1

 www http://www.cdc.gov/mmwr

 www http://www.cdc.gov/vitalsigns

 www http://www.cdc.gov/cancer

36%

Only 36% of uninsured adults 

aged 50–75 are up-to-date with 

colorectal cancer screening.

Only 56% of uninsured women 

56%

aged 50–74 are up-to-date 

with mammography screening.

Cancer 

Screening

Colorectal Cancer

Breast Cancer

22M

22 million adults aged 50–75 

need to be screened for colorectal 

cancer, and 7 million women aged 

50–74 need to be screened for 

breast cancer.

Most adults are getting recommended breast and 

colorectal cancer screenings. Yet a new CDC report 

says more than 22 million adults have not had 

screening tests for colorectal cancer, and more than 

7 million women have not had a recent mammogram 

to screen for breast cancer as recommended. This 

CDC report also points out why more people need 

to get tested for colorectal and breast cancer and 

what can be done to increase screening.

Want to learn more? Visit—

National Center for Chronic Disease Prevention and Health Promotion 

Division of Cancer Prevention and Control

July 2010
2

Colorectal Cancer

1. Colorectal cancer screening

prevents cancer and saves lives. 

◊ Colorectal cancer is cancer of the colon or rectum, and is often called simply “colon cancer.” 

It is the #2 cause of cancer deaths in the 

United States and kills more nonsmokers than 

any other cancer. African American men and 

women are particularly at risk of dying from 

colon cancer.

◊ In 2006, more than 139,000 people learned 

they had colon cancer, and more than 53,000 

people died of it.

◊ At least 6 of every 10 deaths could be prevented from colon cancer if every adult 50 years 

or older got tested regularly. 

◊ Screening tests can find precancerous polyps 

(abnormal growths) in the colon or rectum. 

These growths can be removed before they 

turn into cancer. In this way, you can prevent 

colon cancer. The earlier colon cancer is found 

during a screening, the easier it is to cure.

2. What screening tests look for

colon cancer?

At age 50 and until age 75 (sometimes younger or older, if your doctor recommends it), men 

and women should have one or more of three 

tests to check for colon cancer. In particular, 

adults aged 50–59 years should get screened 

because their testing rate is so low. The maximum benefit is expected when people in their 

50s are informed and start getting tested. 

22 Million Adults Aged 50–75

Still Need to Be Tested

Problem

Colon cancer tests are—

◊ A stool test, also called a fecal occult blood 

test (FOBT) - every year. FOBT is done in the 

privacy of your home. 

◊ Flexible sigmoidoscopy - every 5 years. This 

takes place at a doctor’s office or other medical setting. If any unusual growths are found, 

they can usually be removed at the time. Some 

people will need a follow-up colonoscopy.

◊ Colonoscopy - every 10 years. This test takes 

place at a doctor’s office or other medical 

setting under light sedation. If any unusual 

growths are found, they can be removed at the 

time. 

3. About a third of people are not getting screened for colon cancer according to national recommendations. 

◊ As of 2008, about a third of adults between the 

ages of 50 and 75 (about 22 million people) 

are not up-to-date with colon cancer screening. 

4.Why don’t more men and women get 

tested for colon cancer? 

◊ They don’t know that anyone can develop colon 

cancer as they get older. 

◊ They didn’t get recommendation from a 

health care provider.

◊ They don’t have health insurance or a health 

care provider.
3

0

10

20

30

40

50

60

70

80

50-59 years 60-69 years 70-75 years

Percentage of Colorectal Cancer Screening, by Age

Percentage of Colorectal Cancer Screening,

by Annual Income

0

10

20

30

40

50

60

70

80

< $15,000 $15,000

- - $34,999 -

$35,000

$49,999

$50,000

$74,999

≥ $75,000

% 

% 

Who’s at Risk?

5. Who needs to get tested for

colon cancer?

People of all racial and ethnic groups aged 50 

to 75 years should get tested. 

Some groups of people don’t get tested at all 

or as often as their doctors recommend. The 

following people should be especially encouraged to get tested— 

◊ African Americans. This group has the highest 

death rate for colon cancer.

◊ Hispanics.

◊ People with low income. 

◊ People with low education levels.

◊ People who don’t have health insurance.

◊ People who have a family history of colon 

cancer. One in five people has a family history of colon cancer and should speak with a 

doctor about getting tested earlier and more 

often than others.

Some people may be at especially high risk because of a personal history of having polyps or 

having several close family members (parent, 

grandparent, sister, brother) who have had 

polyps or colon cancer. 

Risk is higher for people with certain conditions including Crohn’s disease, inflammatory bowel disease, and some genetic 

disorders. People with these conditions 

should talk with their health care providers 

about getting tested at younger ages or more 

frequently.
4

0

10

20

30

40

50

60

70

80

90

Insured

Uninsured

Source: Behavioral Risk Factor Surveillance System (BRFSS)

% Colorectal Cancer Test Mammogram

U.S. State Info

Percentage of People Screened Among 

Insured and Uninsured in 2008

The number of people who get screened for colon or 

breast cancer is very different from state to state.

The highest number of people who get tested are in 

the northeastern United States.
5

Alabama

Arizona

Arkansas

California Colorado

Connecticut

Delaware

Florida

Georgia

Illinois Indiana

Iowa

Kansas

Kentucky

Louisiana

Maine

Maryland

Massachusetts

Michigan

Minnesota

Mississippi

Missouri

Nebraska

New

Hampshire

New Jersey

New York

North Carolina

North

Dakota

Ohio

Oklahoma

Oregon

Pennsylvania

Rhode Island

South

Carolina

South

Dakota

Tennessee

Texas

Utah

Vermont

Virginia

Washington

West

Virginia

Wisconsin Idaho

Montana

Nevada

New Mexico

Wyoming

Hawaii

Alaska

Alabama

Arizona

Arkansas

California Colorado

Connecticut

Delaware

Florida

Georgia

Illinois Indiana

Iowa

Kansas

Kentucky

Louisiana

Maine

Maryland

Massachusetts

Michigan

Minnesota

Mississippi

Missouri

Nebraska

New

Hampshire

New Jersey

New York

North Carolina

North

Dakota

Ohio

Oklahoma

Oregon

Pennsylvania

Rhode Island

South

Carolina

South

Dakota

Tennessee

Texas

Utah

Vermont

Virginia

Washington

West

Virginia

Wisconsin Idaho

Montana

Nevada

New Mexico

Wyoming

Hawaii

Alaska

Colorectal Cancer Screening:

Fecal occult blood test use within past year or lower 

endoscopy (either sigmoidoscopy or colonoscopy) in 

past 10 years, adults aged 50–75 years, United States, 

BRFSS 2008

Mammogram: Mammogram use in past 2 years,

women aged 50–74 years, United States, BRFSS 2008

53%–60%

72%–78%

>60%–67%

>78%–84%

>67%–74%

>84%–90%

The percentage of people up-to-date with colorectal cancer screening ranged 

from 53.2% in Oklahoma to 74.1% in Massachusetts. States with the highest 

number of screenings were in the northeastern United States.

Mammography screening use varied by state, with the highest mammography 

use in the northeastern United States.
6

Breast Cancer

1. Screening for breast cancer

prevents cancer and saves lives.

◊ Breast cancer is the most common cancer 

among adult women in the United States and 

second leading cause of death from cancer 

among women. 

◊ One of every eight adult women will get 

breast cancer in her lifetime. The risk of cancer increases with age. 

◊ In 2006, more than 190,000 women were discovered to have breast cancer, and more than 

41,000 died of the disease. 

◊ Although white women are more likely to get 

breast cancer, African American women are 

the most likely to die of it. Minority women 

are most likely to have advanced breast cancer 

when the cancer is first discovered.

◊ If a close family member (mother, grandmother, sister, and father or brother) has 

had breast cancer, the risk for other family 

members getting breast cancer may be higher. 

If you think you may be at increased risk, ask 

your doctor if you should be tested earlier or 

more often than other women. 

2. What test looks for breast cancer?

◊ The best way to find breast cancer is by having 

a mammogram. A mammogram is an X-ray of 

the breasts. 

◊ Mammograms can find breast cancer early, before it is big enough to feel or cause symptoms 

and when it is easier to treat. 

3. Women are not getting screened for breast 

cancer as often as recommended 

◊ In 2008, about one of five adult women between the ages of 50 and 74 never had a mammogram or were not up-to-date with getting 

screened. 

◊ Overall, mammography screening rates in the 

United States have not improved since 2002.

◊ Getting a mammogram every 2 years should 

be a priority for women aged 50–74 years. 

Screening can find breast cancer at an early 

stage, when treatment is most effective. 

7 Million Women Still Need to

Be Screened for Breast Cancer

Problem
7

Percentage of Mammography Screening, by Age

Percentage of Mammography Screening, by Annual Income

0

10

20

30

40

50

60

70

80

90

100

79

80

81

82

83

% 50-59 years 60-69 years 70-74 years

% < $15,000 $15,000

-$34,999 -

$35,000

$49,999 -

$50,000

$74,999

≥ $75,000

4. Who needs to get screened for breast 

cancer?

All women aged 50 to 74 should have a mammogram every 2 years. Women between 40 

and 50 years should talk with their doctor 

about when to start getting mammograms. 

Some women are less likely than others to be 

up-to-date with breast cancer screening. 

They include women aged 50–74 years who—

◊ Are uninsured—only 56% of uninsured 

women had a mammogram in the past

2 years, while 84% of women with health 

insurance had a mammogram.

◊ Are American Indian and Alaska Native.

◊ Have a low income.

◊ Have less than a high school education.

5. How effective are mammograms in 

preventing death from breast cancer?

◊ Getting screened for breast cancer beginning 

at age 50, or earlier if you have a family history of the disease or your doctor recommends 

it, helps find this cancer early, when treatment 

can be most effective. 

6. Why don’t more women get screened for 

breast cancer?

The #1 reason women say they didn’t get a 

mammogram is that their health care provider didn’t tell them to get one. 

◊ Some women don’t get a mammogram 

because they don’t have health insurance and 

can’t afford it. In the future, health care reform may help reduce this problem. 

◊ Some women are not aware of, or convinced 

of, the benefits of screening.

Who’s at Risk?
8

 www Want to learn more? Visit http://www.cdc.gov/mmwr

For more information, please contact 

Centers for Disease Control and Prevention

1600 Clifton Road NE, Atlanta, GA 30333

Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348

E-mail: cdcinfo@cdc.gov Web: www.cdc.gov

Publication date: 07/06/2010

What Can Be Done

Health departments can

◊ Inform people about who should be 

screened and about test options. 

◊ Explain the benefits of screening for

colon and breast cancer. 

◊ Identify groups in the community 

who are not getting screened. 

◊ Make sure tests are done correctly.

◊ Work with minority and other hard-toreach groups to encourage and facilitate 

screening. 

◊ Identify problems (barriers) that keep 

people from getting screened.

◊ Create programs to solve these problems and increase screening such as 

using “patient navigators.” Patient 

navigators can guide people through 

the screening process, making it easier 

to get screened, learn test results 

promptly, receive appropriate followup care, and find support networks. 

◊ Encourage medical practices, especially 

those with low screening rates, to 

remind patients to be screened, track 

who has been screened, and follow 

up with patients who have not been 

screened or who need additional tests 

or treatment.

Doctors, nurses, and other 

health care providers can

◊ Inform patients about who should be 

screened, when screening should be 

done, and why it is important. 

◊ Establish standing orders for nurses so 

they can request tests themselves.

◊ Make sure patients who cannot afford testing know about free 

cancer screening services in their area.

◊ Establish systems that make screening automatic, such as reminding patients when they’re due for a recommended cancer 

screening by sending cards or e-mails or calling them.

◊ Ensure patients receive test results promptly and that those 

with positive results quickly get an appointment for diagnosis 

and treatment.

◊ Systematically monitor and improve screening rates.

People can

◊ Talk to their health care providers about their risk of getting 

cancer and ask which screening tests they should have, at 

what age to begin, and how often to be screened. 

◊ Get screened regularly for colon cancer at age 50 or older, 

using either one or a combination of tests, including a fecal 

occult blood test, flexible sigmoidoscopy, or colonoscopy. 

◊ Get a mammogram every 2 years if you are a woman aged 

50 or older. Women younger than 50 should talk with their 

health care provider about breast cancer risk and when to 

begin getting a mammogram.

◊ Talk to their health care provider about whether they should 

be tested at an earlier age or more often than other people if 

they have a family history of colon or breast cancer. 

◊ Contact their local health department about free or low-cost 

screening if they can’t pay for colon or breast cancer testing 

or if their insurance doesn’t cover it. Call 1-800-CDC-INFO or 

visit www.cdc.gov/cancer to find a local program. 

◊ See a doctor promptly to determine the next steps needed if

a screening test shows there might be a problem.

What can be done to help more people get screened for 

colon and breast cancer?