Among adults aged 45 and older, just 65% are currently with any recommended colorectal cancer screening test, according to a 2026 report from the American Cancer Society.
Here are 10 numbers to know about the CRC screening gap:
1. Young adults are barely screening at all. Only 37% of adults aged 45–49 are up to date with screening, and even the 50–54 group sits at just 55%. These are also the two age groups where CRC incidence is rising fastest.
2. The uninsured are largely unscreened. Only 25% of uninsured adults are up to date with CRC screening, compared to 68% of those with private insurance and 78% of Medicare recipients aged 65+.
3. Hispanic adults have the lowest screening rates of any racial/ethnic group. Just 56% of Hispanic adults are up to date, compared to 67% of White adults and 66% of Black adults. Recent immigrants fare even worse, with only 43% of adults who have lived in the U.S. for less than 10 years screened.
4. Education and income create a steep screening gradient. Only 51% of adults without a high school diploma are up to date, vs. 73% of college graduates. Similarly, just 51% of adults below the federal poverty level are screened, vs. 68% of those at 200%+ of the poverty level.
5. State screening rates vary by nearly 20 percentage points. Screening prevalence in 2024 ranges from as low as 59–63% in New Mexico, Wyoming, Nevada, and Alaska to as high as 76–78% in Massachusetts, Connecticut, and Rhode Island.
6. Colonoscopy follow-up after a positive stool test is failing. Among nearly 33,000 individuals who had a positive stool test, only 53% received a follow-up colonoscopy within one year — a critical gap since timely follow-up is essential for stool testing to be effective.
7. Screening before 50 works, but almost no one was doing it until recently. Studies show screening adults aged 45–49 reduces CRC incidence by 21–50% and mortality by 39%. Yet uptake in this group only rose from 20% to 37% between 2019 and 2023.
8. Stool testing is underused but growing. Colonoscopy dominates US screening (56% of adults report a recent colonoscopy), while stool testing sits at just 16% overall. However, stool test uptake grew from 6.6% in 2019 to 10.1% in 2021, helping offset pandemic-related colonoscopy declines.
9. Alaska Native people have the highest CRC burden in the world, and some of the worst screening access Alaska Native individuals have CRC incidence rates more than twice those of White individuals (80.9 vs. 35.2 per 100,000) and mortality rates nearly two and a half times higher (31.5 vs. 12.9 per 100,000) — the highest rates recorded anywhere globally. Statewide, only 63% of Alaskans are up to date with screening, among the lowest in the country, though targeted initiatives within the Alaska Tribal Health System have begun to improve uptake in recent years.10. Screening has averted nearly 1 million deaths, but progress is stalling. An estimated 940,000 CRC deaths were averted between 1975 and 2020, with prevention and screening accounting for 79% of that total. Yet overall CRC mortality, which declined roughly 2% annually from 2005 to 2020, has now stalled, sitting essentially flat from 2020 to 2023, largely because gains in older adults are being offset by rising deaths in younger age groups.
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