Colorectal Cancer Screening Capacity in the United States
Of all cancers that both men and women can get, colorectal cancer (cancer of the lower colon or rectum) is the second leading cancer killer. Because screening for colorectal cancer has been shown to be effective in reducing the number of cancers found and the number of people who die from the disease, it is recommended that adults ages 50 to 75 be screened for colorectal cancer regularly using one or more of the recommended tests.
The percentage of the adult population that has been screened for colorectal cancer has increased over the last 10 years, largely because of an increase in colonoscopy procedures. During a colonoscopy, a patient goes under general anesthesia (goes to sleep) and a doctor uses a probe to search the colon and rectum for precancerous polyps (abnormal growths) and cancer. Despite the increase in colonoscopies, still only about 58% of adults in that age range are up-to-date on screening.
An initiative from the National Colorectal Cancer Roundtable, which is a group of public and private organizations, aims to raise the percentage of people screened for colorectal cancer to 80% of the 50 to 75 age group by 2018. This study used a mathematical model to estimate how many colonoscopies would be needed to screen 80% of the eligible population over a period of 10 years. It also predicted whether the United States has, in theory, enough equipment and facilities to screen 80% of those ages 50 to 75.
- A colonoscopy program would need to perform about 16 million colonoscopies in the first year and 12 to 13 million each year afterward to meet the goal of screening 80% of the eligible population over the 10-year period.
- A program with both colonoscopies and fecal immunochemical testing (FIT)—a take-home test—would require about 13 million colonoscopies in the first year, going down to about 5 million per year after 10 years.
- With the colonoscopy screening capacity in the United States now, 80% of the eligible population could potentially be screened by 2024.
About 15 million colonoscopies were done in the United States in 2012. In its current state, the U.S. health care system could perform enough colonoscopies to screen 80% of all adults between the ages of 50 and 75 for colorectal cancer by 2024. However, the model used in this study does not take into account barriers to screening, like being able to afford screening or having access to screening in one’s area.
Joseph DA, Meester RGS, Zauber AG, Manninen DL, Winges L, Dong FB, Peaker B, van Ballegooijen M. Colorectal cancer screening: Estimated future colonoscopy need and current volume and capacity. Cancer 2016;122(16):2479–2486. DOI: 10.1002/cncr.30070.