Cancer Screening Not Meeting Targets

An anticancer program to increase screening and counseling fell short of some of its objectives, according to a study in the government journal Preventing Chronic Disease. The Healthy People (HP) program, launched by the Department of Health and Human Services in 1979, tracks 10-year objectives for improving health based on guidelines from the U.S. Preventive Services Task Force.

Using the National Health Interview Survey (NHIS), which tracks cancer care, the HP program’s current objectives are for 2020.

So far, we’re behind schedule.

“From 2008 to 2010, rates of breast and cervical cancer screening declined slightly while colorectal cancer screening increased by 7 percentage points,” says the study “Challenges in Meeting Healthy People 2020 Objectives for Cancer-Related Preventive Services, National Health Interview Survey, 2008 and 2010.”

The target for 2020 for cervical cancer screening is 93%. In 2008, 84.4% of women who should have been screened based on guidelines were screened. In 2010, the number was 82.9%.

The 2020 target for breast cancer screening is 81.1%. In 2008, 73.7% of women who should have been screened were screened. In 2010, the number was 72.4%.

Cancer counseling by providers also did not hit targets.

The 2020 HP goal for cervical cancer counseling is 66.2%. In 2008, 60.2% of women who should have had counseling received it. In 2010, the number slipped to 53.9%.

The 2020 HP goal for breast cancer counseling is 76.8%. In 2008, the number was 69.8%. In 2010, the number dropped to 59.5%.

Colorectal cancer screening did better, but still fell short of the 70.5% 2020 goal. In 2008, 52.1% of those who should have been screened for colorectal cancer were screened. In 2010, the number climbed to 59.1%.

Researchers allow that “the gaps we observed for some HP measures may reflect the adverse state of the U.S. economy during 2008 through 2010. However, neither Pap test nor mammography use increased during the past decade, suggesting that factors influencing cancer screening trends predate the most recent economic downturn and that meeting HP 2020 targets for cervical and breast cancer screening may be challenging.”

The study also focused on subgroups, finding that Hispanics and people below 200% of the federal poverty level were furthest off target.

It suggests that “attaining HP cancer-related targets by 2020 may be challenging in the absence of new approaches to expand health insurance coverage, improve access to cancer screening and treatment services, better integrate clinical and community preventive services, and improve health literacy.”