A Stagnant Scene for Cancer Screening

Cancer screening rates in US stagnated or dropped in recent years

(RxWiki News) Public health campaigns and billboards promoting cancer screening abound, but are these efforts working?

Maybe not. A new study from Centers for Disease Control and Prevention (CDC) researchers found that US screening rates for several types of cancer, such as colon, rectal, breast, and cervical cancers either slowed or did not improve in 2013.

"Regular breast, cervical, and colorectal cancer (CRC) screening with timely and appropriate follow-up and treatment reduces deaths from these cancers," wrote the authors of this study, led by Susan A. Sabatino, MD, of the CDC's Division of Cancer Prevention and Control.

Dr. Sabatino and team wanted to compare recent rates of cancer screening to Healthy People 2020 target rates — national health goals set for the year 2020.

To do so, these researchers looked at data from the 2000 to 2013 National Health Interview Survey, which studied adults across the US. Population data was then used to provide estimates for the entire country.

Dr. Sabatino and team asked patients about recent cancer screening based on guidelines from the US Preventive Services Task Force. Women between the ages of 50 and 74 were asked if they had had breast cancer screening with mammography within the past two years. Women between the ages of 21 and 65 were asked if they had had cervical cancer screening with Pap tests within the past three years.

All patients between the ages of 50 and 75 were asked if they had had either a colorectal cancer stool test within a year, a sigmoidoscopy that looks inside the colon and rectum within five years or a colonoscopy to check the entire large intestine within 10 years.

Overall, screening use was stagnant and the nation did not appear to be on target to meet the 2020 health goals, Dr. Sabatino and team found.

The rates for 2013 use of mammography screening among older women came in at 72.6 percent — a stable rate since 2000, but one showing no recent progress toward the 2020 goal of 81.1 percent.

Pap test screening for cervical cancer saw a 5.5 percent decline from 2000 to 2013 to a rate of 80.7 percent — a step away the 93 percent goal for 2020.

Colorectal cancer screening saw a big jump of 24.6 percent between 2000 and 2013 overall, but increases fell off in the most recent years studied, and showed no major progress between 2010 and 2013. In 2013, 58.2 percent of older adults had had recent colorectal cancer screening — far from the 2020 goal of 70.5 percent.

While certain subgroups showed higher rates, such as women with high income and education, other groups showed lower rates, such as those without insurance or a consistent source of health care.

"Increased efforts are needed to reach Healthy People 2020 cancer screening targets and reduce disparities," Dr. Sabatino and team wrote. "More intensive or focused efforts might be required to overcome persistent barriers among specific population subgroups."

Patients self-reported this screening data, which was then used to create estimates. Further research is needed to understand cancer screening in the US, Dr. Sabatino and team said. Patients should discuss the risks and benefits of cancer screening with their doctors.

This study was published online May 7 in the CDC's Morbidity and Mortality Weekly Report. Dr. Sabatino and team disclosed no funding sources or conflicts of interest.

Review Date: 
May 7, 2015