Screening rates lower among Asian and Hispanic Americans
The percentage of U.S. citizens screened for cancer remains below
national targets, with significant disparities among racial and ethnic
populations, according to the first federal study to identify cancer
screening disparities among Asian and Hispanic groups. The report by
the Centers for Disease Control and Prevention and the National Cancer Institute (NCI), part of the National Institutes of Health, was published January 26 in the CDC Morbidity and Mortality Weekly Report.
In 2010, breast cancer screening rates were 72.4 percent, below the Healthy People 2020
target of 81 percent; cervical cancer screening was 83 percent, below
the target of 93 percent; and colorectal cancer screening was 58.6
percent, below the target of 70.5 percent, according to the study,
“Cancer Screening in the United States – 2010.”
Screening rates for all three cancers were
significantly lower among Asians (64.1 percent for breast cancer, 75.4
percent for cervical cancer, and 46.9 percent for colorectal cancer)
compared to other groups, the study found. Hispanics were less likely
to be screened for cervical and colorectal cancer (78.7 percent and
46.5 percent, respectively) when compared to non-Hispanics (83.8
percent and 59.9 percent, respectively).
“It is troubling to see that not all Americans are
getting the recommended cancer screenings and that disparities continue
to persist for certain populations. Screening can find breast,
cervical, and colorectal cancers at an early stage when treatment is
more effective,” said Sallyann Coleman King, M.D., an epidemic
intelligence service officer in CDC’s Division of Cancer Prevention and Control and lead author of the study. “We must continue to monitor cancer screening rates to improve the health of all Americans.”
sets national objectives for improving the health of
all Americans. Such objectives include the use of screening tests
recommended by the United States Preventive Services Task Force for
breast, cervical, and colorectal cancers. Women aged 50-74 years should
be screened for breast cancer with a mammogram every two years. Women
who have been sexually active for three years or are aged 21-65 years
should be screened for cervical cancer with a Pap test at least every
three years. Colorectal cancer screening is recommended for
average-risk men and women aged 50-75 years, using high-sensitivity
fecal occult blood test (FOBT), done at home every year; sigmoidoscopy
every five years, with high-sensitivity FOBT every three years; or
colonoscopy every 10 years.
To assess the use of currently recommended cancer
screening tests by age, race, ethnicity, education, length of residence
in the United States, and the source and financing of health care
researchers analyzed data from the 2010 National Health Interview Survey,
which tracks progress toward the achievement of Healthy People 2020
objectives. For the ethnic subgroups, Asians were classified as
Chinese, Filipino, or other Asian and Hispanics as Puerto Rican,
Mexican, Mexican-American, Central or South American, or other
Hispanic.
Significant findings include:
- Screening rates for breast cancer remained relatively stable and varied no more than 3 percent over the period 2000-2010.
- From 2000-2010, colorectal cancer screening rates
increased markedly for men and women, with the rate for women
increasing slightly faster so that rates among both sexes were nearly
identical (58.5 percent for men and 58.8 percent for women) in 2010. - From 2000-2010, a small but statistically
significant downward trend of 3.3 percent was observed in the rate of
women who reported getting a Pap test within the last three years. - Considerably lower breast, cervical, and
colorectal cancer screening use was reported by those without any usual
source of health care or health insurance.
The authors note that this study reinforces the need
to identify and track cancer screening disparities. Additionally, the
report provides guidance for the development programs to increase the
use of screening tests in order to meet Healthy People 2020 targets and
simultaneously reduce cancer morbidity and mortality.
“Healthy People objectives are important for
monitoring progress toward reducing the burden of cancer in the United
States. Our study points to the particular need for finding ways to
increase the use of breast, cervical, and colorectal cancer screening
tests among Asians, Hispanics, as well as adults who lack health
insurance or a usual source of health care” said Carrie Klabunde,
Ph.D., an epidemiologist in NCI’s Division of Cancer Control and Population Sciences and a co-author of the study.
According to the authors, the Affordable Care Act is
expected to reduce financial barriers to care by expanding insurance
coverage. Other efforts are needed such as developing systems that
identify individuals eligible for cancer screening tests, actively
encouraging the use of screening tests, and monitoring participation to
improve screening rates, they say.
Through the National Breast and Cervical Cancer Early Detection Program,
CDC provides low-income, uninsured, and underinsured women access to
timely breast and cervical cancer screening and diagnostic services in
all 50 states, the District of Columbia, five U.S. territories, and 12
American Indian/Alaska Native tribes or tribal organizations. The CDCs Colorectal Cancer Control Program
funds 25 states and four tribal organizations to implement
population-based approaches to increase screening among men and women
aged 50 years and older. Population-based approaches include policy and
health systems change, outreach, case management, and selective
provision of screening services. For information about CDC efforts to
prevent cancer, visit www.cdc.gov/cancer
NCI leads the National Cancer Program and NIH’s effort to dramatically
reduce the burden of cancer and improve the lives of cancer patients
and their families, through research into prevention and cancer
biology, the development of new interventions, and the training and
mentoring of new researchers. For more information about cancer, visit www.cancer.gov or call NCI’s Cancer Information Service at 1-800-4-CANCER (1-800-422-6237).
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