Public Confused on Cholesterol, Cancer Screening

Most know they should get tests but too few do, survey finds

THURSDAY, March 25, 2004 (HealthDayNews) -- Is cholesterol screening only for folks over 40? What does the Pap smear test for, anyway? Don't feel odd if you don't know the answers: neither does a large percentage of Americans surveyed in a recent Gallup poll.

Most people aren't getting tested, either. While 98 percent of those polled believe screening for cancer or cholesterol does save lives, a much smaller percentage actually go out and get the tests, according to the survey, which further found that doctors aren't urging people to get tested.

"We've got some work to do," says Dr. Paula Szypko, a spokeswoman for the College of American Pathologists, which sponsored the poll. "We need to not only educate our public about what needs to be done, but push them to try and go ahead and get screenings."

The findings were released March 24.

Telephone interviews with nearly 1,500 U.S. adults in late 2003 uncovered serious misconceptions about several common tests aimed at the early detection of disease, pollsters report.

First of all, there seems to be a serious "age gap" in cholesterol screening awareness. While most adults over 40 now get their blood cholesterol checked regularly, most under 40 do not -- even though experts advise that all individuals over 20 get tested every five years.

Moreover, 42 percent of men and 29 percent of women under 40 think they need never get the test, the survey found.

As early as adolescence, blood cholesterol levels are linked "to the development of vascular disease in young and middle-aged adults," warns Dr. Michael S. Lauer, a heart expert with the Cleveland Clinic Foundation. "So the argument is made that by knowing cholesterol levels at a young age, one can potentially change lifestyle habits that might be of benefit later on down the line."

But are doctors prompting younger patients to get tested? When asked by pollsters whether their doctor had suggested getting a cholesterol test, 71 percent of men under 40 and 67 percent of women under 40 replied "no."

Lauer isn't surprised by the finding. "From the point of view of many doctors, as well as patients, they'd say, 'At this point in my life the risk is very low, so is it really critical that we have to check this right now?'"

But while high cholesterol in youth may not pose an immediate threat, Lauer believes for some high-risk individuals -- the obese, diabetics and those with a family history of early heart disease -- it's important to get checked regularly.

The American public seems confused when it comes to tests for colon cancer as well. Even though 91 percent of men over 50 said they knew they should undergo some form of colon cancer screening, just 54 percent had ever done so, according to the poll.

Current guidelines recommend that all men and women aged 50 and over get stool-based screening annually and undergo full colonoscopy once every 10 years, to check for precancerous polyps in the colon.

"A lot of people said they just did not have time" for screening, Szypko says. "They just hadn't gotten round to it." Many others may have an exaggerated idea of the trauma involved in colonoscopy. "It's done under sedation," Szypko points out, "and people that have it done really don't think it's a big deal -- and it can save your life."

Advocates for mammography got better news from the poll. Seventy percent of women over 40 -- the recommended age at which to begin screening -- said they did, in fact, get a mammogram every year. Many were confused, however, regarding the age at which such screening should begin, with 53 percent guessing the threshold was set at 30 years of age or younger.

Women also expressed confusion about one of the oldest and most reliable early-detection tests of all: the Pap smear, used to spot cervical cancer or precancerous lesions of the cervix.

"What was bothersome in our survey was that a lot of women didn't quite know what the Pap test was for," Szypko notes. "They're having it, but a lot of them think they are being screened for STDs."

In fact, just 48 percent of women surveyed understood the Pap test is specific to cervical cancer, while 13 percent believed it was used to detect STDs or ovarian or uterine cancer.

"That's kind of dangerous," Szypko says, "because if women think they have an STD they need to talk to their doctor -- there are [other] tests that can look for those problems." There are currently no effective early-detection tests for either ovarian or uterine cancer.

The survey suggests more needs to be done to get patients into doctor's offices for tests that can help save their lives. Computer technology and the Internet may be key, Lauer said, citing a new initiative that uses e-mails to jog physician memories. "We have a system here at the Cleveland Clinic that will give [doctors] a reminder that a person is due for a cholesterol check, so you don't have to remember."

More information

Try the American Heart Association to learn about cholesterol screening, while the American Cancer Society can teach about early detection. You can set up your own screening reminders by visiting this link set up by the College of American Pathologists.

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