Why this matters for Black families
Black Americans have the highest colorectal-cancer incidence and mortality of any racial group in the US: roughly 20% higher incidence and 40% higher mortality than white Americans (ACS, 2024).
The American Cancer Society's 2024 report on Black-American colorectal cancer documents 20% higher incidence and 40% higher mortality than white Americans, plus a disproportionate share of cases diagnosed under age 50. These data drove the USPSTF to lower the screening start age from 50 to 45 in 2021, but the under-45 population still carries disproportionate risk that age-based screening alone cannot address.
Stool-based FIT tests (annual) and Cologuard (every 3 years) are both USPSTF Grade A recommended and cost less than $50 per test. Colonoscopy remains the gold standard; whether a state program pays for the diagnostic colonoscopy after a positive FIT is program-specific, so ask before the test is done.
Who qualifies (federal baseline)
State colorectal screening programs target low-income uninsured and under-insured adults; each sets its own limits:
- Age: screening is recommended starting at age 45-75 (the USPSTF 2021 update lowered the start age to 45); program age bands vary
- Income: commonly up to 250% FPL, but several states use 200% or 300%; check the state page
- Insurance status: uninsured or insured with cost-sharing that blocks screening
State variations: Delaware's Screening for Life is the most famous, open to every uninsured resident regardless of income and credited with eliminating the state's Black-white colorectal mortality gap (Grubbs et al., Am J Public Health 2015). Most other states cap income at 250% FPL and age-limit to 45-75.
The three federal eligibility gates
All 50 states & DC
Alabama
No CDC grantee, see alternatives
Alaska
No CDC grantee, see alternatives
Arizona
No CDC grantee, see alternatives
Arkansas
No CDC grantee, see alternatives
California
No CDC grantee, see alternatives
Colorado
No CDC grantee, see alternatives
Connecticut
No CDC grantee, see alternatives
Delaware
Screening for Life
302-744-1040
Florida
No CDC grantee, see alternatives
Georgia
No CDC grantee, see alternatives
Hawaii
No CDC grantee, see alternatives
Idaho
No CDC grantee, see alternatives
Illinois
No CDC grantee, see alternatives
Indiana
No CDC grantee, see alternatives
Iowa
No CDC grantee, see alternatives
Kansas
No CDC grantee, see alternatives
Kentucky
Kentucky Colon Cancer Screening and Prevention Program (KCCSP)
Louisiana
No CDC grantee, see alternatives
Maine
No CDC grantee, see alternatives
Maryland
No CDC grantee, see alternatives
Massachusetts
No CDC grantee, see alternatives
Michigan
No CDC grantee, see alternatives
Minnesota
Sage Scopes
888-643-2584
Mississippi
No CDC grantee, see alternatives
Missouri
No CDC grantee, see alternatives
Montana
No CDC grantee, see alternatives
Nebraska
No CDC grantee, see alternatives
Nevada
No CDC grantee, see alternatives
New Hampshire
No CDC grantee, see alternatives
New Jersey
NJCEED colorectal screening
800-328-3838
New Mexico
No CDC grantee, see alternatives
New York
Cancer Services Program (CSP)
866-442-2262
North Carolina
No CDC grantee, see alternatives
North Dakota
North Dakota Colorectal Cancer Screening Initiative (Get:Screened)
833-220-2981
Ohio
No CDC grantee, see alternatives
Oklahoma
No CDC grantee, see alternatives
Oregon
No CDC grantee, see alternatives
Pennsylvania
No CDC grantee, see alternatives
Rhode Island
No CDC grantee, see alternatives
South Carolina
Colorectal Cancer Prevention Network (CCPN)
803-777-1231
South Dakota
South Dakota Colorectal Cancer Program (GetScreenedSD)
Tennessee
No CDC grantee, see alternatives
Texas
No CDC grantee, see alternatives
Utah
Huntsman Cancer Institute Screening Voucher Program
801-213-6251
Vermont
No CDC grantee, see alternatives
Virginia
No CDC grantee, see alternatives
Washington
No CDC grantee, see alternatives
West Virginia
No CDC grantee, see alternatives
Wisconsin
No CDC grantee, see alternatives
Wyoming
Wyoming Cancer Program
800-264-1296
District of Columbia
DC Colorectal Cancer Control Program (via WISH)
202-442-5900
Data sources
- CDC CRCCP recipients: cdc.gov/cancer/crccp/recipients
- American Cancer Society Black Colorectal Cancer Report, 2024
- USPSTF Colorectal Cancer Screening Recommendation (2021)
- Grubbs et al., American Journal of Public Health (2015): elimination of Black-white colorectal mortality gap in Delaware
Data refreshed: