Observations from the CDC: CDC's Screen for Life: a National Colorectal Cancer Action Campaign.

Colorectal cancer is the second leading cause of cancer-related deaths in the United States. Despite the availability of several different screening tests for colorectal cancer, screening rates remain low. To raise awareness about colorectal cancer and encourage men and women aged 50 and older to speak with their physicians about being screened for colorectal cancer, the Centers for Disease Control and Prevention and the Health Care Financing Administration launched Screen for Life: A National Colorectal Cancer Action Campaign in 1999. The purpose of this paper is to outline the development of this multiyear, multimedia campaign, from conducting formative research to developing campaign messages and materials. Limited process evaluation results are presented.

Colorectal cancer-screening tests and associated health behaviors.

BACKGROUND: Studies have shown that screening reduces colorectal cancer mortality. We analyzed national survey data to determine rates of use of fecal occult blood testing (FOBT) and sigmoidoscopy, and to determine if these rates differ by demographic factors and other health behaviors. METHODS: A total of 52,754 respondents aged >or=50 years were questioned in the 1997 Behavioral Risk Factor Surveillance System (BRFSS) survey (a random-digit-dialing telephone survey of the non-institutionalized U.S. population) about their use of FOBT and sigmoidoscopy. RESULTS: The age-adjusted proportion of respondents who reported having had a colorectal cancer screening test during the recommended time interval (past year for FOBT and past 5 years for sigmoidoscopy) was 19.8% for FOBT, 30.5% for sigmoidoscopy, and 41.1% for either FOBT or sigmoidoscopy. Rates of use of colorectal cancer screening tests were higher for those who had other screening tests (mammography, Papanicolaou smear, and cholesterol check). There were also differences in rates of use of colorectal cancer screening tests according to other health behaviors (smoking, seat belt use, fruit and vegetable intake, and physical activity) and several demographic factors. However, none of the subgroups that we examined reported a rate of FOBT use above 29% within the past year or a rate of sigmoidoscopy use above 41% within the past 5 years. CONCLUSIONS: While rates of use of FOBT and sigmoidoscopy were higher among people who practiced other healthy behaviors, rates of use were still quite low in all subgroups. There is a need for increased awareness of the importance of colorectal cancer screening.