Cancer Screenings - Ages 65-75 in United States

United States

Cancer has been one of the top two leading causes of death in the United States for over 75 years. Cancer screenings may detect cancer early, when treatment is easiest and most effective. Mammography and colorectal cancer screenings have saved many lives and are important methods for preventing breast and colorectal cancer deaths. Both mammography and colorectal screening are cost-effective compared with no screening.

Despite their effectiveness in preventing cancers, mammography and colorectal cancer screening rates remain below national targets, and in the spring of 2020 screening rates declined sharply because of the COVID-19 pandemic. Factors that may affect cancer screening behavior include screening costs, health insurance status, access to health care facilities and sociodemographic differences.

According to America’s Health Rankings analysis, the prevalence of receiving the recommended number of breast and colorectal cancer screenings is higher among:

• Older men compared with older women. 
• White and Black older adults compared with Hispanic, Asian, Hawaiian/Pacific Islander and American Indian/Alaska Native older adults.
• College graduates compared with those with lower levels of education; the prevalence is higher with each increase in education level.
• Older adults with an annual household income of $75,000 or more compared with those with lower incomes.
• Older adults living in metropolitan areas compared with those in non-metropolitan areas.
• Older adults who have served in the U.S. armed forces than those who have not served.
• Older adults without a disability compared with older adults who have difficulties with independent living.

The United States Preventive Services Task Force recommends women older than the age of 40 receive a breast cancer screening mammogram every two years. Current evidence is insufficient to assess if the benefits of mammography outweigh the harms for women age 75 and older. Routine colorectal cancer screening is also recommended for all adults ages 50-75; for adults older than 75, it is an individual choice to be discussed with a doctor. 

The Community Guide assesses evidence-based community-level interventions to increase cancer screening, such as patient reminders and one-on-one education. The Return-to-Screening quality improvement project and clinical study has shown significant increases in cancer screening volume at hospitals recovering from the impact of the COVID-19 pandemic.

The Centers for Disease Control and Prevention recommends interventions that simplify the health care navigation process and expand accessibility and availability of care to address structural barriers. Evidence-based approaches include:

• Reducing paperwork.
• Helping patients schedule appointments.
• Expanding screenings to more locations and extending clinic hours. 
• Offering transportation, child care and translation services.

Healthy People 2030 has several objectives regarding cancer screenings, including: 

• Increasing the proportion of women who get screened for breast cancer.
• Increasing the proportion of adults who get screened for colorectal cancer.

“Cancer Facts & Figures 2021.” Atlanta, GA: American Cancer Society, 2021. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2021/cancer-facts-and-figures-2021.pdf.

Chen, Ronald C., Kevin Haynes, Simo Du, John Barron, and Aaron J. Katz. “Association of Cancer Screening Deficit in the United States With the COVID-19 Pandemic.” JAMA Oncology 7, no. 6 (June 1, 2021): 878. https://doi.org/10.1001/jamaoncol.2021.0884.

Jayasekera, Jinani, and Jeanne S. Mandelblatt. “Systematic Review of the Cost Effectiveness of Breast Cancer Prevention, Screening, and Treatment Interventions.” Journal of Clinical Oncology 38, no. 4 (February 1, 2020): 332–50. https://doi.org/10.1200/JCO.19.01525.

Joung, Rachel Hae-Soo, Timothy W. Mullett, Scott H. Kurtzman, Sarah Shafir, James B. Harris, Katharine A. Yao, Karl Y. Bilimoria, et al. “Evaluation of a National Quality Improvement Collaborative for Improving Cancer Screening.” JAMA Network Open 5, no. 11 (November 16, 2022): e2242354. https://doi.org/10.1001/jamanetworkopen.2022.42354.

Khalili, Farhad, Behzad Najafi, Fariborz Mansour-Ghanaei, Mahmood Yousefi, Hadi Abdollahzad, and Ali Motlagh. “Cost-Effectiveness Analysis of Colorectal Cancer Screening: A Systematic Review.” Risk Management and Healthcare Policy Volume 13 (September 2020): 1499–1512. https://doi.org/10.2147/RMHP.S262171.

Ma, Zhen-Qiang, and Lisa C. Richardson. “Cancer Screening Prevalence and Associated Factors Among US Adults.” Preventing Chronic Disease 19 (April 21, 2022): 220063. https://doi.org/10.5888/pcd19.220063.