Medical Expenditure Panel Survey Agency for Healthcare 

Research and Quality

STATISTICAL BRIEF #188 

November 2007 

Screening Colonoscopy among U.S. 

Noninstitutionalized Adult Population 

Age 50 and Older, 2005 

Anita Soni, PhD 

Introduction 

Colorectal cancer is the second leading cause of cancer deaths in 

the United States. Colonoscopy is best known for its use as a 

screening tool for the early detection of colorectal cancer. It is one of 

many options available for screening colorectal cancer. The U.S. 

Preventive Services Task Force (USPSTF) strongly recommends 

that clinicians screen men and women 50 years of age or older for 

colorectal cancer.

 

This Statistical Brief estimates the screening colonoscopy among the 

U.S. civilian noninstitutionalized population age 50 and older. All 

estimates are derived from the Household Component of the Medical 

Expenditure Panel Survey (MEPS-HC) questionnaire. All differences 

discussed in the text are statistically significant at the 0.05 level or 

better. 

Findings 

In 2005, 44 million, or about half (50.1 percent), of the U.S. civilian 

noninstitutionalized population age 50 and older reported that they 

have never had a screening colonoscopy (figure 1). 

Age 

Age was found to be strongly related to getting a screening 

colonoscopy. A higher percentage of those in the younger age group 

(50–64) reported that they never had the screening colonoscopy, 

compared with those ages 65 and older (57.5 percent versus 39.4 percent). 

Highlights 

 Half of the U.S. civilian 

noninstitutionalized

population age 50 and 

older reported that they 

have never had a 

screening colonoscopy. 

 Two-thirds of Hispanic 

adults age 50 and older 

reported that they have 

never had a screening

colonoscopy. 

 More than three-fourths of 

uninsured adults between 

the ages of 50 and 64 

reported that they have 

never had a screening

colonoscopy. 

 About 60 percent of never 

married adults reported

that they have never had a

screening colonoscopy. 

 More than half of those 

with less than a high 

school education reported 

they have never had a 

screening colonoscopy. 

Sex 

Among those 65 and older, more females reported that they never had a screening colonoscopy as 

compared with males (41.6 percent versus 36.4 percent) (data not shown in figures). 
Race/ethnicity 

A higher percentage of Hispanic adults age 50 and older reported that they have never had a screening 

colonoscopy as compared with white non-Hispanic, or black non-Hispanic adults (66.9 percent versus 

47.1 percent and 55.8 percent) (figure 2). 

Educational level 

Adults age 50 and older with less than a high school education were more likely to have never had a 

screening colonoscopy as compared with those who had either completed high school or had at least 

some college education (57.6 percent versus 52.0 percent and 45.6 percent respectively) (figure 3). 

Marital status 

Single (never married) adults age 50 and older were more likely to have never received a screening 

colonoscopy as compared with those who were married or no-longer married adults (61.5 percent versus 

48.2 percent or 51.8 percent) (figure 4). 

Insurance status 

Among adults ages 50–64 who were uninsured had the highest rate of not ever receiving a screening 

colonoscopy as compared with those in the same age group who had either private or public only 

insurance (77.1 versus 54.1 percent and 60.6 percent) (figure 5). 

Among those ages 65 and older, and those who had Medicare plus some other public insurance, about 

half have never had a screening colonoscopy. This percentage was much higher than those who were 65 

and older and had Medicare only or Medicare plus some private insurance (50.7 percent versus 44.5 

percent and 34.6 percent). 

Data Source 

The estimates in this Statistical Brief were derived from the MEPS 2005 Full Year Population 

Characteristics data file (HC-090). 

Definitions 

The question on having had a screening colonoscopy was asked in the Preventive Care section of the 

MEPS-HC questionnaire. 

Racial and ethnic classifications 

Classification by race and ethnicity was based on information reported for each family member. 

Respondents were asked if each family member was Hispanic or Latino. Respondents were also asked 

which race or races best described each family member. Race categories included white, black/African 

American, American Indian or Alaska Native, Asian, Native Hawaiian or other Pacific Islander, and other. 

Based on these questions, sample persons were classified into the following race/ethnicity categories: 

Hispanic, white non-Hispanic single race, black non-Hispanic single race, Asian non-Hispanic single race, 

and other (Hawaiian/Pacific Islander non-Hispanic, American Indian/Alaska Native non-Hispanic, and 

multiple races non-Hispanic). 

Educational level 

Respondents were asked to report the highest grade or schooling year ever completed by each family 

member as of the date of the interview: not a high school graduate (grade less than 12), high school 

graduate/GED/other (grade 12 equivalent), and at least some college. 

Health insurance status 

Individuals under age 65 were classified into the following three insurance categories based on 

household responses to the health insurance status questions: 

- Any private health insurance: Individuals who, at any time during the year, had insurance that provided 

coverage for hospital and physician care (other than Medicare, Medicaid, or other public 

hospital/physician coverage) were classified as having private insurance. Coverage by TRICARE 

(Armed Forces-related coverage) was also included as private health insurance. Insurance that 

provided coverage for a single service only, such as dental or vision coverage, was not included. 
- Public coverage only: Individuals were considered to have public coverage only if they met both of the 

following criteria: 1) they were not covered by private insurance at any time during the year, and 2) they 

were covered by one of the following public programs at some point during the year: Medicare, 

Medicaid, or other public hospital/physician coverage. 

- Uninsured: The uninsured were defined as people not covered by private hospital/physician insurance, 

Medicare, TRICARE, Medicaid, or other public hospital/physician programs at any time during the entire 

year or their period of eligibility for the survey. 

Individuals 65 and older were classified into the following three insurance categories: 

- Medicare only: Individuals who, at any time during the year, were covered by Medicare only. 

- Medicare plus private: Individuals who at any time during the year, were covered by a combination of 

Medicare, TRICARE or private insurance. 

- Medicare plus other public coverage: Individuals who, at any time during the year, were covered by 

Medicare and some other type of public insurance, but had no private coverage. 

Marital status 

The category “No Longer Married” includes individuals who are widowed, divorced or separated. 

About MEPS-HC 

MEPS-HC is a nationally representative longitudinal survey that collects detailed information on health 

care utilization and expenditures, health insurance, and health status, as well as a wide variety of social, 

demographic, and economic characteristics for the civilian noninstitutionalized population. It is cosponsored by the Agency for Healthcare Research and Quality and the National Center for Health Statistics. 

For more information about MEPS, call the MEPS information coordinator at AHRQ (301-427-1406) or 

visit the MEPS Web site at http://www.meps.ahrq.gov/. 

References 

For a detailed description of the MEPS survey design, sample design, and methods used to minimize 

sources of nonsampling errors, see the following publications: 

Cohen, J. Design and Methods of the Medical Expenditure Panel Survey Household Component. MEPS 

Methodology Report No. 1. AHCPR Pub. No. 97-0026. Rockville, Md.: Agency for Health Care Policy and 

Research, 1997. 

Cohen, S. Sample Design of the 1996 Medical Expenditure Panel Survey Household Component. MEPS 

Methodology Report No. 2. AHCPR Pub. No. 97-0027. Rockville, Md.: Agency for Health Care Policy and 

Research, 1997. 

Cohen, S. Design Strategies and Innovations in the Medical Expenditure Panel Survey. Medical Care,

July 2003: 41(7) Supplement: III-5–III-12. 

For information on colorectal cancer and screening colonoscopy and treatment, see the following: 

Nation Digestive Diseases Information Clearinghouse (NDDIC): Colonoscopy, 

http://digestive.niddk.nih.gov/ddiseases/pubs/colonoscopy/ 

Fact Sheet: Colorectal Cancer Screening, March 2003: 

http://www.cdc.gov/od/oc/media/pressrel/fs030314.htm 

Colonoscopy Screening, August 2006: http://www.emedicine.com/med/topic2966.htm 

Screening for Colorectal Cancer – Recommendations, July 2002 

http://www.ahrq.gov/clinic/uspstf/uspscolo.htm#summary#summary 
Suggested Citation 

Soni, A. Screening Colonoscopy Among U.S. Noninstitutionalized Adult Population Age 50 and Older, 

2005. Statistical Brief #188. November 2007. Agency for Healthcare Research and Quality, Rockville, 

MD. http://www.meps.ahrq.gov/mepsweb/data_files/publications/st188/stat188.pdf 

∗ ∗ ∗

AHRQ welcomes questions and comments from readers of this publication who are interested in 

obtaining more information about access, cost, use, financing, and quality of health care in the United 

States. We also invite you to tell us how you are using this Statistical Brief and other MEPS data and 

tools and to share suggestions on how MEPS products might be enhanced to further meet your needs. 

Please e-mail us at mepsprojectdirector@ahrq.hhs.gov or send a letter to the address below: 

Steven B. Cohen, PhD, Director 

Center for Financing, Access, and Cost Trends 

Agency for Healthcare Research and Quality 

540 Gaither Road 

Rockville, MD 20850 
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 2005

50.1

57.5

39.4

0

5

10

15

20

25

30

35

40

45

50

55

60

65

70

Total 50-64 65+

Never had a screening colonoscopy

Percent

Figure 1. Percentage of adults age 50 and 

older, who never had a screening 

colonoscopy, by age, 2005

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 2005

62.6

55.8 55.4

47.1

66.9

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

Hispanic White nonHispanicBlack nonHispanicAsian nonHispanicOther nonHispanic

Never had a screening colonoscopy

Percent

Figure 2. Percentage of adults age 50 and 

older, who never had a screening 

colonoscopy, by race/ethnicity, 2005

Statistical Brief #188: Screening Colonoscopy among U.S. Noninstitutionalized Adult Population Age 50 

and Older, 2005
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 2005

57.6

52.0

45.6

0.0

10.0

20.0

30.0

40.0

50.0

60.0

Less than High School Completed High School At least some College

Never had a screening colonoscopy

Percent

Figure 3. Percentage of adults age 50 and 

older, who never had a screening 

colonoscopy, by education, 2005

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 2005

61.5

48.2

51.8

0

10

20

30

40

50

60

70

Never Married Married No Longer Married

Never had a screening colonoscopy

Percent

Figure 4. Percentage of adults age 50 and 

older, who never had a screening 

colonoscopy, by marital status, 2005

Statistical Brief #188: Screening Colonoscopy among U.S. Noninstitutionalized Adult Population Age 50 

and Older, 2005
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 2005 Percent

Figure 5. Percentage of adults 50 and 

older, who never had a screening 

colonoscopy, by insurance status, 2005

50-64

54.1

60.6

77.1

0

5

10

15

20

25

30

35

40

45

50

55

60

65

70

75

80

Private Public Only Uninsured

65+

44.5

34.6

50.7

0

5

10

15

20

25

30

35

40

45

50

55

60

Medicare Only Medicare+Private Medicare+Public

Private Public only Uninsured Medicare only Medicare+Private Medicare+Public

Statistical Brief #188: Screening Colonoscopy among U.S. Noninstitutionalized Adult Population Age 50 

and Older, 2005