Academic Journal
Main Category: Cancer / Oncology
Also Included In: Preventive Medicine; Public Health
Article Date: 28 Dec 2012 - 6:00 PST
Despite evidence that earlier diagnosis and improved treatment increases survival, rates of people seeking preventive cancer screening have fallen in the US in the last ten years. Failure of leading bodies to agree screening guidelines, plus reductions in workers with insurance cover could be among reasons for the decline, suggest researchers from the University of Miami Miller School of Medicine.
They write about their NIH-funded study in a paper published 27 December in the online open-access journal Frontiers in Cancer Epidemiology.
In the US, although numbers of cancer survivors have gone up as a result of improved diagnosis and treatment, cancer is still one of the most prominent chronic diseases that in 2011 killed more than 570,000 people.
Alongside a fall in rates of advanced cancer diagnoses in the US in the last ten years, has been an increase in the number of cancer survivors returning to work. The researchers suggest, in their background information, that keeping to a cancer screening schedule could be an important factor (as this helps detect secondary tumors early and reduce potentially limiting side effects).
However, their analysis reveals that although cancer survivors tend to show much higher rates of screening adherence, their numbers too have started falling off in the last three years.
Lead author Tainya Clarke, a research associate in the School's Department of Epidemiology and Public Health, says in a statement:
"There is a great need for increased cancer prevention efforts in the US, especially for screening as it is considered one of the most important preventive behaviors and helps decrease the burden of this disease on society in terms of quality of life, the number of lives lost and insurance costs."
"But despite this, our research has shown that adherence rates for cancer screenings have generally declined with severe implications for the health outlook of our society," she adds.
In January 2012, a new report by the Centers for Disease Control and Prevention (CDC) and the National Cancer Institute (NCI) showed that the percentage of people screened for cancer in the US remains below national targets for 2020, with rates lower among Asian and Hispanic Americans than other groups.
The NIH Study Also Looks at Workforce
For this latest study, Clarke and colleagues examined cancer screening adherence rates of the general public and cancer survivors and compared them to government-recommended "Healthy People" screening goals.They looked at screening rates for colorectal, prostate, breast and cervical cancers. Not only did they compare rates between the general population and cancer survivors, but they also looked at rates among workers.
The data on screening rates came from National Health Interview Surveys conducted between 1997 and 2010 that in total covered nearly 174,400 people aged 18 and over. These annual surveys randomly sample the US population by household, and collect demographic and health information, including cancer history and cancer-related health behaviors such as cancer screening.
The Results
When they analyzed the data, Clarke and colleagues found that the general population did not meet the government's "Healthy People" screening goals for any type of cancer, apart from colorectal cancer (for this cancer, 54% of the general population underwent screening: the government's 2010 goal is 50%).But among cancer survivors, who have a higher risk for cancer, the pattern was quite different. Their screening rates, for all types of cancer except cervical (this fell to 78% over the last ten years), exceeded the government goals.
However, the researchers also noticed a decline in the number of cancer survivors who went for cancer screening in the last three years.
Disparities Among Workers
The NIH Survey results also enabled the researchers to include data on working adult Americans with and without a history of cancer: including more than 7,500 with a history of cancer (representing 3.8 million working cancer survivors), and over 119,300 workers with no history of cancer (representing more than 100 million).They found that among survivors, white collar workers on the whole had higher cancer screening rates than blue collar workers.
Clarke says this was a key finding that she hopes will lead to changes in employment policies to eliminate disparities among different groups of the working population of cancer survivors.
She hopes it will also spur researchers to look more closely at factors influencing screening rates so as to design better workplace interventions and encourage more workers in all occupations to take up screening.
She and her colleagues speculate that ongoing disputes over screening guidelines among bodies like the United States Preventive Services Task Force, American Cancer Society and others, plus reductions in rates of workers covered by insurance that have occurred in the past decade, may lie behind the trend.
Written by Catharine Paddock PhD
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today
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Visitor Opinions (latest shown first)
Insurance policies at odds with medical science
posted by Patrick on 28 Dec 2012 at 8:45 amSure early detection increases treatment and survival rates. Hard evidence proves that. And sure, insurance companies CLAIM to be in favor of preventative care. Unfortunately their own policies don't reflect this interest.
u had to ask
posted by bruce on 28 Dec 2012 at 8:28 amI don't go to the doctor very much anymore because of cost.just basic visits cost me over 11 hundred in co-pays this year alone.I cancell visits when i'm not feeling bad
Cancer screening rates have falled in US
posted by Debra Grossman on 28 Dec 2012 at 8:18 amThe simple and basic reason falls on word, EXPENSE! A lot of health insurance companies have made it very difficult and nearly impossible to get screenings because they won't pay for the pet scan or x-rays. Mine only gives me 3 appointments with my co-pay and that only covers the visit with the Doctor and nothing else! A lot of us have very bad health insurance. I can't wait until better laws kick in.
All those "doctors"
posted by Dr. Oz on 28 Dec 2012 at 7:58 amAll those doctors and they can't figure out how to lower prices.
Well Duh...Cancer survivor in remission for 7 years
posted by Angelia on 28 Dec 2012 at 7:51 amI am a cancer survivor and have been in remission for 7 years now. At least that is what I hope. I lost my job in 2010 and thus my insurance along with it. The cost to get my scans and MRI is around $5000. We barely make it each month to keep the power bill on, yet I am to come up with $5k to pay for a scan? Health insurance is insane and I dont know how anyone can afford it on their own.
My hubby says we are going to take me to the emergency room and say I fell on my head and need a scan. They will have to do it and we will just have another bill, but at least we will know if the cancer is back. Its sad to think of how many others are just like me.
The REAL reason screening has declined.
posted by H. Edgy on 28 Dec 2012 at 7:06 amI know first hand why it has declined....EXPENSE! I am a 4 year survivor and there was a time I had to tell my oncologist that I could not afford a CT or PET because I already owe the hospital $9k from previous scans. With a $3k annual ins. deductible and the costs of a scan at $6k plus and a dr. visit usually runs $500. That...is why it has dropped. Some just cannot afford it...Like me.
Why the surprise?
posted by Bruce on 28 Dec 2012 at 6:53 amI have a physical yearly. My doctors used to do chest xray, psa, prostate exam each year, and colonoscopy every other year. They dropped the xray, psa, and prostate exam altogether and changed the colonoscopy to every 5 years. Before my first 5 years was up, they changed it to every 10 years. My wife used to have a yearly mamogram. Now it's every other year. Help me understand: Why is it that academics are surprised that screening frequency is down?
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