal cancer incidence''' by about 20% to 25%, and use of colonoscopy decreases both '''colorectal cancer mortality''' and '''colorectal cancer incidence''' (at least for cancers of the left colon) by about 60% to 70%. 1. National Cancer Institute. [https://www.cancer.gov/types/colorectal/hp/colorectal-screening-pdq Colorectal Cancer Screening - Health Professional Version] [last reviewed: 1/27/20]

Related Health Status Outcomes Indicators:



Data Tables


Percent of Adults Ages 50-75 who are Current with Colorectal Cancer Screening Recommendations by Year, New Jersey 2012-2017

YearEstimated Percent (Age-adjusted)Lower LimitUpper Limit
Record Count: 5
201262.961.264.6
201465.463.567.3
201565.963.768
201665.262.767.6
201767.565.369.6

Data Notes

All prevalence estimates are age-adjusted to the U.S. 2000 standard population.

Data Source

Behavioral Risk Factor Survey, Center for Health Statistics, New Jersey Department of Health, [http://www.state.nj.us/health/chs/njbrfs/]


Percent of Adults Ages 50-75 who are Current with Colorectal Cancer Screening Recommendations by Race/Ethnicity, New Jersey, 2012-2017

Race/EthnicityYearEstimated Percent (Age-adjusted)Lower LimitUpper Limit
Record Count: 20
White201264.3%62.4%66.1%
White201467.4%65.4%69.4%
White201567.4%65.1%69.7%
White201668.2%65.4%70.8%
White201769.1%66.8%71.3%
Black201264.3%59.3%69.0%
Black201464.9%59.0%70.3%
Black201566.9%59.8%73.3%
Black201666.2%59.2%72.6%
Black201768.9%62.8%74.4%
Hispanic201262.2%56.7%67.4%
Hispanic201460.8%54.8%66.5%
Hispanic201559.2%51.8%66.3%
Hispanic201657.3%48.8%65.3%
Hispanic201759.9%52.0%67.3%
Asian201248.9%38.3%59.6%
Asian201456.9%45.5%67.7%
Asian201556.9%42.7%70.1%
Asian201653.3%38.1%68.0%
Asian201765.3%51.9%76.6%

Data Notes

All prevalence estimates are age-adjusted to the U.S. 2000 standard population. Data for Whites, Blacks, and Asians do not include Hispanics. Hispanic ethnicity includes all races.

Data Source

Behavioral Risk Factor Survey, Center for Health Statistics, New Jersey Department of Health, [http://www.state.nj.us/health/chs/njbrfs/]


Percent of Adults Ages 50-75 who are Current with Colorectal Cancer Screening Recommendations by County, New Jersey, 2015-2017

CountyEstimated Percent (Age-adjusted)Lower LimitUpper Limit
Record Count: 22
Atlantic66.761.871.3
Bergen64.558.370.2
Burlington71.066.675.0
Camden68.463.573.0
Cape May64.559.269.6
Cumberland60.554.865.8
Essex67.663.671.5
Gloucester66.361.271.1
Hudson64.959.170.2
Hunterdon72.667.876.9
Mercer71.867.176.1
Middlesex60.855.366.2
Monmouth69.564.774.0
Morris68.563.173.4
Ocean67.462.471.9
Passaic62.256.767.4
Salem65.960.970.5
Somerset69.263.674.4
Sussex68.063.272.4
Union62.356.567.7
Warren58.353.563.0
New Jersey66.365.067.6

Data Notes

All prevalence estimates are age-adjusted to the U.S. 2000 standard population.

Data Source

Behavioral Risk Factor Survey, Center for Health Statistics, New Jersey Department of Health, [http://www.state.nj.us/health/chs/njbrfs/]

Page Content Updated On 08/13/2018, Published on 01/29/2020
The information provided above is from the Department of Health's NJSHAD web site (https://nj.gov/health/shad). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Sat, 11 July 2020 20:45:12 from Department of Health, New Jersey State Health Assessment Data Web site: https://nj.gov/health/shad ".

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