Except for Colorectal Exams, the Past Decade Saw Declining US Rates for Cancer Screening

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(ChemotherapyAdvisor) – US screening rates for most cancers declined between 1999 and 2010, according to a population-based study published in the journal Frontiers in Oncology: Cancer Epidemiology and Prevention.

“The US population met the Healthy People 2010 goal for colorectal screening, but declined in all other recommended cancer screening,” reported lead author Tainya C. Clarke, MPH, MS, of the department of Epidemiology and Public Health, Miller School of Medicine at the University of Miami in Miami FL, and coauthors.

The authors analyzed adult participants in the National Health Interview Survey and calculated rates of compliance with screening recommendations from the American Cancer Society and achievement of federal Healthy People 2010 cancer screening goals.

In the general population, only colorectal screening rates significantly improved, increasing by 16.6% (more than 2.3 million Americans) during 1999-2010, with 50% of participants older than age 50 years reporting a colorectal exam, the researchers found.

For cervical, prostate, and breast cancer screening, the findings were less reassuring. Prostate specific antigen (PSA) screening declined from approximately 64.6% of eligible men in 1999 to 46% in 2010, the authors reported. Mammography rates “showed little change,” with an average annual decline of 4.3% during 1999-2010, the authors reported.

During 1999-2010, Pap test screening for cervical cancer declined by a modest 3.7%. The decline might be associated with increasing rates of HPV vaccination among young women since 2008, the authors noted.

“However, as the available vaccines protect women from only two to four of the many cancer-causing HPV infections, this trend of higher vaccinations at the price of lower screening may be more detrimental than the previous unavailability of a vaccine but higher screening rates,” they noted.

Except for cervical cancer survivors, people with a history of cancer met and maintained Healthy People 2010 screening goals; cancer survivors overall sought screening tests more frequently than the general public, the coauthors noted.

The past decade saw increasing numbers of cancer survivors returning to the workforce. Fewer workers with health insurance over time could partly account for declines in cancer screening, the authors speculated – as could disagreement among experts about cancer screening recommendations. PSA screening declined as questions about its efficacy made headlines, the authors noted.

“Among survivors, white-collar and service occupations had higher screening rates than blue-collar survivors,” the authors reported. “Nevertheless, national screening rates are lower than desired, and disparities exist by cancer history and occupation.”

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