BACKGROUND: National colorectal cancer (CRC) screening averages 50% to 60%. We aimed to identify screening prevalence in select Department of Defense (DOD) beneficiaries with equal access to care. METHODS: December 2007 cross-sectional data of patients over 50 years of age included patient demographics, screening modality. and compliance. RESULTS: Of 17,252 patients (52% males mean age 63.2 +/- 8.1 years), 12,229 (71%) were up-to-date with national screening guidelines. Modalities included colonoscopy (83.0%), flexible sigmoidoscopy with fecal occult blood testing (FOBT) (32.2%), and air-contrast barium enema (0.7%). African American or Hispanic background (70% African American, 68% Hispanic vs 73% Caucasian), Younger patients (66.1% <65 years vs 78.6% >65 years), and male gender (69.9% vs 72.1% all P <.001) all had lower rates. Compared to 2005, more patients were Current with guidelines (71% vs 64%) and colonoscopic screening (83% vs 71%). CONCLUSIONS: Although ethnicity-. gender-. and age-related disparities were observed. screening rates are improved in an equal access healthcare system. Published by Elsevier Inc.