Cancer Screening in the USA

One out of four deaths in the US is due to cancer. In 2010, approximately 569,490 Americans die of cancer. The US Preventive Services Task Force (USPSTF) recommends screening for female breast cancer, cervical cancer and colorectal cancer. A surveillance study conducted by the US Division of Cancer Prevention and Control was published in November 2010 (see reference below). This report uses the most recent available estimates of later stage cancer incidence (2004-2006) and screening prevalence (2008). Later stage is defined as regional (involving lymph nodes or neighboring tissues) and/or distant (involving distant lymph nodes or distant organs) disease. The results are summarized as follows:

Breast cancer:

In 2004-2006, approximately one third of female breast cancer was discovered at a later stage. The percentage was lowest for white women (32.7%), and highest for African American women (42.4%). The highest rate of later stage cancer was found in black women aged 50-59 years (46.4%). The overall incidence varied a great deal between the 50 states, with a range from 27% to 41%.

In 2008, 81.2% of females aged 50-74 years reported having received recommended breast cancer screening. This rate was only lower for American Indian or Alaskan native women (70.4%). The overall percentage varied across the 50 states, ranging from 72.1% to 89.8%.

Cervical cancer:

In 2004-2006, about 47% of cervical cancer was discovered at a later stage. The percentage of later cases was lowest for Hispanic women (45.9%), and highest for African American women (52.8%). The overall incidence varied a great deal between the 50 states, with a range from 34% to 53%.

In 2008, 87.6% of females aged 21-64 years reported having received recommended cervical cancer screening. This rate was lower for women 50 or older (83.1% - 86%). The overall percentage varied across the 50 states, ranging from 81% to 92.6%.

Female colorectal cancer:

In 2004-2006, approximately half of female colorectal cancer was discovered at a later stage. The percentage of later cases was lowest for white women (50.9%), and highest for American Indian or Alaskan native women aged 50-59 years (60.5%). The overall incidence varied a great deal between the 50 states, with a range from 45% to 58%.

In 2008, 62% of females aged 50-75 years reported having received recommended colorectal cancer screening. This rate was lower for all females aged 50-59 years (53.6%), and lower for Hispanic (51%), Asian & Pacific islander (56.4%), and American Indian or Alaskan native (53.9%) women of any age. The overall percentage varied across the 50 states, ranging from 48.6% to 72.5%.

Male colorectal cancer:

In 2004-2006, about half of male colorectal cancer was discovered at a later stage. The percentage of later cases was lowest for white men, and highest for American Indian or Alaska native men aged 50-59 years (61.5%). The overall incidence varied a great deal between the 50 states, with a range from 43% to 57%.

In 2008, 61.9% of males aged 50-75 reported having received recommended colorectal cancer screening. This rate was lower for males aged 50-59 years (52.6%), and lower for Hispanic (46.5%), Asian & Pacific islander (50.7%), and American Indian or Alaskan native (53 %) men of any age. The overall percentage varied across the 50 states, ranging from 51.3% to 74.7%.

Differences in later stage cancer incidence are due at least partially to different rates in screening use. The above data can be used to target groups with higher later stage cancer and/or lower screening rates, for better outreach. It is clear that cancer is much less morbid and lethal if detected early; in fact, cancer can be cured. If the already available screening tools are utilized more widely, the fight against cancer can be won more often NOW!

Mai Brooks

Reference: Henley SJ, King JB, German RR, Richardson LC, Plescia M; Centers for Disease Control and Prevention (CDC). Surveillance of screening-detected cancers (colon and rectum, breast, and cervix) - United States, 2004-2006. Morbidity Mortality Weekly Report Surveillance Summary, Nov. 26, 2010. Volume 59, pages 1-25.