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U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion

Increase the proportion of adults who get screened for colorectal cancer — C‑07 Data Methodology and Measurement

This objective is a Leading Health Indicator (LHI). Learn about LHIs.

On this page:  About the National Data  |  Methodology  |  History

About the National Data

Data

Data Source:  National Health Interview Survey (NHIS), CDC/NCHS

Baseline: 58.7 percent of adults aged 45 to 75 years received a colorectal cancer screening based on the most recent guidelines in 2021

Target: 68.3 percent

Numerator
Number of adults aged 45 to 75 years who received a colorectal cancer screening based on the most recent USPSTF recommendation.
Denominator
Number of adults aged 45 to 75 years, excluding those with a history of colorectal cancer.
Target-setting method
Percentage point improvement
Target-setting method details
Percentage point improvement from the baseline using Cohen's h effect size of 0.20.
1
Target-setting method justification
Trend data were evaluated for this objective but it was not possible to project a target because the slope of the line was not statistically significant. A percentage point improvement was calculated using Cohen's h effect size of 0.2. This method was used because the proportion of adults receiving colorectal screening, based on the most recent guidelines, improved over the past decade. The Healthy People 2030 Workgroup Subject Matter Experts took into consideration the observed improvement and emergence, along with uptake, of improved and less invasive screening technologies, when selecting the target.

Methodology

Questions used to obtain the national baseline data

(For additional information, please visit the data source page linked above.)

From the 2021 National Health Interview Survey:

Numerator:
Have you ever had a blood stool or FIT test, using a HOME test kit?
  1. Yes
  2. No
  3. Refused
  4. Don't know
When was your most recent blood stool or FIT test, using a home test kit?
  1. Within the past year (anytime less than 12 months ago)
  2. Within the past 2 years (1 year but less than 2 years ago)
  3. Within the past 3 years (2 years but less than 3 years ago)
  4. Within the past 5 years (3 years but less than 5 years ago)
  5. Within the past 10 years (5 years but less than 10 years ago)
  6. 10 years ago or more
  7. Refused
  8. Don't know
These next questions are about colorectal cancer screening. Colonoscopy and sigmoidoscopy are exams to check for colon cancer. Have you ever had either of these exams?
  1. Yes
  2. No
  3. Refused
  4. Don't know
Have you had a colonoscopy, a sigmoidoscopy, or both?
  1. Colonoscopy
  2. Sigmoidoscopy
  3. Both
  4. Refused
  5. Don't know
When was your MOST RECENT sigmoidoscopy?
  1. Within the past year (anytime less than 12 months ago)
  2. Within the past 2 years (1 year but less than 2 years ago)
  3. Within the past 3 years (2 years but less than 3 years ago)
  4. Within the past 5 years (3 years but less than 5 years ago)
  5. Within the past 10 years (5 years but less than 10 years ago)
  6. 10 years ago or more
  7. Refused
  8. Don't know
About how long has it been since your MOST RECENT colonoscopy?
  1. Within the past year (anytime less than 12 months ago)
  2. Within the past 2 years (1 year but less than 2 years ago)
  3. Within the past 3 years (2 years but less than 3 years ago)
  4. Within the past 5 years (3 years but less than 5 years ago)
  5. Within the past 10 years (5 years but less than 10 years ago)
  6. 10 years ago or more
  7. Refused
  8. Don't know
CT colonography, sometimes called virtual colonoscopy, is a test that looks for cancer in the colon. Unlike regular colonoscopies, you do not need medication to make you sleepy during the test. In this test, your colon is filled with air and you are moved through a donut-shaped X-ray machine as you lie on your back and then your stomach. Have you ever had a CT colonography or virtual colonoscopy?
  1. Yes
  2. No
  3. Refused
  4. Don't know
When was your most recent CT colonography or virtual colonoscopy?
  1. Within the past year (anytime less than 12 months ago)
  2. Within the past 2 years (1 year but less than 2 years ago)
  3. Within the past 3 years (2 years but less than 3 years ago)
  4. Within the past 5 years (3 years but less than 5 years ago)
  5. Within the past 10 years (5 years but less than 10 years ago)
  6. 10 years ago or more
  7. Refused
  8. Don't know
Was the blood stool or FIT test you reported earlier conducted as part of a Cologuard test?
  1. Yes
  2. No
  3. Refused
  4. Don't know
When was your MOST RECENT colonoscopy or sigmoidoscopy?
  1. Within the past year (anytime less than 12 months ago)
  2. Within the past 2 years (1 year but less than 2 years ago)
  3. Within the past 3 years (2 years but less than 3 years ago)
  4. Within the past 5 years (3 years but less than 5 years ago)
  5. Within the past 10 years (5 years but less than 10 years ago)
  6. 10 years ago or more
  7. Refused
  8. Don't know

Methodology notes

Healthy People 2030 uses the current U.S. Preventive Services Task Force (USPSTF) recommendation to measure this objective:

  1. Grade A: offer or provide this service for ages 50-75; and
  2. Grade B: offer or provide this service for ages 45-49.
Data include persons who have had a blood stool test (gFOBT or FIT) within the past year, sigmoidoscopy within the past 5 years or, a colonoscopy within the past 10 years, or Stool DNA-FIT (sDNA-FIT) within the past three years, or CT colonography within the past 5 years.
The denominator does not include respondents with a history of colorectal cancer.
The baseline was updated based on the changes to the USPSTF recommendation for colorectal cancer, which was released in May 2021.

Age-adjustment notes

This indicator uses Age-Adjustment Groups:

  • Total: 45-54, 55-64, 65-75
  • Sex: 45-54, 55-64, 65-75
  • Race/Ethnicity: 45-54, 55-64, 65-75
  • Country of Birth: 45-54, 55-64, 65-75
  • Geographic Location: 45-54, 55-64, 65-75
  • Family Income: 45-54, 55-64, 65-75
  • Educational Attainment: 45-54, 55-64, 65-75
  • Marital Status: 45-54, 55-64, 65-75
  • Disability Status: 45-54, 55-64, 65-75
  • Sexual Orientation: 45-54, 55-64, 65-75
  • Veteran Status: 45-54, 55-64, 65-75
  • Health Insurance: 45-54,55-64

History

Comparable HP2020 objective
Modified, which includes core objectives that are continuing from Healthy People 2020 but underwent a change in measurement.
Changes between HP2020 and HP2030
This objective differs from Healthy People 2020 objective C-16 in that the measure was revised to match updated screening recommendations put forth by the U.S. Preventative Services Task Force (USPSTF).
Revision History
  • Revised. 

    In 2023, due to the updated USPSTF recommendation, the 2019 NHIS survey redesign, and a revised denominator to exclude persons with a history of colorectal cancer, the baseline for this objective was changed from 65.2% in 2018 to 58.7% in 2021 and the target was changed from 74.4% to 68.3%.
  • Revised. 

    In 2024, the following categories were recalculated with the use of a newer variable: Never married, American Indian or Alaska Native only, Native Hawaiian or Other Pacific Islander only, 2 or more races only, Not Hispanic or Latino American Indian or Alaska Native only, Not Hispanic or Latino Native Hawaiian or Other Pacific Islander only, Not Hispanic or Latino 2 or more races only. Estimates from data year 2022 or earlier may vary slightly from estimates previously reported. The baseline, baseline year and target were not affected.

1. Effect size h=0.2 was chosen to correspond with 20% improvement from a baseline of 50%.