As new report shows colorectal cancer rates rising, Washington lags in appropriate screening

A new study from the American Cancer Society published in JAMA shows that rates of colorectal cancer (CRC) are rising among younger adults, ages 20-54. Current recommendations do not advise CRC screening until age 50 (unless other risk factors or symptoms are present), so many cases in younger adults are not being identified until the cancer is in more advanced stages.

The five-year survival rate for people with CRC discovered early is about 90 percent. But only 39 percent of CRCs are found at that early stage (stage 1). Five-year survival rates go down when the cancer has spread to nearby organs or lymph nodes.

While the risk factors for colon cancer are well established – poor diet, obesity, alcohol consumption, lack of physical exercise, and smoking – the reason for the increased rate in younger adults has not yet been determined.

One key, however, is to be aware of colon cancer symptoms and let your doctor know if you experience any of them. According to the American Cancer Society, these include a change in bowel habits, such as diarrhea or constipation that lasts more than a few days; rectal bleeding; cramping or abdominal pain; weakness and fatigue; and unintended weight loss.

Colorectal cancer in Washington state

Colorectal cancer is the second-most common cancer in Washington and the second-leading cause of cancer deaths in the state. In 2011, over 1,000 Washington residents died of this disease. Both men and women should be screened and there are three different ways to screen for colon cancer. Regular screening beginning at age 50 can prevent colorectal cancer by finding and removing precancerous growths before they develop into cancer, as well as detect colon cancer early, when it is most treatable.

As the new study in JAMA indicates, with CRC rising among younger adults, it’s important not to put off screening if you’re in the recommended age group or have other risk factors. The Alliance’s Community Checkup measures the percentage of adults in Washington 50-75 years of age who had appropriate screening for CRC with any of the following tests: annual fecal occult blood test; flexible sigmoidoscopy every five years; or colonoscopy every ten years.

Unfortunately, even among this population, only 63% of commercially insured adults have received the appropriate screening. For Medicaid patients, only 43% have received the appropriate screening.

As you can see on the map below, three counties exceed the state average for CRC screening, while geographically, the vast majority of the state is below average. What is important to note is that this map measures against a state average of 63% of commercially insured people receiving appropriate CRC screening, still far below full adherence. The national 90th percentile of CRC screening is 72%.

colorectal cancer





Among clinics, hospitals, and health plans measured by the Alliance, 84 scored better than state average on appropriate CRC screening for the commercially insured, and 106 scored worse.


How to improve colorectal cancer screening rates

Clearly this is an area that the health system in Washington needs to emphasize and improve. And with rising rates among a younger population, people should be getting screened as soon as they enter the recommended age range or sooner if they exhibit symptoms or have other risk factors.

  • If you’re an employer, share messages with your employees about the importance of screening and early detection. You can use the articles on Own Your Health, and the American Cancer Society provides helpful resources on early detection, diagnosis, and treatment.
  • If you are a provider or part of a health plan, use the Community Checkup to see where you rank in CRC screening, and make a concerted effort to talk with your patients about the importance of getting screened and being on the lookout for symptoms of CRC. Additionally, have a system in place that enables you to reach out to patients within the recommended age range who have not been screened.
  • If you’re a patient, learn about the symptoms and warning signs mentioned above, and if you have concerns or are in the age group recommended for screening, talk to your doctor about your options.



Published: August 9, 2017

About Washington Health Alliance

The Washington Health Alliance is a place where stakeholders work collaboratively to transform Washington state’s health care system for the better. The Alliance brings together organizations that share a commitment to drive change in our health care system by offering a forum for critical conversation and aligned efforts by stakeholders: purchasers, providers, health plans, consumers and other health care partners. The Alliance believes strongly in transparency and offers trusted and credible reporting of progress on measures of health care quality and value. The Alliance is a nonpartisan 501(c)(3) nonprofit with more than 185 member organizations. A cornerstone of the Alliance's work is the Community Checkup, a report to the public comparing the performance of medical groups, hospitals and health plans and offering a community-level view on important measures of health care quality (www.wacommunitycheckup.org).

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