US cancer screening rates decline over the last 10 years, study finds

The rate of people who seek preventive cancer screenings has fallen over the last ten years in the United States with wide variations between white-collar and blue-collar workers, according to a University of Miami Miller School of Medicine study published on December 27 in the open-access journal Frontiers in Cancer Epidemiology.

While earlier diagnoses and improved treatments have increased the number of survivors, cancer remains one of the most prominent chronic diseases and, last year alone, claimed the lives of more than 570,000 people in the U.S.

"There is a great need for increased cancer prevention efforts in the U.S., 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," said lead author Tainya Clarke, M.P.H., research associate in the Department of Epidemiology and Public Health.

"But despite this," Clarke continued, "our research has shown that adherence rates for cancer screenings have generally declined with severe implications for the health outlook of our society."

For their NIH-funded study, Clarke and her team evaluated the cancer screening behaviors of the general public and cancer survivors to see if government-recommended screenings goals were achieved.

The study looked at cancer screening adherence rates for colorectal, breast, cervical and prostate cancers and compared the screening rates among the general public to all cancer survivors and to the subpopulation of employed survivors.

Results showed that the general public did not meet government recommendations for cancer screenings for any cancer types except colorectal cancer. About 54 percent of the general public underwent colorectal screenings, exceeding the 50 percent goal of the government's "Healthy People 2010" national health promotion and disease prevention initiative.

By contrast, cancer survivors, who are at an increased risk of developing the disease, had higher screening rates and underwent the recommended cancer screenings for all types except cervical cancer, which decreased to 78 percent over the last decade. The study also showed a decline among cancers survivors who sought cancer screenings over the last three years.

The researchers used the recommended cancer screening rates set by the U.S. Department of Health and Human Services and looked at data from the National Health Interview Survey between 1997 and 2010. In total, 174,393 people were included in the study analysis, with 7,528 employed cancer survivors and 119,374 people representing the general population.

In addition, the study showed that among survivors, white collar workers had higher screening rates than blue collar workers – a crucial discovery that Clarke hopes will help change current job-related policies and overcome disparities within different professions of working cancer survivors.

The researchers speculated that ongoing disagreements among the United States Preventive Services Task Force, American Cancer Society and others over screening guidelines, as well as the decrease in worker insurance rates over the decade may have influenced the decline in screening rates.

Clarke hopes that more comprehensive research will assess the combined factors affecting screening rates and lead to more effective workplace interventions and increase screening within each occupational sector.