Cancer screening in the United States, 2018: A review of current American Cancer Society guidelines and current issues in cancer screening

Smith, Robert A.; Andrews, Kimberly S.; Brooks, Durado; Fedewa, Stacey A.; Manassaram‐Baptiste, Deana; Saslow, Debbie; Brawley, Otis W.; Wender, Richard C.

doi:10.3322/caac.21446

Cited by 444 publications

(346 citation statements)

References 114 publications

(251 reference statements)

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“…The most recent data on cancer screening rates are cause for concern, which we also noted in 2018 . As described above, although CRC screening rates have steadily risen, screening rates for cervical cancer have declined since 2005, breast cancer screening rates have remained stable at a discouragingly low level, and uptake of lung cancer screening is hardly measurable.…”

Section: Discussionmentioning

confidence: 99%

“…Although there is very limited empirical evidence on screening outcomes in adults younger than 50 years (because of the traditional starting age of 50 years in research studies and clinical practice), the qualified recommendation that average‐risk adults begin screening at age 45 years is based on the prolonged trends in disease burden showing increases in CRC incidence and mortality in adults younger than 55 years and modeling analyses showing efficient strategies for CRC screening starting at age 45 years . The underlying evidence pertaining to rising incidence in adults younger than 55 years was discussed in detail in the guideline article and was summarized in last year's annual cancer screening update …”

Section: Screening and Surveillance For The Early Detection Of Adenommentioning

confidence: 99%

“…The 2013 guideline statement placed a high priority on smoking cessation counseling for current smokers who were considering screening as one of the core elements of the discussion about lung cancer screening . In the 2017 clarification and update, the importance of smoking cessation counseling was stated more clearly as an important element in the process of identifying high‐risk adults who are eligible for lung cancer screening …”

Section: Screening For Lung Cancermentioning

confidence: 99%

“…In this update, we provide the most recent national screening data from the NHIS, a nationally representative, in‐person household survey that includes questions regarding cancer screening every 2 to 3 years . The most recent data available are from the 2015 NHIS and were included in the 2017 and 2018 annual reviews of cancer screening published in this journal. Here, we include these basic data for reference (Table ), but readers should refer to the prior articles for greater detail.…”

Section: Surveillance Of Cancer Screening: Colorectal Breast Cervicmentioning

confidence: 99%

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Cancer screening in the United States, 2019: A review of current American Cancer Society guidelines and current issues in cancer screening

Smith

Andrews

Brooks

et al. 2019

CA A Cancer J Clinicians

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559

392

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Each year, the American Cancer Society publishes a summary of its guidelines for early cancer detection, data and trends in cancer screening rates, and select issues related to cancer screening. In this issue of the journal, the current American Cancer Society cancer screening guidelines are summarized, and the most current data from the National Health Interview Survey are provided on the utilization of cancer screening for men and women and on the adherence of men and women to multiple recommended screening tests.

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Section: Discussionmentioning

confidence: 99%

Section: Screening and Surveillance For The Early Detection Of Adenommentioning

confidence: 99%

Section: Screening For Lung Cancermentioning

confidence: 99%

Section: Surveillance Of Cancer Screening: Colorectal Breast Cervicmentioning

confidence: 99%

See 2 more Smart Citations

Cancer screening in the United States, 2019: A review of current American Cancer Society guidelines and current issues in cancer screening

Smith

Andrews

Brooks

et al. 2019

CA A Cancer J Clinicians

Self Cite

559

392

View full text Add to dashboard Cite

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“…National guidelines (including those of the USPSTF and American Cancer Society) are explicit in specifying that CRC screening using FOBT/FIT should be done at home . Moreover several randomized trials point to the efficacy of home‐based FOBT for CRC screening .…”

Section: Introductionmentioning

confidence: 99%

Physician‐office vs home uptake of colorectal cancer screening using FOBT/FIT among screening‐eligible US adults

et al. 2019

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Background Guidelines of the American Cancer Society and US Preventive Services Task Force specify that colorectal cancer (CRC) screening using guaiac‐based fecal occult blood test (FOBT)/fecal immunochemical test (FIT) should be done at home. We therefore examined the prevalence and correlates of CRC screening using FOBT/FIT in physicians' office vs at home. Methods Analysis of 9493 respondents 50‐75 years old from the Cancer Control Supplement of the 2015 National Health Interview Survey was conducted. Weighted multivariable logistic regression was used to identify the determinants of in‐office vs home use of FOBT/FIT for CRC screening. Results Of the overall sample of screening‐eligible adults (n = 9403), only 937 (10.4%) respondents underwent CRC screening using FOBT/FIT within the past year; among this screening population, 279 (28.3%) respondents were screened in‐office. We found that sociodemographic factors alone, not CRC risk factors, determined whether FOBT/FIT would be used in‐office or at home. Hispanics had greater odds of being screened in‐office using FOBT/FIT (aOR: 2.04; 95% CI: 1.05‐3.99). Compared with those 50‐59 years old, respondents 70‐75 years old were less likely to be screened in‐office using FOBT/FIT (aOR: 0.44, 95% CI: 0.25‐0.79). Similarly, individuals residing in the Western region of the country had lower odds of in‐office FOBT/FIT (aOR: 0.26; 95% CI: 0.11‐0.58). Conclusion Amid low overall uptake rates of FOBT/FIT in the United States, in‐physician office testing is high, indicative of a missed opportunity for effective screening and poor adherence of physicians to national guidelines. Sociodemographic factors are determinants of uptake of FOBT/FIT at home or in‐office and should be considered in designing interventions aimed at providers and the general population.

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Comparison of Abbreviated Breast MRI vs Digital Breast Tomosynthesis for Breast Cancer Detection Among Women With Dense Breasts Undergoing Screening

Comstock

Gatsonis

Newstead

et al. 2020

JAMA

326

162

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Importance: Improved screening methods for women with dense breasts are needed because of their increased risk of breast cancer and of failed early diagnosis by screening mammography. Objective: To compare the screening performance of abbreviated breast MRI (AB-MR), and digital breast tomosynthesis (DBT) in women with dense breasts. Design, Setting, and Participants: Cross-sectional study with longitudinal follow-up at 48 academic, community hospital, and private practice sites in the US and Germany, conducted between December 2016 and November 2017, that included average-risk women aged 40-75 years with heterogeneously dense or extremely dense breasts undergoing routine screening. Follow up ascertainment of cancer diagnoses was complete through September 12 th , 2019. Exposure: All women underwent screening by both DBT and AB-MR, performed in randomized order and read independently to avoid interpretation bias. Main outcome measures: The primary endpoint was the invasive cancer detection rate. Secondary outcomes included sensitivity, specificity, the additional-imaging-recommendation-rate, and positive predictive value (PPV) of biopsy, using invasive cancer and DCIS to define a positive reference standard. All outcomes are reported at the participant level. Pathology of core or surgical biopsy was the reference standard for cancer detection rate and PPV; interval cancers reported until the next annual screen were included in the reference standard for sensitivity and specificity. Results: Among 1516 enrolled women, 1444 (median age 54, range 40-75) completed both examinations and were included in the analysis. The reference standard was positive for invasive cancer with or without DCIS in 17 women, and for DCIS alone in another 6. No interval cancers were observed during follow-up. AB-MR detected all 17 women with invasive cancer, and 5/6 women with DCIS. DBT detected 7/17 women with invasive cancer, and 2/6 women with DCIS. The invasive-cancer-detection-rate was 11.8 per 1000 women [95% CI 7.4-18.8] for AB-MR versus 4.8 per 1000 women [95% CI 2.4-10.0] for DBT, a difference of 7 per 1000 women [95% CI for the difference 2.2-11.6] (exact McNemar p=0.002). For detection of invasive cancer and Comstock et al.

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Cancer screening in the United States, 2018: A review of current American Cancer Society guidelines and current issues in cancer screening

Cited by 444 publications

References 114 publications

Cancer screening in the United States, 2019: A review of current American Cancer Society guidelines and current issues in cancer screening

Cancer screening in the United States, 2019: A review of current American Cancer Society guidelines and current issues in cancer screening

Physician‐office vs home uptake of colorectal cancer screening using FOBT/FIT among screening‐eligible US adults

Comparison of Abbreviated Breast MRI vs Digital Breast Tomosynthesis for Breast Cancer Detection Among Women With Dense Breasts Undergoing Screening

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