Updated: February 2023

Author: Cancer Program, Vermont Department of Health

Colorectal cancer is the third most common cancer diagnosed and the second leading cause of cancer death in men and women in Vermont. Incidence and mortality rates for colorectal cancer declined from 2000 to 2019 both in Vermont and nationally.

The prognosis and treatment of colorectal cancer is largely determined by what stage the cancer is diagnosed at. Nationally, 90 percent of men and women whose colorectal cancer is diagnosed at a localized (early) stage survive their cancer for at least five years, compared to 12 percent of those diagnosed with distant (late) stage colorectal cancer.

Regular colorectal cancer screening can, in many cases, prevent colorectal cancer altogether by finding and removing polyps before they develop into cancer. Screening also provides an opportunity to find and treat cancers early, resulting in a better prognosis.  At the creation of Healthy Vermonters and this indicator, the United States Preventive Services Task Force (USPSTF) recommended colorectal cancer screening for all adults ages 50-75. In 2016 and then again in 2021, USPSTF updated its screening recommendations for colorectal cancer.  It now recommends beginning screening at age 45 years and continuing until age 75 years. Testing options for average-risk adults include: (1) colonoscopy every 10 years; or (2) stool test annually; or (3) sigmoidoscopy every five years; or (4) flexible sigmoidoscopy every 10 years plus FIT every year; or (5) CT colonography every 5 years.

In Vermont, colorectal cancer screening rates remained steady from 2008 to 2018, with no significant, measurable change in the percentage of Vermont adults ages 50-75 that have received screening. In 2020 there was a methodology change such that more types of screening options were included in the possible response options. The screening rate for 2020 therefore is not comparable to previous years. 

Cancer is a leading cause of death in Vermont and colorectal cancer is the second leading cause of cancer death in Vermont men and women. This measure is important because with screening, colorectal cancer can be found early and even prevented, which would result in a significant reduction in the cancer burden in Vermont.

This indicator is part of Healthy Vermonters 2020 (the State Health Assessment) that documents the health status of Vermonters at the start of the decade and the population health indicators and goals that guided the work of public health through 2020.

This indicator is also aligned with the Healthy People 2020 developmental objective C-16 which is to “increase the proportion of adults who receive a colorectal cancer screening based on the most recent guidelines” (http://www.healthypeople.gov/2020/topics-objectives/topic/cancer/objectives).

It was also included as an objective in the 2020 Vermont State Cancer Plan as well as the current 2025 Vermont Cancer Plan.

Vermonters Taking Action Against Cancer (VTAAC)

Vermont Department of Health Offices of Local Health

American Cancer Society

Centers for Disease Control and Prevention

University of Vermont Cancer Center

American Lung Association

The number of new cancer cases can be reduced, and many cancer deaths can be prevented through a comprehensive strategy:

• Prevention of cancer through promotion of healthy lifestyle behaviors (tobacco prevention, increased physical activity, improved nutrition, sun safety) and vaccinations (such as for human papilloma virus (HPV)).
• Early detection of cancer through screening for breast, cervical, colorectal, skin and lung cancers, to find these diseases at an early stage when treatment works best.
• Effective treatment of cancer to result in better outcomes and decreased mortality.

Within each of these categories there are many proven approaches that decrease cancer incidence and mortality. A comprehensive approach focusing on cancer prevention, early detection and treatment is the most effective way to impact cancer mortality outcomes in Vermont.

The 2025 Vermont Cancer Plan, published by the Vermont Department of Health Comprehensive Cancer Control Program and statewide cancer coalition Vermonters Taking Action Against Cancer (VTAAC), provides a strategic roadmap for reducing the burden of cancer in Vermont. The plan includes measurable objectives as priorities for action in the following areas:

• Health Equity
• Cancer Prevention
• Cancer Early Detection
• Cancer Directed Therapy & Supportive Care
• Survivorship & Advanced Care Planning

Through the Vermont Cancer Plan, the Department of Health focuses and prioritizes the numerous efforts carried out statewide to reduce behaviors that are cancer risk factors, increase early detection of cancers, and provide access to quality cancer treatment for all Vermonters. The combined work of these Departmental Programs and partners influences the overall burden of cancer in Vermont.

Data is updated as it becomes available, and timing may vary by data source.

The method for calculating screening rates was based on 2008 USPSTF recommendations. These calculations include men and women aged 50-75 years who had either a fecal occult blood test (FOBT) within one year; a sigmoidoscopy within 5 years AND a FOBT within 3 years; or a colonoscopy within 10 years.

This indicator is age-adjusted to the 2000 U.S. standard population. In U.S. data, age adjustment is used for comparison of regions with varying age breakdowns. In order to remain consistent with the methods of comparison at a national level, some statistics in Vermont are age adjusted. The estimates were adjusted based on the proportional age breakdowns of the U.S. population in 2000. For more detailed information on age adjustment visit /www.cdc.gov/nchs/data/statnt/statnt20.pdf.

Due to BRFSS weighting methodology changes beginning in 2011, comparisons between data collected in 2011 and later and that from 2010 and earlier should be made with caution. Differences between data from 2011 forward and earlier years may be due to methodological changes, rather than changes in opinion or behavior.