Dr. C. Joseph Bennett, Navigating Cancer, 02/12/13

Despite evidence that earlier diagnosis and improved treatment increases survival, the rate of people seeking preventive cancer screening has fallen in the United States in the past 10 years. And a lot of the blame for this falls at the feet of major cancer organizations and our government agencies for failing to agree about screening guidelines.

Another reason for the drop is the reductions in workers with insurance to cover the cost of screening. Researchers write about their NIH-funded study in a paper published Dec. 27 in the online open-access journal Frontiers in Cancer Epidemiology.

In the U.S., although the number of cancer survivors has 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 U.S. in the past 10 years has been an increase in the number of cancer survivors returning to work. Research suggests that almost 12 million people are alive and well in this country who have survived cancer. And in these patients, continued surveillance is critical.

We know that keeping to a cancer screening schedule could be an important factor as this helps detect secondary tumors early, and reduces potentially limiting side effects. However, research also reveals that although cancer survivors tend to show much higher rates of screening adherence, their numbers, too, have started falling off in the past three years, as well.

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. Yet the major agencies in this country don’t seem to be able to agree on anything.

Despite the overwhelming proof that screening leads to early detection and increased cure rates, research has shown that adherence rates for cancer screenings have generally declined with severe implications for the health outlook of our society.

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 U.S. remains below national targets for 2020, with rates lower among Asian and Hispanic Americans than other groups.

In this study, researchers 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 age 18 and older. These annual surveys randomly sample the U.S. population by household, and collect demographic and health information, including cancer history and cancer-related health behaviors such as cancer screening.

When the researchers analyzed the data, they 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 percent of the general population underwent screening: the government’s 2010 goal is 50 percent.

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 percent over the past 10 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.

Researchers also found that among survivors, white collar workers on the whole had higher cancer screening rates than blue collar workers.

Researchers 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.

Nonetheless, I hope all of my readers appreciate the importance of screening, early detection, and successful treatment, a formula that will lead to fewer deaths and more cancer survivors in the years to come.

Dr. C. Joseph Bennett is a board-certified radiation oncologist and a member of the Citrus County Unit of the American Cancer Society. Watch “Navigating Cancer” on WYKE TV at 7:30 p.m. Tuesdays and at 10 a.m. Thursdays. If you have any suggestions for topics, or have any questions, contact him at 522 N. Lecanto Highway, Lecanto, FL 34461, or email cjbennett@rboi.com. ­