Data and trends in cancer screening in the United States

Swan, Judith; Breen, Nancy; Graubard, Barry I.; McNeel, Timothy S.; Blackman, Donald; Tangka, Florence; Ballard‐Barbash, Rachel

doi:10.1002/cncr.25215

Cited by 118 publications

(71 citation statements)

References 94 publications

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“…The adherence rates in this study (overall 89.3 %) are considerably higher than in other published reports [3,6,10]. Reminder phone calls and postcards are effective in increasing rates of CRC screening [11].…”

contrasting

confidence: 67%

“…Colonoscopy, regarded by most expert advisory groups as the mainstay of CRC screening, is the only modality that both detects and removes neoplastic polyps from the entire colon. Despite its efficacy, only 20-38 % of the population is adherent to CRC screening guidelines [2,3]. Colonoscopy at present is estimated to decrease CRC-related mortality by 53 %, with further decrements expected if a greater proportion of individuals received age-appropriate screening [4].…”

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confidence: 99%

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Adherence to Screening Colonoscopy: Can We Get Our Recommendations to Stick?

Rogers

Keswani

2015

Dig Dis Sci

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Although colorectal cancer (CRC) remains the second leading cause of cancer-related mortality in the USA, its incidence and mortality have decreased in men and women since 1997, a reduction attributed, in part, to the increased use of CRC screening modalities [1]. Colonoscopy, regarded by most expert advisory groups as the mainstay of CRC screening, is the only modality that both detects and removes neoplastic polyps from the entire colon. Despite its efficacy, only 20-38 % of the population is adherent to CRC screening guidelines [2,3]. Colonoscopy at present is estimated to decrease CRC-related mortality by 53 %, with further decrements expected if a greater proportion of individuals received age-appropriate screening [4]. Given limited healthcare resources, information that enables practitioners to focus interventions on populations most likely to be non-adherent to screening colonoscopy is valuable.Multiple patient factors influence adherence to CRC screening [5,6]. Demographic factors associated with lower rates of screening include female gender, younger age, low income or educational attainment, recent immigrant status, lack of health insurance, and persons of African-American or Hispanic descent [5]. Health factors associated with non-adherence include multiple medical comorbidities and decreased primary care utilization [6]. Nevertheless, little is known about how adherence differs among patients who are undergoing surveillance colonoscopy indicated for a history of colorectal polyps or are undergoing screening colonoscopy.In this issue of Digestive Diseases and Sciences, Greenspan et al. [7] report the results of a prospective study comparing rates of adherence to screening and surveillance colonoscopy in a population of 617 patients seeking care at an urban, tertiary medical center. Of multiple demographic factors studied in patients scheduled to undergo colonoscopy, patients scheduled for screening colonoscopy were significantly less likely to undergo their procedures than those scheduled for surveillance of adenomatous polyps (RR 5.42,). This intuitive finding represents a new, easily identifiable factor toward which patient adherence efforts can be directed.While univariate analysis indicated that female gender and the presence of medical comorbidities (represented by clopidogrel use and a history of congestive heart failure) were associated with an increased risk of non-adherence, these were not significant according to multivariable logistic regression analysis, consistent with prior studies [8]. The single factor associated with non-adherence and repeated procedure cancellations according to multivariable analysis, was indication for colonoscopy [7]. Although patients with a prior history of adenomatous polyps are at high risk of the development of adenomas or carcinoma (20-50 %) at subsequent surveillance colonoscopy, the risk of adenoma or carcinoma in asymptomatic patients undergoing screening colonoscopy can also be as high as 50 % [9]. Thus, it is appropriate to direct efforts toward ensuri...

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contrasting

confidence: 67%

mentioning

confidence: 99%

Adherence to Screening Colonoscopy: Can We Get Our Recommendations to Stick?

Rogers

Keswani

2015

Dig Dis Sci

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“…In a population-based study, parcipitation in screening programs with fecal occult blood test was higher in patients with higher education levels, married and higher income (Frederiksen et al, 2010). Similarly (Swan et al, 2010) suggested that the rate of SC were positively associated with education and income.…”

Section: Discussionmentioning

confidence: 95%

Screening Colonoscopy Participation in Turkish Colorectal Cancer Patients and their First Degree Relatives

Kılıçkap¹,

Arslan²,

Rama³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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Background: This study aimed to research the awareness of screening colonoscopy (SC) among patients with colorectal cancer (CRC) and their relatives. Methodology: A questionnaire form including information and behavior about colonoscopic screening for CRCs of patients and their first-degree relatives (FDRs) was prepared. Results: A total of 406 CRC patients were enrolled into the study, with 1534 FDRs (siblings n: 1381 and parents n: 153) . Positive family history for CRC was found in 12% of the study population. Previous SC was performed in 11% of patients with CRC. Mean age of the patients whose FDRs underwent SC was lower than the patients whose FDRs did not (52 vs 57 years; p<0,001). The frequency of SC in FDRs was 64% in patients diagnosed CRC under 35 years of age. Persons having a positive family history of CRC had SC more often (51 vs 22%, p<0,001). FDRs of patients having a higher educational level and income had SC more frequently. Conclusions: When screening for CRC is planned, elderly subjects, those with family history for CRC, and those with low educational and lower income should be given esspecial attention in order that they be convinced to undergo screening for CRC.

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“…This result must be tempered by knowledge that PSA testing may serve as a proxy for individual socioeconomic status. 42 In addition, more PSA screening will result in more local/regional diagnoses, leading to possible overtreatment. The risk of a local/regional diagnosis rose 2% for white males with 1 PSA test every 3 years and 6% for black males with 2 PSA tests every 3 years, versus those who had no PSA tests.…”

Section: Discussionmentioning

confidence: 99%

Explaining racial differences in prostate cancer mortality

Taksler

Keating

Cutler

2012

Cancer

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BACKGROUND:In the United States, black males have an annual death rate from prostate cancer that is 2.4 times that of white males. The reasons for this are poorly understood. METHODS: Using the Surveillance, Epidemiology, and End Results-Medicare database, 77,038 black and white males aged >65 years were identified with a first primary diagnosis of prostate cancer between 1995 and 2005, as well as 49,769 controls. The racial gap in mortality was decomposed to differential incidence and stage-specific prostate cancer mortality. The importance of various clinical and socioeconomic factors to each of these components was then examined. RESULTS: The estimated mortality gap for prostate cancer-specific mortality was 1320 more cases per 100,000 males among black than white men. This gap was due to higher prostate cancer incidence among black males (76%) and higher stage-specific mortality once diagnosed (24%). Differences in prostate-specific antigen testing, comorbidities, and income explained 29% of the difference in metastatic cancer incidence but none of the racial gap for local/regional incidence. Conditional on diagnosis, tumor characteristics explained 50% of the racial gap, comorbidities an additional 4%, choice of treatment and physician 17%, and socioeconomic factors 15%. Overall, approximately 25% of the racial gap in mortality and 86% of the gap in mortality conditional on diagnosis could be explained. CONCLUSIONS: More frequent prostate-specific antigen testing for black and low-income males could potentially reduce the prostate cancer mortality gap through earlier diagnosis of tumors that otherwise may become metastatic. More aggressive treat-

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Data and trends in cancer screening in the United States

Cited by 118 publications

References 94 publications

Adherence to Screening Colonoscopy: Can We Get Our Recommendations to Stick?

Adherence to Screening Colonoscopy: Can We Get Our Recommendations to Stick?

Screening Colonoscopy Participation in Turkish Colorectal Cancer Patients and their First Degree Relatives

Explaining racial differences in prostate cancer mortality

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