Screening Rates Stalled For Common Cancers

When it comes to cancer, the right screening test at the right time can go a long way toward catching the disease while it can be stopped.

But many Americans aren't getting recommended screening tests for colorectal, breast and cervical cancer. In fact, there's been a notable lack of progress in reaching national screening goals, according to the Centers for Disease Control and Prevention.

Only 72.6 percent of women between 50 and 72 said they were up to date on mammograms in 2013. The proportion of eligible women who got the breast cancer test is 8.5 percentage points short of the goal that federal public health agencies have set for 2020. And the mammogram trend is flat.

Results for the Pap test to detect cervical cancer were a little better but still short of the goal. In 2013, 80.7 percent of women said they had recently had a Pap test. The proportion was 12.3 percentage points below the 2020 target. What's more, use of the Pap test has "declined significantly," dropping 5.5 percentage points between 2000 and 2013, wrote the authors of the CDC report in the latest issue of Morbidity and Mortality Weekly Report.

The screening rate for colorectal cancer also fell short of the mark. Some 58.2 percent of people ages 50 to 75 had been recently screened for colorectal cancer in 2013. That's far below the national goal of 70.5 percent in 2020. And, overall, colorectal cancer screening rates are flat going back to 2010, after rising sharply starting in 2000.

"The first reaction is that we've reached this plateau, and it's hard to get off the plateau," says Dr. Richard Wender, chief cancer control officer at the American Cancer Society. The findings, he tells Shots, "are a call to action to recommit to the proven cancer screening tests."

A lengthening of the interval between cervical cancer screens will make it easier for women to stay current, he says. As for colorectal cancer screening, he says, that it's important to consider a range of options, including fecal immunochemical test, which is inexpensive and less invasive than a colonoscopy. "We're not going to get off this dime if we only offer colonoscopy," he says.

Wender also says that ongoing debate about mammogram guidelines has obscured the agreement over the value of the test every other year for women ages 50 to 74.

The CDC report, based on an annual federal survey, also identified notable disparities in screening by income, insurance status, race and ethnicity. Lack of insurance and low income, in particular, hinder compliance with screening recommendations.

The full implementation of the Affordable Care Act could make a difference. "I think expansion of insurance rolls is one of the most important reasons for optimism," Wender says. "Insurance is not all it takes, but it's a huge facilitator."