Colon cancer rates drop in older Americans, but disparities remain

Article published March 17, 2014


By Sabriya Rice
“Dramatic” progress has been made in reducing colon cancer incidence and death rates in the U.S., but concerns remain about “striking” racial and socioeconomic disparities, according to new national statistics on colorectal cancer.

During the past decade, colon cancer incidence rates dropped by 30% in adults 50 and older, with the largest improvements seen in people older than age 65, the group most likely to die from the disease, found the report published Monday in CA: A Cancer Journal for Clinicians.

“We were very surprised to see that kind of drop in just one decade. That’s enormous,” said Rebecca Siegel, director of surveillance information for the American Cancer Society, and a co-author of the report.

Typically, declines in cancer rates average 1% to 2% annually, Siegel said, but in the case of colon cancer it was closer to 4%, which the report attributes to widespread increases in colonoscopy screening over the years.Between 2000 and 2010, the use of colorectal cancer screenings increased from 19% to 55% among adults ages 50 to 75, the analysis found. In 2010, 64% of people age 65 years and older reported having undergone a recent screening test. “Colorectal cancer is one of the few cancers that we can actually prevent with screening, so it’s a great opportunity,” Siegel said.

Despite the progress, researchers say there’s still more work to do.
“This is a really important and is a lifesaving test,” said Siegel, “but we still have more than a third of adults for whom screening is recommended (who are) not getting tested, and others who say they have never been screened.”

Screening rates remain low among the poor and uninsured, the report said, and there were substantial racial and ethnic differences in both incidence and death rates. For example, the death rate for blacks was 50% higher than that of whites, attributed to disproportionately higher poverty rates in the black community.

With more people gaining access to coverage as a result of the Patient Protection and Affordable Care Act, Siegel says she hopes some of the disparities will be addressed. But in general, she says, she is often shocked by how unaware the public remains on the role they can play in prevention.

“Colon cancer is one of the cancers we do know a lot about in terms of risk factors,” she said noting that any effort to encourage patients to achieve and maintain a healthy weight, increase physical activity, eat plant-based diets low in red and processed meats and quit smoking can help.

Colon cancer is currently the third leading cause of death for both men and women in the U.S. This year more than 136,000 individuals are projected to receive a colorectal cancer diagnosis, and more than 50,000 are projected to die from the disease.

The CA report used colon cancer incidence data drawn from the National Cancer Institute’s Surveillance, Epidemiology, and End Results program and the North American Association of Central Cancer Registries, and mortality data from the Centers for Disease Control and Prevention’s National Center for Health Statistics.

The CDC last November issued a report noting that comparative effectiveness data have shown at-home stool tests to be equivalent to colonoscopies at catching cancer early in patients who don’t have additional risk factors.

Follow Sabriya Rice on Twitter: @MHSRice