Colorectal Cancer Screening in US Seniors Ages 76–84 Years

The US Preventive Services Task Force recommends patient-physician discussions about the appropriateness of colorectal cancer (CRC) screening among adults ages 76–84 years who have never been screened. In this study, we used data from the 2010 National Health Interview Survey to examine patterns of CRC screening and provider recommendation among seniors ages 76–84 years, and made some comparisons to younger adults. Nationally-representative samples of 1379 adults ages 76–84 years and 8797 adults ages 50–75 years responded to questions about CRC screening status, receipt of provider recommendation, and discussion of test options; 22.7 % (95 % CI 20.1–25.3) of seniors ages 76–84 had never been tested for CRC and therefore were not up-to-date with guidelines; 3.9 % (95 % CI 2.0–7.6) of these individuals reported a recent provider recommendation for screening. In multivariate analyses, the likelihood of never having been tested was significantly greater for seniors of other/multiple race or Hispanic ethnicity; with high school or less education; without private health insurance coverage; who had ≤1 doctor visit in the past year; without recent screening for breast, cervical, or prostate cancer; with no or unknown CRC family history; or with ≤1 chronic disease. Among the minority of respondents ages 50–75 and 76–84 reporting a provider recommendation, 73.2 % indicated that the provider recommended particular tests, which was overwhelmingly colonoscopy (≥89 %). Nearly one-quarter of adults 76–84 have never been screened for CRC, and rates of provider recommendation in this group are very low. Greater attention to informed CRC screening discussions with screening-eligible seniors is needed.