{"doi":"10.1111/jgs.17890","title":"Prevalence of colorectal cancer screening test use by test type and age among older adults in the United States","abstract":"The United States Preventive Services Task Force (USPSTF) creates age-based recommendations for colorectal cancer (CRC) screening. Their most recent statement, published in 2021, recommends screening for adults aged 45–49 years (B-grade) and 50–75 years (A-grade), selective screening for adults aged 76–85 years (C-grade), and does not recommend screening for adults aged 86 years and older (no grade assigned).1 Several types of tests are available to screen for CRC, and the potential harms and potential benefits of screening vary by test type and age group.1 We provide national estimates of CRC screening test use among adults aged 65 years and older by test type and age group. The National Health Interview Survey (NHIS) is designed to produce estimates representative of the civilian non-institutionalized US adult population. Additional documentation is available online.2 The 2019 dataset included 9,295 adults aged 65 years and older. We excluded adults who reported a personal history of CRC (n = 155) or had unknown information about their test type or test timing (n range = 138–376). SAS 9.4 (SAS Institute Inc., Cary, NC) survey procedures adjusted for household non-response (adult response rate = 59.1%) and accounted for the complex sampling design. We calculated the population-weighted prevalence of test use (colonoscopy, any stool test, flexible sigmoidoscopy, CT colonography) in the past year. Traditional analyses of NHIS screening data report test receipt within time intervals corresponding to USPSTF recommendations.3-5 Because we sought to understand current test use at ages 65 years and older, we focused our analyses on tests that occurred no more than 1 year before the interview. We also present estimates of having never received any CRC test. We present all results stratified by age groups aligned as closely as possible with age groups used by the USPSTF (65–75 years, 76–84 years, 85 years and older). It was not possible to present data for adults aged 86 years and older because the public-use datafile top-coded age at 85 years. In 2019, about 1 in 4 (25.2%) adults aged 65–75, 1 in 6 (17.2%) adults aged 76–84, and 1 in 12 (8.0%) adults aged 85 years and older in the United States reported receipt of a CRC test in the past year (Figure 1). Across the 3 age groups, colonoscopy was the most common test received, followed by stool testing (Table S1). Less than 2% of older Americans reported receipt of flexible sigmoidoscopy or CT colonography in 2019. Across each age group, some adults reported having never received any type of CRC test: 65–75 years: 15.6 (14.4, 16.9), 76–84 years: 16.1 (14.1, 18.1), 85 years and older: 25.7 (22.1, 29.5). Table S1 contains additional point estimates and 95% confidence intervals. Well over half of all cases of CRC are diagnosed among adults aged 65 years and older; 3 in 10 are diagnosed at ages 75 years and older.6 Among the age groups included in our analyses, colonoscopy was the most common test type. Given the elevated risk of colonoscopy harms among older adults, including post colonoscopy bleeding,7 several experts have called for increased consideration of stool testing among adults aged 76 years and older.7, 8 Our study found stool testing was less common than colonoscopy among older Americans in 2019, and CT colonography and flexible sigmoidoscopy were rarely used. These patterns by test type mirror 2018 test use patterns reported for US adults aged 50–75 years.3 Colonoscopy was also the most common test used among adults aged 65 years and older in 2000 and 2005.5 In 2010, colonoscopy was the test type most recommended by physicians for adults aged 76–84 years who had never been screened.4 The proportion of US adults who reach age 76–84 years having never received a CRC test has declined over time, from 33%–37% in 2000 to 26%–30% in 2005 and 23% in 2010.4, 5 Our results report a further decline to 16% in 2019. These findings suggest that about 1 in 6 older adults currently “age out”","journal":"Journal of the American Geriatrics Society","year":2022,"id":288761,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":7,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.961,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":319737,"name":"Mary C. White","orcid":"0000-0002-9826-3962","position":1,"is_corresponding":false},{"id":388636,"name":"Jean A. Shapiro","orcid":"0000-0002-7167-3726","position":2,"is_corresponding":false},{"id":702495,"name":"Emily E. Adam","orcid":"0000-0002-3778-7893","position":0,"is_corresponding":true}],"reference_count":9,"raw_metadata":null,"created_at":"2026-07-19T00:30:14.968626Z","pmid":"35652514","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}