Underuse of Screening Sigmoidoscopy and Colonoscopy in a Large Cohort of US Adults
Ann Chao, PhD,
Cari J. Connell, MPH,
Vilma Cokkinides, PhD,
Eric J. Jacobs, PhD,
Eugenia E. Calle, PhD and
Michael J. Thun, MD
The authors are with the Epidemiology and Surveillance Research, American Cancer Society, Atlanta, Ga.
Correspondence: Requests for reprints should be sent to Ann Chao, Epidemiology and Surveillance Research, American Cancer Society, 1599 Clifton Road NE, Atlanta, GA 303294251 (e-mail: annchao{at}zamnet.zm).
Objectives. We examined the prevalence of endoscopy (sigmoidoscopyor colonoscopy) by indication and by demographic and lifestylefactors.
Methods. We analyzed cross-sectional data collected in 1997from participants aged 50 years and older in the Cancer PreventionStudy (CPS) II Nutrition Cohort.
Results. Fifty-eight percent of men and 51% of women reportedever having undergone endoscopy; only 42% of men and 31% ofwomen reported endoscopy for screening rather than for diseasediagnosis or follow-up. Prevalence varied by demographic andlifestyle factors.
Conclusions. Efforts to increase colorectal cancer screeningneed to target women, all persons aged 5064 years, andthose with colorectal cancer risk factors. Future studies shoulddistinguish endoscopy for screening from procedures for diseasediagnosis and follow-up to avoid overestimating screening compliance.
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