U.S. fails to meet most cancer screening goals

Although the general U.S. population did not meet most Healthy People 2010 goals for cancer screening, cancer survivors met all goals except cervical cancer screening, according to a study published Dec. 27, 2012, in Frontiers in Cancer Epidemiology.

Advanced cancer diagnoses have declined in the U.S., while the number of cancer survivors returning to work has increased. Tainya C. Clarke, MPH, from the department of epidemiology and public health at University of Miami, and colleagues sought to examine adherence to colorectal, breast, cervical and prostate cancer screening recommendations among the general population and compare these with cancer survivors and working cancer survivors.

The researchers used the recommended cancer screening rates set by the U.S. Department of Health and Human Services and looked at data from the National Health Interview Survey between 1997 and 2010. In total, 174,393 people were included in the study analysis, with 7,528 employed cancer survivors and 119,374 people representing the general population.

“Our research has shown that adherence rates for cancer screenings have generally declined with severe implications for the health outlook of our society,” Clarke said in a statement.

The bright spot in general screening was colorectal cancer screening. A total of 54 percent of the general public underwent colorectal screening, surpassing the 50 percent goal of the Healthy People 2010 initiative.

The general population failed to meet the screening mammography adherence goal of 70 percent of eligible women undergoing a mammogram in the previous two years. The goals for cervical cancer screening and prostate cancer screening also were unmet among the general population.

In contrast, cancer survivors exceeded general population rates by approximately 10 percent during the decade and met screening goals for three of the four cancers studied: colorectal, breast and prostate cancer. They failed to meet the cervical cancer screening goal. In addition, Clarke and colleagues observed a downward trend in most screenings among cancer survivors during the last three years of the study.

“This declining trend foreshadows a future negative impact on mortality from cancers of the breast, and cervix as well as increased morbidity associated with a later diagnosis of prostate cancer,” wrote Clarke and colleagues, who suggested the dip in screening may signal the need for continued medical advice post-treatment and diagnosis for survivors.

The researchers surmised that the declines may be related to disagreements regarding screening among the U.S. Preventive Services Task Force, the American Cancer Society and other organizations as well as decreases in worker insurance rates. They also noted that increasing use of the Human Papillomavirus vaccine may play a role in reduced cervical cancer screening. Prostate-specific antigen screening dropped as various recommending bodies questioned its effectiveness.

Finally, the researchers found that among survivors, white collar workers had higher screening rates than blue collar workers. Clarke et al noted the need for change in current job-related policies to help overcome disparities within different professions of working cancer survivors.