This past June 3^rd marked the 25^th observance of National Cancer Survivors Day. With various community events planned across the US, this day was used as a celebration of the lives of those living with, or who have lived with, cancer.  And there is even more reason to celebrate. A study published last year from the Centers for Disease Control and Prevention and the National Cancer Institute found the number of Americans who are cancer survivors  continues to be on the rise—in 1971, there were 3.0 million cancer survivors; in 2001, there were 9.8 million survivors; and in 2007, there were 11.7 million survivors [2].

According to the American Cancer Society, for cancers such as colorectal cancer, the number of people diagnosed with and who have died from this disease has been decreasing over the past 20 years [1]. Much of the decline in both the diagnosis of and death from colorectal cancer is due to improvements in early screening tests to detect cancerous polyps. In fact, one recent study confirmed what many people already suspected—that colonoscopies save lives [5].

In recognition of June 3^rd as National Cancer Survivors Day and the recent research findings that colonoscopies save lives, the following article presents information from PHMC’s 2010 Southeastern Pennsylvania Household Health Survey about colorectal cancer screenings among adults who are 55 years of age or older and residing in Bucks, Chester, Delaware, Montgomery, or Philadelphia County. More specifically, this article focuses attention on adults 55 years or older who have never received either a sigmoidoscopy or colonoscopy in their lifetime. The colonoscopy and sigmoidoscopy are two of the most commonly used diagnostic tests that can check for cancerous polyps. While it is recommended that colorectal cancer screenings should begin around the age of 50, this article examines adults 55 years of age or older because everyone should have received a colorectal cancer screening test by this age.

Demographic and Socio-economic Characteristics

• In Southeastern Pennsylvania, more than one in five adults 55 years of age or older (22.2%) has never had either a colonoscopy or sigmoidoscopy to detect for colorectal cancer, representing nearly 247,200 adults in our region.

• Women (24.2%) are more likely than men (19.9%) to have never had either a colonoscopy or sigmoidoscopy.

• Nearly one in three Latino adults (31.5%) has never had either screening test for colorectal cancer compared with Black (22.4%) and White (21.9%) adults.

• As educational attainment increases, the percentage of adults who have never had either a colonoscopy or sigmoidoscopy decreases—that is, 32.9% of adults with less than a high school education, 27.5% of adults with a high school education, 21.8% of adults with some college education, 18.2% of adults with a college education, and 11.8% of adults with a post-college education have never had either a colonoscopy or sigmoidoscopy (Figure 1).

• More than one in three adults living below 150% of the Federal Poverty Level (33.8%) have never had either a colonoscopy or sigmoidoscopy compared with one in five adults (19.8%) living at or above that poverty level.*

• Adults who live alone (25.5%) are slightly more likely than adults who live with at least one other person (21.3%) to have never had either screening test for colorectal cancer.

Physical Activity 

• Some evidence suggests that an inactive lifestyle may be associated with an increased risk of developing colorectal cancer [4].

• For example, in Southeastern Pennsylvania, adults who exercise less than three times per week are more likely to have never received a colonoscopy or sigmoidoscopy (24.3%) compared with 20.7% of adults that exercise more frequently.

Access to Care

• More than one in three adults with no regular source of healthcare (34.0%) have never received a colonoscopy or sigmoidoscopy compared with 21.4% of adults with a regular source of care (Figure 2).

• Almost half of all adults in Southeastern Pennsylvania with no health insurance (43.6%) have never had either a colonoscopy or sigmoidoscopy compared with 21.3% of adults with health insurance (Figure 2).

• There is also some evidence to suggest that adults who have never had other cancer screening tests are more likely to have also never had either a colonoscopy or sigmoidoscopy.

• For example, two in three women who have never had a mammogram screening for breast cancer also have never had a colorectal cancer screening (67.3%). In comparison, 22.0% of women who have ever had a mammogram have never had a colorectal cancer screening.

• In addition, nearly eight in ten men who have never had a prostate cancer screening also have never had a colorectal cancer screening (78.5%). In comparison, 14.7% of men who have ever had a prostate cancer screening have never had a colorectal cancer screening.

Conclusion

Colorectal cancer screening saves lives each year, yet, in Southeastern Pennsylvania, disparities have been found by gender, educational attainment, race/ethnicity, and poverty level. Additionally, adults are less likely to receive either screening test for colorectal cancer if they live alone; exercise less frequently; have no regular source of care; or have not been screened for other cancers.

Colorectal cancer can be detected early with routine screening. The CDC’s Colorectal Cancer Control Program (CRCCP) offers free or low-cost colorectal cancer screening tests for residents in 25 states, including Pennsylvania. To find out if you qualify, visit their website (click here).