Colonoscopy Screening in the US 2026
Colonoscopy screening remains one of the most powerful tools in the fight against colorectal cancer in the United States. As of 2026, federal health agencies including the Centers for Disease Control and Prevention (CDC) and the National Cancer Institute (NCI) continue to track and report robust data on how well Americans are complying with recommended screening guidelines. The U.S. Preventive Services Task Force (USPSTF) updated its guidance in May 2021, lowering the recommended screening start age from 50 to 45 years, a shift that has since reshaped the national landscape of colorectal cancer prevention and dramatically expanded the pool of screening-eligible adults. With an estimated 154,270 new colorectal cancer cases projected for 2025 — and rising incidence rates among younger adults — the urgency behind colonoscopy screening in the US has never been more pronounced.
Despite meaningful progress over the past two decades, significant gaps remain. According to the most recent National Health Interview Survey (NHIS) data compiled by the NCI’s Cancer Trends Progress Report (updated April 2025), 72.6% of US adults aged 50 to 75 were up to date with colorectal cancer screening as of 2023. The national goal, set by the USPSTF and echoed by the American Cancer Society National Colorectal Cancer Roundtable, is to achieve an 80% screening rate among all eligible adults aged 45 and older. Achieving this milestone — combined with advances in colonoscopy quality metrics and broader insurance coverage expansions — forms the backbone of the US strategy to reduce colorectal cancer incidence and mortality well into 2026 and beyond.
Interesting Facts: Colonoscopy Screening in the US 2026
| Fact | Detail |
|---|---|
| Screening Start Age (USPSTF, 2021) | Lowered from 50 to 45 years for average-risk adults |
| National Colonoscopy Frequency | Every 10 years for average-risk adults (USPSTF) |
| High-Risk Medicare Coverage | Colonoscopy covered every 24 months (Medicare.gov) |
| Average-Risk Medicare Coverage | Colonoscopy covered every 120 months / 10 years (Medicare.gov) |
| Colorectal Cancer Rank | 4th most common cancer in US men and women (CDC) |
| 2025 New CRC Cases (Projected) | 154,270 (NCI SEER / American Cancer Society) |
| 2025 Projected CRC Deaths | 52,900 (NCI SEER / American Cancer Society) |
| 2026 New Colon Cancer Cases (ACS) | ~108,860 colon + 49,990 rectal = 158,850 total (ACS) |
| 1 in 24 | Lifetime risk of colorectal cancer for US adults (NCI SEER) |
| Colonoscopy Market Size (2024) | $4.95 Billion (US Colon Screening Market) |
| CRC Incidence Decline (older adults) | Dropped over 30% in 15 years among adults 50+ (ACS/NCCRT) |
| Rising Incidence in Under-50s | Rates rising by 2.9% per year (2013–2022) among under-50s (ACS) |
| 5-Year Survival (Localized Stage) | 91.5% when detected at localized stage (NCI SEER) |
| 5-Year Survival (Distant Stage) | 14% for advanced-stage diagnosis (NCI SEER) |
| Adenoma Detection Rate (ADR) Improvement | ADR increased from 58.5% to 66.8% (2024 quality initiative, PMC) |
| CRC Proportion in Under-55s | Rose from 11% in 1995 to 20% in 2019 (NCI SEER) |
| CTC/Virtual Colonoscopy (Medicare) | Now covered under Medicare starting 2025 (CMS) |
Source: CDC (cdc.gov), NCI SEER (seer.cancer.gov), Medicare.gov (medicare.gov), American Cancer Society (cancer.org), NCI Cancer Trends Progress Report (progressreport.cancer.gov), April 2025
The table above captures the most striking realities of colonoscopy screening in the US in 2026. The single most headline-grabbing fact is the soaring rate of colorectal cancer among younger Americans — a 2.9% annual rise in under-50 cases that directly drove the USPSTF’s decision to lower the recommended screening age to 45. At the same time, the survival disparity between localized (91.5%) and distant-stage diagnosis (14%) makes a powerful case for why catching colorectal cancer early through colonoscopy is, quite literally, a life-or-death matter. The US colon screening market, valued at $4.95 billion in 2024, reflects both the scale of the public health challenge and the substantial economic infrastructure built around it.
What is equally compelling is the 30% drop in colorectal cancer incidence and mortality among adults 50 and older over the past 15 years — a decline directly attributable to increased colonoscopy and other CRC screening uptake. The 2024 quality improvements in colonoscopy practice, where the Adenoma Detection Rate jumped from 58.5% to 66.8% under updated 2024 guidelines, are a concrete signal that procedural quality continues to improve alongside access. These facts together illustrate both the success and the ongoing urgency of colonoscopy screening in the US.
Overall Colonoscopy & CRC Screening Rates in the US 2026
| Metric | Rate / Figure | Year of Data | Source |
|---|---|---|---|
| Adults 50–75 up-to-date with any CRC screening | 72.6% | 2023 | NCI Cancer Trends Progress Report |
| Adults 45+ up-to-date with any CRC screening | 65% | 2023 | ACS/NHIS via NCCRT |
| Adults 45+ screened (2021 baseline) | 59% | 2021 | ACS/NHIS via NCCRT |
| Healthy People 2030 Target | 74.4% | Target | HHS / NCI |
| National Goal (NCCRT) | 80% | Goal | ACS/NCCRT |
| FQHC Patients 45–75 screened (2024) | 3,617,246 total | 2024 | HRSA Uniform Data System |
| FQHC Patients screened (2023) | 3,306,873 total | 2023 | HRSA Uniform Data System |
| CRC Screening Rate (all ages, overall claim) | ~58% | 2023 | ASCO Symposium Data |
| Sigmoidoscopy or Colonoscopy use (50–75) | 62.8% | 2023 | NCI Cancer Trends Progress Report |
| Fecal DNA Test use (50–75) | 11.1% | 2023 | NCI Cancer Trends Progress Report |
Source: NCI Cancer Trends Progress Report (progressreport.cancer.gov, April 2025); ACS National Colorectal Cancer Roundtable (nccrt.org); HRSA Uniform Data System (hrsa.gov); ASCO 2025 GI Cancers Symposium
The overall colonoscopy and CRC screening rate in the US as of the most recent verified federal data sits at 72.6% for adults aged 50 to 75, according to the NCI Cancer Trends Progress Report released in April 2025. This figure, drawn from the National Health Interview Survey, represents a sustained upward trend — up from 59% in 2021 to 65% in 2023 when looking at the broader eligible population aged 45 and older. The Federally Qualified Health Center network alone served over 3.6 million patients for CRC screening in 2024, up from 3.3 million in 2023, showing meaningful real-world progress in reaching underserved communities. Still, the national goal of 80% — set by the American Cancer Society National Colorectal Cancer Roundtable — remains out of reach for 2026, and the Healthy People 2030 target of 74.4% for adults 50–75 is only narrowly within grasp.
Within the screening method breakdown, colonoscopy and sigmoidoscopy combined account for 62.8% of all screening among adults 50–75, making visualization tests the dominant modality. The fecal DNA test has emerged as a meaningful complement, accounting for 11.1% of screening in 2023, up substantially from near-zero a decade ago. This dual-track growth — more colonoscopies and more non-invasive alternatives — is the mechanism driving the overall screening rate upward. However, the gap between the current 72.6% rate and the 80% goal still represents tens of millions of Americans who remain unscreened or behind on their screening schedule.
Colonoscopy Screening Rates by Sex in the US 2026
| Sex | Screening Rate (2023) | 95% Confidence Interval | Source |
|---|---|---|---|
| Both Sexes (Combined) | 72.6% | 71.6% – 73.7% | NCI Cancer Trends Progress Report |
| Male | 71.3% | 69.9% – 72.7% | NCI Cancer Trends Progress Report |
| Female | 73.9% | 72.6% – 75.2% | NCI Cancer Trends Progress Report |
Source: NCI Cancer Trends Progress Report, National Health Interview Survey 2023 data, published April 2025 (progressreport.cancer.gov)
The sex-based breakdown of colonoscopy and CRC screening rates in the US shows a modest but consistent pattern: women (73.9%) are more likely than men (71.3%) to be up to date with colorectal cancer screening. This 2.6 percentage point gap has been a persistent trend documented across multiple survey years in the National Health Interview Survey. Women, on average, have historically demonstrated higher rates of preventive healthcare engagement, including cancer screenings, which is reflected in these federal figures. Notably, however, men face a higher absolute colorectal cancer incidence and mortality burden, making the lower screening rate among males a disproportionate public health risk.
The public health implication is direct: targeted interventions focused on male screening compliance — particularly among men aged 45 to 54, who are newly eligible under the 2021 USPSTF guidelines — could yield significant reductions in colonoscopy screening gaps in the US by 2026. Both rates remain below the 80% national goal, making the gender gap a secondary concern compared to the overarching shortfall that applies to all adults regardless of sex.
Colonoscopy Screening Rates by Race/Ethnicity in the US 2026
| Race / Ethnicity | Screening Rate (2023) | 95% Confidence Interval | Source |
|---|---|---|---|
| All Races/Ethnicities | 72.6% | 71.6% – 73.7% | NCI Cancer Trends Progress Report |
| Non-Hispanic White | 75.3% | 74.2% – 76.4% | NCI Cancer Trends Progress Report |
| Non-Hispanic Black | 72.5% | 69.5% – 75.2% | NCI Cancer Trends Progress Report |
| Hispanic | 62.9% | 59.6% – 66.1% | NCI Cancer Trends Progress Report |
| Non-Hispanic White (BRFSS, 2023) | 80.1% | — | BRFSS / Digestive Diseases and Sciences |
| American Indian/Alaska Native (BRFSS, 2023) | 48.65% | — | BRFSS / Digestive Diseases and Sciences |
| Uninsured Adults (BRFSS, 2023) | 33.02% | — | BRFSS / Digestive Diseases and Sciences |
| Insured Adults (BRFSS, 2023) | 78.13% | — | BRFSS / Digestive Diseases and Sciences |
| Black Americans vs. White: Mortality Risk | 35% more likely to die from CRC | — | American Cancer Society |
Source: NCI Cancer Trends Progress Report (progressreport.cancer.gov, April 2025); BRFSS data via Digestive Diseases and Sciences, 2025; American Cancer Society (cancer.org)
The racial and ethnic breakdown of colonoscopy screening rates in the US reveals some of the most troubling and persistent public health inequities in the entire cancer control landscape. Non-Hispanic White adults have the highest screening rates at 75.3% (NHIS) and as high as 80.1% under BRFSS methodology. Meanwhile, Hispanic adults lag significantly at 62.9% — a gap of over 12 percentage points compared to Non-Hispanic Whites under the same NHIS survey. Most striking is the American Indian and Alaska Native population, where the BRFSS-based screening rate stood at just 48.65% in 2023 — the lowest of any racial group and well under half the national 80% goal.
The consequences of these disparities are real and measurable. Black Americans are 35% more likely to die from colorectal cancer and 15% more likely to develop it compared to Non-Hispanic White adults, according to the American Cancer Society. The insurance dimension compounds the racial disparities — uninsured adults of all races had a screening rate of just 33.02%, compared to 78.13% among insured adults, a staggering gap that underscores how access to coverage remains one of the most powerful determinants of colonoscopy screening compliance in the US in 2026.
Colonoscopy Screening Rates by Income & Education in the US 2026
| Demographic Category | Screening Rate (2023) | 95% Confidence Interval | Source |
|---|---|---|---|
| Below 200% Federal Poverty Level | 63.3% | 61.1% – 65.4% | NCI Cancer Trends Progress Report |
| At or Above 200% Federal Poverty Level | 75.7% | 74.6% – 76.8% | NCI Cancer Trends Progress Report |
| Less Than High School Education | 58.8% | 55.0% – 62.5% | NCI Cancer Trends Progress Report |
| High School Education | 67.1% | 65.2% – 69.1% | NCI Cancer Trends Progress Report |
| Greater Than High School Education | 77.7% | 76.6% – 78.8% | NCI Cancer Trends Progress Report |
Source: NCI Cancer Trends Progress Report, National Health Interview Survey 2023 data, published April 2025 (progressreport.cancer.gov)
Income and education levels show a direct and measurable correlation with colonoscopy screening compliance in the US. Adults living below 200% of the federal poverty level had a screening rate of just 63.3%, compared to 75.7% for those at or above that threshold — a 12.4 percentage point gap driven by financial access barriers, lack of paid time off, transportation challenges, and inequitable healthcare infrastructure. The colonoscopy cost for uninsured or underinsured individuals, which can range from $1,000 to $5,000 out of pocket, makes colonoscopy an economically inaccessible procedure for lower-income Americans without coverage.
The education gradient is equally pronounced. Adults without a high school diploma had a colonoscopy and CRC screening rate of just 58.8%, while those with more than a high school education reached 77.7% — approaching the national 80% goal and nearly 19 percentage points higher than the least-educated group. Education levels correlate strongly with health literacy, understanding of screening guidelines, ability to navigate insurance systems, and likelihood of receiving a clinician recommendation — which the National Health Interview Survey has identified as one of the most powerful predictors of screening uptake in the US.
Colonoscopy Screening Among Younger Adults (45–49) in the US 2026
| Metric | Figure | Year | Source |
|---|---|---|---|
| Adults 45–49 never screened (2022 baseline) | ~2 in 3 (approx. 66%) | 2022 | CDC / Prev Chronic Dis, 2025 |
| Adults 45+ up-to-date (2021) | 59% | 2021 | NHIS / NCCRT |
| Adults 45+ up-to-date (2023) | 65% | 2023 | NHIS / NCCRT |
| Colonoscopies performed (45–49 vs 50–54), any adenoma | 35.4% vs 40.8% | 2021–2024 | JAMA, June 2025 (Kaiser Permanente) |
| CRC incidence rise in under-50s (2013–2022) | +2.9% per year | 2013–2022 | American Cancer Society |
| CRC incidence rise in adults 50–64 | +0.4% per year | 2013–2022 | American Cancer Society |
| CRC cases in under-50s (2023) | ~19,550 new cases | 2023 | ACS / NCI |
| CRC deaths in under-50s (2023) | ~3,750 deaths | 2023 | ACS / NCI |
| CRC proportion in under-55s | Rose from 11% (1995) to 20% (2019) | 1995–2019 | NCI SEER |
Source: CDC Preventing Chronic Disease (pcd22.250175, 2025); JAMA June 2025 (PMC12131172); American Cancer Society Key Statistics (cancer.org, updated January 2026); NCI SEER (seer.cancer.gov)
The colonoscopy screening gap among adults aged 45 to 49 is one of the most urgent challenges in US cancer prevention entering 2026. According to CDC BRFSS-based research published in 2025, approximately 2 in 3 newly eligible adults aged 45 to 49 had never been screened for colorectal cancer as of the 2022 baseline — precisely the age group that became eligible following the 2021 USPSTF guideline update. This is a staggering under-screening rate for a group whose cancer risk is rising faster than any other adult population segment in the United States. Early colonoscopy data in this group, from a major Kaiser Permanente Northern California study published in JAMA in June 2025, found that 35.4% of adults aged 45–49 had at least one adenoma detected at screening colonoscopy — compared to 40.8% among 50–54 year olds, confirming meaningful cancer risk in this younger cohort.
The alarming trend driving this clinical urgency is the 2.9% annual rise in colorectal cancer incidence among adults under 50 — a figure that has made colorectal cancer the deadliest cancer in men aged 20–49 and the second deadliest among young women in that same age group. The proportion of CRC cases occurring in adults under 55 has nearly doubled from 11% in 1995 to 20% in 2019, and an estimated 19,550 new CRC cases and 3,750 deaths occurred in under-50 Americans in 2023 alone. Expanding colonoscopy access, awareness, and clinical recommendations to this younger eligible population is among the most pressing colonoscopy screening priorities in the US for 2026.
Colorectal Cancer Incidence, Mortality & Survival in the US 2026
| Metric | Figure | Year / Period | Source |
|---|---|---|---|
| New CRC cases (2025, projected) | 154,270 | 2025 | NCI SEER / ACS |
| CRC deaths (2025, projected) | 52,900 | 2025 | NCI SEER / ACS |
| New colon cancer cases (2026, ACS estimate) | 108,860 | 2026 | ACS (cancer.org, Jan 2026) |
| New rectal cancer cases (2026, ACS estimate) | 49,990 | 2026 | ACS (cancer.org, Jan 2026) |
| CRC rate — new cases per 100,000 | 37.1 per 100,000 | 2018–2022 | NCI SEER |
| CRC death rate per 100,000 | 12.9 per 100,000 | 2019–2023 | NCI SEER |
| People living with CRC (2022) | 1,416,499 | 2022 | NCI SEER |
| 5-year survival — localized stage | 91.5% | 2015–2021 | NCI SEER |
| 5-year survival — distant stage | 14% | 2015–2021 | NCI SEER |
| % diagnosed at localized stage | 34.2% | 2015–2021 | NCI SEER |
| CRC incidence decline (avg. annual rate) | –0.7% per year | 2013–2022 | NCI SEER |
| CRC mortality decline (avg. annual rate) | –1.3% per year | 2014–2023 | NCI SEER |
| Death rate decline in older adults | ~1.5% per year | Past decade | ACS |
| Death rate rise in under-55s | ~1% per year | Since mid-2000s | ACS |
Source: NCI SEER Cancer Stat Facts – Colorectal Cancer (seer.cancer.gov); American Cancer Society Key Statistics (cancer.org, updated January 14, 2026)
The overall colorectal cancer incidence and mortality landscape in the US is one of measured but unequal progress. On the positive side, age-adjusted CRC incidence has been falling at an average rate of 0.7% per year from 2013 to 2022, and mortality has declined even faster at 1.3% per year from 2014 to 2023, largely credited to increased colonoscopy screening uptake and the removal of precancerous polyps before they develop into cancer. For adults 50 and older, this progress has been substantial — death rates have dropped approximately 1.5% per year over the past decade. The 5-year survival rate for localized colorectal cancer stands at 91.5% — a number that powerfully illustrates why early detection through colonoscopy is so impactful.
The darker side of this data is the alarming reverse trend among younger Americans. In adults under 55, CRC death rates have been rising approximately 1% per year since the mid-2000s, and for those under 50, incidence climbs at 2.9% annually. Yet only 34.2% of all CRC cases are diagnosed at the localized stage, where survival is near 91%. The majority are diagnosed at regional or distant stages — where 5-year survival plummets to 14% for the most advanced presentations. The ACS projects 158,850 total new colorectal cancer cases in 2026 (108,860 colon + 49,990 rectal), making the case for expanded and earlier colonoscopy screening in the US as clear and evidence-based as any in oncology.
Colonoscopy Coverage: Insurance, Medicare & Federal Policy in the US 2026
| Coverage Category | Key Detail | Source |
|---|---|---|
| ACA Private Insurance Requirement | Covers all USPSTF-recommended CRC screening — $0 out-of-pocket | ACA / HHS |
| Medicare Part B Coverage (average risk) | Covered every 120 months (10 years) — $0 cost if provider accepts assignment | Medicare.gov |
| Medicare Part B Coverage (high risk) | Covered every 24 months — $0 cost if provider accepts assignment | Medicare.gov |
| Medicare — Polyp Removal Copay | 15% co-insurance if polyp removed during screening | Medicare.gov |
| Medicare Part B Deductible (2025) | $257 (not required before colonoscopy coverage applies) | Medicare.gov |
| CT Colonography (Medicare) | Covered under Medicare starting 2025 | CMS |
| Medicaid Coverage | Varies by state; no uniform federal mandate for all states | ACS |
| Colonoscopy cost (uninsured) | $1,000 – $5,000 out-of-pocket | ACS / HHS |
| mt-sDNA test (e.g., Cologuard) | ~94% of patients have $0 out-of-pocket via Medicare/private insurance | Exact Sciences / CMS |
| US Colon Screening Market (2024) | $4.95 Billion | Market Research, 2025 |
| Projected Market Size (2033) | $6.56 Billion (CAGR 3.18%) | Market Research, 2025 |
Source: Medicare.gov (medicare.gov/coverage/colonoscopies); ACA (HHS); American Cancer Society Insurance Coverage page (cancer.org); CMS.gov; Market Research Report, GlobeNewswire, November 2025
Insurance and federal policy coverage for colonoscopy screening in the US has been substantially expanded since the passage of the Affordable Care Act. Under the ACA, private insurers are required to cover all USPSTF-recommended colorectal cancer screening tests — including colonoscopy — with absolutely no out-of-pocket cost to the patient, such as co-pays or deductibles. Medicare Part B covers colonoscopy every 10 years for average-risk adults and every 24 months for high-risk individuals at zero cost when the provider accepts Medicare assignment. A critical 2025 development saw CT colonography (virtual colonoscopy) added to Medicare coverage, expanding options for patients who may be unable or unwilling to undergo traditional optical colonoscopy — a move expected to reduce income-based and access-related disparities in CRC screening participation.
Still, coverage gaps persist for uninsured and underinsured Americans. Without insurance, a colonoscopy can cost between $1,000 and $5,000 — a prohibitive barrier for lower-income adults. Medicaid coverage for colonoscopy screening varies dramatically by state, with no federal requirement that all state Medicaid programs cover colorectal cancer screening for asymptomatic adults. This patchwork coverage structure is a primary driver of the 33% screening rate documented among uninsured adults compared to 78% among insured individuals. The US colon screening market, valued at $4.95 billion in 2024 and projected to reach $6.56 billion by 2033 at a CAGR of 3.18%, reflects the scale of both commercial investment and public health infrastructure surrounding colonoscopy screening — a market driven by policy mandates, population aging, and growing awareness of early detection’s life-saving value.
Historical Trends in Colonoscopy Screening Rates in the US 2026
| Year | CRC Screening Rate (Adults 50–75) | Method / Source |
|---|---|---|
| 1999 | 41.5% | BRFSS (CDC WONDER) |
| 2005 | 47.7% | NHIS |
| 2008 (pre-ACA) | ~53% | BRFSS |
| 2010 | 65.4% | BRFSS |
| 2012 | Baseline for 9.3M additional adults screened by 2018 | BRFSS / NCCRT |
| 2018 | +9.3 million adults screened vs. 2012 | BRFSS / NCCRT |
| 2019–2020 | COVID-19 disruption — screening declined | BRFSS / NCI |
| 2021 | 59% (for adults 45+, new expanded guideline group) | NHIS / NCCRT |
| 2021 | 69.9% (for adults 50–75, NHIS trend) | NHIS (Ebner et al., 2024) |
| 2023 | 72.6% (adults 50–75) | NHIS / NCI |
| 2023 | 65% (adults 45+) | NHIS / NCCRT |
| 2023 | 76.3% (overall, BRFSS methodology) | BRFSS / Digestive Diseases and Sciences |
Source: CDC BRFSS (cdc.gov/brfss); NCI Cancer Trends Progress Report (progressreport.cancer.gov, April 2025); ACS National Colorectal Cancer Roundtable (nccrt.org); Digestive Diseases and Sciences, 2025; NHIS 2019–2023
The historical arc of colonoscopy and CRC screening rates in the US is one of clear, sustained progress interrupted only by the COVID-19 pandemic. Starting from a low of just 41.5% in 1999, CRC screening rates among adults aged 50–75 climbed steadily over two decades, reaching 65.4% by 2010 following a major expansion in colonoscopy availability and public awareness campaigns. Between 2012 and 2018, an additional 9.3 million adults were brought into regular CRC screening — a number that represents one of the largest single-period expansions in cancer screening coverage in US history. By 2021, NHIS data captured a rate of 69.9% among adults 50–75, but the COVID-19 pandemic caused visible disruptions to screening schedules, creating a backlog of unscreened or delayed patients that public health authorities are still working to address.
The shift to 72.6% by 2023 under NCI tracking represents a meaningful post-pandemic recovery and upward momentum, but the renaming of the eligible population from 50–75 to 45–75 under the updated USPSTF guidelines has effectively reset the starting line. When the broader 45–75 age group is measured, the rate stands at 65% — a figure that emphasizes how much ground remains to cover to reach the 80% national goal as the US enters 2026. The trajectory is encouraging, but maintaining it will require sustained investment in clinician recommendation programs, insurance outreach, and targeted community campaigns for the populations most lagging behind.
Disclaimer: The data research report we present here is based on information found from various sources. We are not liable for any financial loss, errors, or damages of any kind that may result from the use of the information herein. We acknowledge that though we try to report accurately, we cannot verify the absolute facts of everything that has been represented.
