Colon Cancer Screenings and Mammograms on the Rise, but There's Room for Improvement
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Reviewed By Louise Chang, MD
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July 6, 2010 -- Screenings for colorectal and breast cancer are saving many thousands of lives, but the country could do much better at reducing deaths, the CDC says.
The agency says in its new monthly report, CDC Vital Signs, that thousands of people died last year because they weren't screened for colorectal or breast cancer, but the death toll could be reduced.
The report says that:
- Colorectal screening increased from 52% in 2002 to 63% in 2008.
- 81% of women 50-74 reported that they had mammography screening for breast cancer within the past two years in 2008.
- About 22 million men and women have not had a potentially life-saving screening for colorectal cancer.
- 7 million women 50-74 have not had a recent mammogram.
"It's encouraging to see more adults getting recommended cancer screenings," CDC Director Thomas Frieden, MD, says in a news release. "But we have more to do, especially when it comes to getting more people screened for colorectal cancer, which kills more American nonsmokers than any other cancer."
The researchers used the most recent data available from the 2008 Behavioral Risk Factor Surveillance System to determine the number of people getting screening.
"Tragically, one in three people who should be screened for colorectal cancer have not yet done so, and rates are even lower among Hispanics and blacks," he says. "Each year about 12,000 lives are saved as a result of mammography and an additional 32,000 lives could be saved if every adult aged 50 year or older got tested regularly for colorectal cancer."
After lung cancer, colorectal cancer is the second leading cause of death in the U.S., the report says. Breast cancer is the most commonly found cancer and is the second leading cause of cancer deaths among women in the U.S.
'Katie Couric Effect'
Frieden said in a news briefing that though progress has been made in saving lives, more could be with additional screenings. He said that what's known as the "Katie Couric effect" is still inducing people to get screened for colon cancer.
Couric, a CBS News anchorwoman, underwent a colonoscopy on live television in March 2000. She became a strong advocate for screening after her husband, then 42-year-old lawyer Jay Monahan, died of the disease in 1998.
After she had the televised procedure, "we had a bump in screening and that has continued to rise," Frieden said. "Public education, such as Katie Couric did, can have a major role."
The new report also says that for colorectal cancer screening:
- Insured adults had higher screening rates than the uninsured, 66% to 36%.
- Highest screening prevalence was found in the Northeast, at 74% in Maine, Delaware, and Massachusetts.
- The lowest prevalence occurred in the central and Western regions in Oklahoma (53%), Arkansas (53%), and Idaho (54%).
- Lowest screening prevalence was among the uninsured, 36%.
- People with a low income and those with less than a high school education had lower prevalence of screening (48%, 46%).
The report also breaks down the most recent data for breast cancer screening:
- 81% of women 50-74 said they had had a mammogram within the past two years.
- American Indian and Alaska Native women had the lowest prevalence for mammography screening at 70%.
- Women with less than a high school education and women with low income had lower prevalence of screening.
- Nevada and Mississippi, at 72%, had the lowest mammography screening prevalence, with Idaho slightly better at 73%.
- Insured women had a 28% higher screening prevalence than uninsured women, 84% vs. 56%. Among women with health insurance, 16% were not up-to-date with mammograms.
Other findings include:
- Doctors' recommendations for screenings are an important but underused motivator.
- The health care reform bill is likely to reduce financial barriers to screening by eliminating cost sharing and expanding insurance coverage.
- In 2006, more than 139,000 new cases of colorectal cancer were diagnosed and more than 53,000 people died from the disease.
- In 2006, more than 191,000 women were diagnosed with invasive breast cancer, and more than 40,000 died from the disease.
With reporting from WebMD Senior Writer Daniel DeNoon.
SOURCES: News release, CDC.
Richardson, L.C. CDC Vital Signs, July 20, 2010.
Morbidity and Mortality Weekly Report, July 6, 2010; vol 59.
Thomas Frieden, MD, director, CDC.
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