The Ball Dropping on Cancer Screening Rates

Cancer screening guidelines adherence has declined over past decade

(RxWiki News) Do you know the age women are to begin having mammograms? What about PSA testing for men? Do you know when to start colorectal cancer screenings? Confusion may be the reason screening rates are dropping.

Today, fewer people are being screened for breast, cervical and prostate cancer than a decade ago. Even cancer survivors aren’t being screened as frequently as the guidelines recommend.

One bright spot was noted – more people are receiving colorectal cancer screenings than predicted.

"Ask your doctor about cancer screening."

A University of Miami Miller School of Medicine study looked at the number of people following recommended cancer screening guidelines. Researchers compared patterns among the general population, all cancer survivors and a subgroup of employed survivors.

Tainya Clarke, MPH, research associate in the UM Department of Epidemiology and Public Health, said in a statement that “adherence rates for cancer screenings have generally declined with severe implications for the health outlook of our society."

Researchers suggest that confusion over what the guidelines are and insurance variations may be to blame for these trends.

The study involved 174,393 people in the US, with a total of 119,374 individuals representing the general population. Researchers looked at screening behaviors between 1999 and 2010. The screening recommendations of the American Cancer Society were used. Healthy People 2010 (HP2010) objectives were used to determine whether or not study participants met screening goals.

Researchers tracked screenings for breast, cervical, colorectal and prostate cancers, and here’s what they learned:

  • Over the last decade, colorectal cancer screening increased by 16.6 percent, which included more than 2.3 million people. 
  • Colorectal cancer screening goals were the only ones met by the general public. A total of 54.6 percent were screened, compared to a 50 percent goal set by HP2010.
  • Little change was seen in breast cancer mammography, with 69.7 percent of women undergoing screening. This number is just shy of the 70 percent HP2010 goal.
  • There was a 3.7 percent decline in clinical breast exams in 2010.
  • Cervical cancer screenings declined 3.7 percent between 1991 and 2010.
  • Similarly, prostate cancer screenings dropped 3.6 percent between 1999 and 2010.
  • Among breast cancer survivors, screening behaviors have been up and down over the last 10 years.
  • Cervical cancer survivor screenings declined by 1.5 percent over the study period.
  • PSA testing among prostate cancer survivors has dropped from 76.5 percent in 1999 to 64.3 percent in 2010.
  • Blue-collar survivors were less likely to adhere to screening guidelines than were white-collar workers.

So what’s causing these declines? Investigators surmise that the ongoing disagreements between the American Cancer Society, the United States Preventive Services Task Force and professional societies have generated confusion. Additionally, worker insurance availability and rates may also played a role in the declines.

Findings from this study were published December 27 in the journal Frontiers in Cancer Epidemiology and Prevention. The National Institutes of Health supported the study.

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Review Date: 
December 26, 2012