Many in U.S. skip follow-up colon cancer screening

One in three adults who have been screened for colon cancer fail to follow up with repeat screenings as recommended, according to a new survey.

Researchers found 33% of U.S. adults between the ages of 60 and 70 years old have only been screened once for colon cancer; 31% of adults over age 50 have never been screened at all.

"The survey suggests that people are not being screened at a rate of frequency that reflects adherence to medical guidelines for colon cancer testing," says Andrew Spiegel, CEO of the Colon Cancer Alliance, which co-sponsored the survey, in a news release. "It is possible that many patients, after being screened once, are lulled into a false sense of security and fail to undergo additional testing."

Colon cancer is the second leading cause of cancer deaths in the U.S. The CDC says 60% of colon cancer deaths could be prevented if people followed guidelines for regular screening.

The American Cancer Society guidelines recommend men and women at average risk for colon cancer begin colon cancer screening at age 50 and repeat screening on a regular basis. Some of the types of recommended screening tests available, and their frequency, include:

* Colonoscopy: every 10 years

* Flexible sigmoidoscopy or virtual colonoscopy: every five years

* Fecal occult blood (FOBT) and fecal immunochemical (FIT) tests: annually

Why people skip screenings

The telephone survey of 1,304 adults suggests that gaps in colon cancer screening persist despite public education campaigns.

The results show nearly one in three adults over age 50 have never been screened for colon cancer by any method. More than a quarter (28%) of these said their health care provider did not recommend colon cancer screening to them.

Other frequently cited reasons for not undergoing colon cancer screening include:

* Time constraints or being "too busy": 18%

* Fear: 16%

* Didn't know screening was necessary: 16%

* Can't afford health insurance co-payment: 15%

* No health insurance: 10%

* Modesty or embarrassment: 9%

Among those who had been screened, 87% said they had been screened by colonoscopy, which is the preferred screening method. But researchers say fears about unpleasant bowel preparation (laxatives and fasting) were cited by 61% of those who said fear was a reason they had never been screened for colon cancer.

Among adults over age 50 who said they had been screened in the past:

* 40% had been screened once

* 22% had been screened twice

* 12% had been screened three times

* 18% had been screened four or more times by any colon cancer screening method

Educating the public

The survey also looked at how people who were aware of colon cancer screening guidelines had learned about them. Eighty percent said their health care provider had told them about the guidelines. Other sources included friends (23%) and family (31%). The Internet was the source of information for 12% of the respondents.

"Clearly, family and friends as well as health care providers can influence public understanding of the value of colon cancer testing," Spiegel says.

Researchers said the survey also suggests that health care providers have the opportunity to educate their patients about the variety of screening options available for colon cancer and their recommended frequency.

By Jennifer Warner

Reviewed by Laura J. Martin, MD