Abstract
Appropriate screening for colorectal cancer saves lives, yet many Americans at average risk for this disease are not being screened. This article presents the results of an inexpensive, manageable telephone survey that can be used by health departments to determine point prevalence estimates for colorectal cancer screening in their community and to determine local barriers to screening. In Onondaga County, this survey demonstrated that only 17% of the eligible population had been screened with annual fecal occult blood test and a fl exible sigmoidoscopy. The study also demonstrated that locally the most significant barrier to screening was lack of knowledge of the importance of such testing. Finally, health care professionals were shown to play a pivotal role in improving the health of their patient population by encouraging screening for colorectal cancer.
Death caused by colorectal cancer is largely preventable, yet colorectal cancer is the second leading cause of cancer-related death in the United States.1 Despite the fact that several different screening tests for colorectal cancer are available, screening rates are low in the United States. According to the 1999 Behavioral Risk Factor Surveillance System (BRFSS), only 44% of adults aged 50 years of age or older were screened within the recommended time interval for a given screening test.2 These figures compare poorly with screening for breast cancer with mammography or for cervical cancer with Papanicolaou smears.3 In March 2002, Health and Human Services Secretary Tommy G. Thompson issued a statement encouraging Americans aged 50 years or older to get screened for colorectal cancer.4 In July 2002, the United States Preventive Services Task Force released updated recommendations for colorectal cancer screening that clearly demonstrate that appropriate screening for colorectal cancer reduces death from the disease.5
Local health departments interested in improving colorectal cancer screening rates in their residents will benefit from first determining baseline screening rates. In addition, information on local barriers to screening can be useful in the development of effective community intervention strategies to improve these rates. This article will address how the Onondaga County Health Department developed and conducted an affordable telephone survey to establish baseline colorectal screening utilization patterns and to determine barriers to screening. It will also describe how a set of recommendations was developed by local health care providers to encourage a unified educational approach to increase local screening rates.