The Burden of Colorectal Cancer in Arkansas Ronald Brown, MPH Cancer Epidemiologist Arkansas Department of Health

Where is Arkansas when it comes to colorectal cancer? Arkansas averaged 608 deaths per year due to colorectal cancer over the most recent five year period of available data (2010-2014). In 2014, Arkansas ranked 8th in the U.S. for highest age-adjusted mortality rate due to colorectal cancer. Arkansas averaged 1453 new colorectal cancer diagnoses per year over the most recent five year period of available data (2009-2013). Arkansas ranked 7th in the U.S. for highest colorectal cancer incidence rate in the most recent year of available data (2013). Sources: CDC Wonder Underlying Cause of Death and ACCR: http://www.cancer-rates.info/ar/index.php

Mortality Due to Colorectal Cancer

Age-Adjusted Colorectal Cancer Mortality Rates in Arkansas, 2004-2013, Age-Adjusted to the 2000 U.S. Standard Million Population Arkansas Rate: 18.5 per 100,000 Source: CDC Wonder Underlying Cause of Death

Incidence of Colorectal Cancer (New Cases)

Source: ACCR: http://www.cancer-rates.info/ar/index.php

Screening for Colorectal Cancer

Screening Recommendations for Colorectal Cancer The U.S. Preventive Services Task Force (USPSTF) recommends one of the following screening tests and intervals beginning at age 50 years and continuing until age 75 years. High-Sensitivity Fecal Occult Blood Test (FOBT) – Every year Flexible Sigmoidoscopy – Every five years with a mid-interval FOBT every three years Colonoscopy – Every 10 years Source: Final Update Summary: Colorectal Cancer: Screening. U.S. Preventive Services Task Force. July 2015. http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/colorectal-cancer-screening

Importance of Screening In the U.S., the lifetime risk of developing colorectal cancer is 1 in 20. Screening is critical to early diagnosis and survival of colorectal cancer. Healthy People 2020 has set a target of 70.5% of adults age 50 to 75 years receiving one of the recommended screening tests for colorectal cancer. Only an estimated 66.3%* of people in the U.S. age 50 to 75 actually received at least one of the recommended screenings according to 2014 BRFSS data. Sources: Healthy People 2020, http://www.healthypeople.gov/2020/topics-objectives/topic/cancer/objectives & State Cancer Profiles, http://statecancerprofiles.cancer.gov/risk * 95% Confidence Interval = 65.9-66.7

Colorectal Cancer Screening in Arkansas In Arkansas, an estimated 60.7%* of adults age 50 to 75 years received one of the recommended screening tests for colorectal cancer in 2014. This equates to the 6th lowest screening rate in the nation. Source: State Cancer Profiles (Directly Estimated 2014 BRFSS Data) http://statecancerprofiles.cancer.gov/risk * 95% Confidence Interval = 58.0-63.3

Conclusions Historically, colorectal cancer mortality and incidence rates have been declining in Arkansas but are currently above the national average. The most recent year of incidence data shows a slight rate increase from the previous two years, but the overall trend is still decreasing. In Arkansas, males are less likely than females to be adequately screened for colorectal cancer, and black males are less likely than white males to be adequately screened for colorectal cancer. Increasing quality screening rates as recommended by the USPSTF could have the greatest impact on reduction of colorectal cancer mortality rates and associated disparities.

For Additional Information Ronald Brown, MPH Cancer Epidemiologist Arkansas Department of Health 501.280.4830 Ronald.Brown@arkansas.gov