Cancer Incidence - 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

New cases of colorectal cancer per 100,000 population in New Mexico Colorectal cancer incidence is defined as new cases of malignant neoplasm of the colon, rectosigmoid junction, or rectum.

Data Sources

• Centers for Disease Control and Prevention, National Center for Health Statistics, CDC WONDER Online Database
  (http://wonder.cdc.gov)
• New Mexico Population Estimates: University of New Mexico, Geospatial and Population Studies (GPS) Program.
  (http://gps.unm.edu/)
• New Mexico Tumor Registry
  (https://nmtrweb.unm.edu/)

How the Measure is Calculated

How Are We Doing?

In New Mexico, the colorectal cancer incidence rate was stable from 1975-2004, but has been decreasing since then. Over the most recent 5-year period (2011-2015), the overall New Mexico colorectal cancer incidence rate of 33.1 new cases per 100,000 population is lower than the Healthy People 2020 goal of 40.0.

How Do We Compare With the U.S.?

Historically, New Mexico has had a lower colorectal cancer incidence rate than the U.S. However, over the past several decades the rate of new cases of colorectal cancer has decreased more rapidly in the U.S. as a whole compared to New Mexico and the overall New Mexico colorectal cancer incidence rate is now more similar to the U.S. colorectal cancer incidence 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

Other relevant HP2020 objectives: C-16: Increase the proportion of adults who receive a colorectal cancer screening based on the most recent guidelines

Available Services

The Department of Health's 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/) United States Preventive Services Task Force (USPSTF) (https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/colorectal-cancer-screening2) Centers for Disease Control and Prevention (CDC) (http://www.cdc.gov/cancer/colorectal/index.htm) National Colorectal Cancer Roundtable (http://nccrt.org/) Surveillance Epidemiology and End Result (SEER) Program (http://seer.cancer.gov/) New Mexico Tumor Registry (NMTR), University of New Mexico Health Sciences Center, School of Medicine (http://nmtrweb.unm.edu/) National Cancer Institute (NCI) (www.cancer.gov) American Cancer Society (ACS) (www.cancer.org) New Mexico Cancer Council (NMCC) (http://www.nmcancercouncil.org/) Albuquerque Cancer Coalition (ACC) (https://acc.nmcca.org/) The National Library of Medicine (NLM) MedlinePlus (www.medlineplus.gov) Commission on Cancer (www.facs.org/quality-programs/cancer) Cancer Control P.L.A.N.E.T. (http://cancercontrolplanet.cancer.gov/) The Guide to Community Preventive Services (http://www.thecommunityguide.org/cancer/index.html) Research-tested Intervetion Programs (RTIPs) (http://rtips.cancer.gov/rtips/index.do)