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Cancer Screening Rates Remain Unchanged

Despite effective tests, not enough people are taking advantage of them, report finds

MONDAY, Jan. 30, 2006 (HealthDay News) -- While proven tests are increasingly available to screen early for common cancers when they can be most successfully treated, too many people aren't taking advantage of the examinations, a new report finds.

There were some slight increases -- and decreases -- in the rates for screening for various cancers overall in 2004. However, the rates were basically unchanged compared to the previous year, said Robert A. Smith, director of cancer screening for the American Cancer Society.

Smith, who wrote the report, said this year's ACS survey showed some changes in screening numbers, including a slight increase in the number of people getting colonoscopies, a test for colorectal cancer, and a slight dip in the numbers of women screened for breast cancer, although the drop might just reflect a normal statistical variation.

But, he added, the important finding was that "the [screening] numbers didn't go up -- what we can take to the bank is that they're too low, whatever's going on."

The result, he said, is that each year people are unnecessarily missing chances to have their cancers diagnosed in earlier, more treatable stages.

For instance, 45.6 percent of Americans received either a colonoscopy of flexible sigmoidoscopy in 2004; 58 percent of women 40 and older received a mammogram; 54 percent of men 50 and older got a PSA test for prostate cancer; while 85 percent of women aged 18 and older received a Pap test for cervical cancer, the survey found.

The report is part of annual ACS screening guidelines, first released in 2000. The new report appears in the January/February issue of CA: A Cancer Journal for Clinicians. The survey of cancer screening rates is based on data from the U.S. Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System (BRFSS), which works with the 50 state health departments, as well as the District of Columbia and Puerto Rico to gather health information annually.

This year, there were no updates to the screening recommendations for common cancers, including breast, prostate, colon and cervical cancers. But the cancer society is in the process of updating screening recommendations for a number of cancers, including early detection of skin cancer, breast cancer screening for women with an inherited risk for the disease and stool testing for colon cancer, Smith said.

There are a number of reasons people aren't taking advantage of available screening tests, he said.

"A doctor's recommendation is the single strongest influence on whether people get cancer screening," Smith said. But there's been a trend away from regular medical checkups, he said, adding, "They are not endorsed by any organization." As a result, doctors are seeing patients only when there's a problem that needs attention, rather than when they would have time to talk about the importance of early screening, he said.

A lack of health insurance is the other big reason people aren't getting regular cancer screenings, Smith said, with the survey showing that for those with no health insurance, screening rates for all cancers except cervical cancer are less than half the rates for those with insurance.

"I am concerned that the pattern of delivery to preventive health practice makes the goal of achieving a high rate of cancer screening very difficult," he said.

Dr. Raymond DuBois, director of the Vanderbilt-Ingram Cancer Center in Nashville, Tenn., agreed, saying lack of insurance as well as low reimbursement rates keep many people from getting cancer screenings.

In his field of colon cancer screening, he said, "We only screen 40 to 50 percent of the population, and in that group we are really increasing early detection and decreasing mortality. It's so sad we can't implement this throughout the whole population."

Smith urged people to become proactive about pushing for screening tests.

"People need to appreciate the fact that if they don't do it, it's not going to happen," he said.

More information

To learn more, visit the American Cancer Society's cancer detection guidelines.

SOURCES: Robert A. Smith, Ph.D., director, cancer screening, American Cancer Society, Atlanta; Raymond N. DuBois, M.D., Ph.D., director, The Vanderbilt-Ingram Cancer Center, Nashville, Tenn.; January/February 2006 CA: A Cancer Journal for Clinicians
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