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Skipping cancer tests

People continue to pass on prevention despite education, access


Many Americans continue to skip screenings for breast, cervical and colorectal cancers, according to a national survey conducted by the Centers for Disease Control and Prevention.   

Almost 30 percent of women eligible for mammograms are not getting the tests and nearly 20 percent had not had a recent Pap smear. Less than 60 percent of adults aged 50 to 75 reported having a colorectal cancer test, according to the survey.

“Screening tests are important,” said Dr. Michael Sherrill, a family practitioner at Novant Health Lakeside Family Physicians in Huntersville, North Carolina. “Some cancers are easier to detect and when you do find them, something can be done to treat them.”

Government researchers were disappointed with the results – given heightened public health campaigns to raise awareness of the benefits of early detection and treatment, greater access to health care through the Affordable Care Act and fewer financial barriers to preventive cancer screenings.

The survey measured use of screens among adults based on the U.S. Preventive Services Task Force guidelines for routine testing. Under these recommendations, women aged 50 to 74 should have a mammogram every other year. The guidelines say women aged 21 to 65 who haven’t had a hysterectomy should get a Pap smear once every three years. For adults 50 to 75, the task force recommends one of the following screenings: a colonoscopy every 10 years, a fecal occult blood test once a year or a sigmoidoscopy every five years.

Convenience and accessibility also affect patient decisions about screening tests, Sherrill said. “For mammograms, it’s relatively easy to schedule and take a test, but with colonoscopies, people have to take a day and half off from work,” he said. “Insurance costs can also be a deterrent.”

Inconsistent guidance affects patient behavior and causes confusion, too. As an example, Sherrill cited medical guidance on prostate-specific antigen testing. The U.S Preventive Services Task Force recommends against using this testing method for prostate cancer, but the American Urological Association takes a more nuanced approach, saying that men aged 55 to 69 might consider the screening based on their preferences.  

To lessen confusion, Sherrill shares current testing guidelines with patients and presents them with options so they can make an informed decision. “If someone has a family history of a disease, getting the test even if a patient doesn’t meet the guidelines makes the most sense in some cases,” he said.

The report also found that people without insurance or a usual source of care generally had the lowest use of screening tests. Only 38 percent of women without health insurance and almost 30 percent of women without a usual source of care had a recent mammogram. Less than a quarter of uninsured adults had a colorectal cancer screening test, the study found.

Sherrill isn’t surprised by the findings. “These tests are expensive,” he said.”A colonoscopy can cost a couple of grand. However, these tests have been proven to save lives.”

More beneficial than education and raising awareness about cancer testing would be helping people without the means to get access to the recommended screenings, Sherrill said. He said his patients often ask him where to get screened affordably and they’re not easy questions to answer.

When was your last cancer screening? Learn more about the prevention and early detection services offered by Novant Health here.





Published: 5/28/2015