Screening rates are lower than desired, and disparities continue.
Although it is well recognized that cancer screening can detect cancer in its earlier stages, data on its utilization by groups other than the general population are lacking. A team of researchers, led by Tainya Clarke from the University of Miami, compared cancer screening trends over the past decade for all cancer survivors as a group, employed cancer survivors, and the general population. This was an interesting approach as it recognized that increasing numbers of cancer survivors are returning (or continuing) to work and therefore may have insurance coverage for cancer screening tests. In addition, post-treatment cancer screening can increase the early detection of secondary and recurring cancers.
Using the Healthy People 2010 goals as a measure of desired adherence, the researchers selected 174,393 study participants who were at least 18 years old. American Cancer Society screening recommendations were used to assess adherence. Data analyses included 7,528 working cancer survivors representing 3.8 million workers, and 119,374 adults representing more than 100 million working Americans with no cancer history. The general population met the Healthy People 2010 goal for colorectal screening (54% of the general population underwent screening and the Healthy People 2010 goal is 50%), but declined in all other recommended cancer screening. Cancer survivors met and maintained the Healthy People 2010 goal for all cancer screening recommendations with the exception of cervical cancer screening. Survivors had higher screening rates than the general population and white-collar and service occupations had higher screening rates than blue-collar cancer survivors.
Although cancer survivors had higher screening rates than the general population, national screening rates are lower than desired, and disparities exist by cancer history and occupation. The researchers concluded that reductions in workers with insurance coverage may be a reason for the decline in cancer screening. They also recommended that leading professional organizations need to agree on screening guidelines, since variations in cancer screening guidelines may contribute to variations in cancer screening test utilization.
Clarke TC, Soler-Vila H, Fleming LE, et al.Trends in adherence to recommended cancer screening: the US population and working cancer survivors. Front Oncol 2012; 2:190. doi: 10.3389/fonc.2012.00190. Published online December 27, 2012.