Cancer Deaths - Colorectal Cancer

Why Is This Important?

Of cancers that affect both men and women, colorectal cancer is the second leading cause of new cancer cases and cancer deaths in New Mexico. Colorectal cancer screening can significantly reduce colorectal cancer mortality through early detection, when treatment tends to be most effective. Colorectal cancer screening can also actually prevent colorectal cancer by detecting and removing polyps in the colon or rectum that could become cancers in the future.

Definition

Colorectal Cancer Deaths per 100,000 population in New Mexico Colorectal cancer mortality is defined as malignant neoplasm of the colon, rectosigmoid junction, or rectum (ICD10: C18-C20, C26).

Data Sources

• New Mexico Death Data: Bureau of Vital Records and Health Statistics (BVRHS), Epidemiology and Response Division, New Mexico Department of Health.
  (https://www.nmhealth.org/about/erd/bvrhs/vrp/)
• Centers for Disease Control and Prevention, National Center for Health Statistics, CDC WONDER Online Database
  (http://wonder.cdc.gov)

How the Measure is Calculated

How Are We Doing?

The rate of death from colorectal cancer among New Mexicans has declined over the past two decades. Of note, the NM colorectal cancer death rate has been below the Healthy People 2020 goal of 14.5 per 100,000 population since 2012.

How Do We Compare With the U.S.?

Historically, New Mexico has had a lower colorectal cancer mortality rate than the U.S. However, over the past two decades the rate of death from colorectal cancer has decreased more rapidly in the U.S. as a whole compared to New Mexico, and the colorectal cancer mortality rate in New Mexico is now very similar to the U.S. colorectal cancer mortality rate.

What Is Being Done?

A goal of the New Mexico Department of Health Comprehensive Cancer Control Program is to reduce deaths from colorectal cancer in New Mexico by promoting evidence-based public health initiatives designed to increase the overall rate of New Mexicans ages 50-75 years who are appropriately screened for colorectal cancer. To this end, the Comprehensive Cancer Program supports health care providers and health systems across the state in using patient reminders, risk assessment tools, reducing structural barriers (e.g., expanding clinic hours), provider reminder and recall systems, and provider assessment and feedback on performance. All of these activities have been shown to increase colorectal cancer screening rates, and are recommended by The Guide to Community Preventive Services, a collection of evidence-based findings of the Community Preventive Services Task Force, established by the U.S. Department of Health and Human Services.

Evidence-based Practices

In June 2016, the U.S. Preventive Services Task Force (USPSTF) released its updated colorectal cancer screening recommendation, which continues to recommend screening average risk adults ages 50-75 years in order to reduce colorectal cancer deaths. The updated recommendation addressed some of the same screening methods endorsed by the previous (2008) USPSTF recommendation, including annual testing with a take-home kit using either a high-sensitivity guaiac-based fecal occult blood test (FOBT) or fecal immunochemical test (FIT), or having a colonoscopy every ten years. The updated recommendation also reviewed evidence for methods of screening not previously endorsed, including flexible sigmoidoscopy every ten years plus annual FIT; CT colonography or flexible sigmoidoscopy every five years; or testing every one or three years with a FIT-DNA test. Of note, the USPSTF found no head-to-head studies demonstrating that any of these screening strategies are more effective than others, although they have varying levels of evidence supporting their effectiveness, as well as different strengths and limitations. Unlike its previous recommendations for colorectal cancer screening, the USPSTF's updated recommendation does not endorse a specific list of screening options. Rather, it notes that the risks and benefits of these screening methods vary considerably in terms of frequency, cost, availability, single-test accuracy, convenience, and potential serious complication - leaving it up to clinicians and patients to use this information to choose a screening method. A modeling study included in the updated 2016 U.S. Preventive Services Task Force recommendations predicted that using any one of the following four screening strategies will have a comparable balance of life-years gained, potential harmful complications, and screening burden, assuming 100% adherence: annual FIT; flexible sigmoidoscopy every ten years plus annual FIT; CT colonography every five years, or colonoscopy every ten years.

Other Objectives

New Mexico Cancer Plan 2012-2017 Objectives: By 2017, increase by 15% the proportion of NM men and women ages 50 through 75 who are up-to-date with colorectal cancer screening, from a 2010 baseline of 59.8% to 68.8%.

Available Services

The New Mexico Department of Health Comprehensive Cancer Program offers cancer education, information and resources to the public and healthcare providers. Contact the Program at: New Mexico Department of Health - Comprehensive Cancer Program 5301 Central Ave. NE, Suite 800 Albuquerque, NM 87108 Phone Number: 505-841-5847 Website: http://archive.cancernm.org/ccp/

More Resources

New Mexico Department of Health Comprehensive Cancer Program (http://archive.cancernm.org/ccp/) U.S. Preventive Services Task Force Recommendations website (https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/colorectal-cancer-screening2?ds=1&s=colorectal cancer) Centers for Disease Control and Prevention (https://www.cdc.gov/cancer/colorectal/basic_info/risk_factors.htm) Centers for Disease Control and Prevention, National Center for Health Statistics, CDC WONDER Online Database (http://wonder.cdc.gov/ucd-icd10.html) The Community Guide to Preventive Services (https://www.thecommunityguide.org/findings/cancer-screening-multicomponent-interventions-colorectal-cancer)