Important Facts for Self-Reported Colorectal Cancer Screening
DefinitionEstimated 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.
NumeratorNumber of New Jersey adults aged 50-75 years who reported that they are current with colorectal cancer screening recommendations.
DenominatorThe total number of survey respondents aged 50-75 excluding those who answered "don't know" or "refused" to the numerator question.
Data Interpretation IssuesThe 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 guidelinesU.S. Target: 70.5 percent
State Target: 70.2 percent