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Disease Prevention

Although Most People Getting Screened for Two of the Nation's Deadliest Cancers, Thousands of People Died Last Year Because They Weren't Screened for Colon or Breast Cancer

More adults in the United States have been getting recommended breast and colorectal cancer screenings, but millions of people still have not had recommended screening, according to data released in the new Centers for Disease Control and Prevention (CDC) monthly report, CDC Vital Signs.

Overall, the data indicate that more people are receiving recommended cancer screenings, with colorectal screening increasing from 52 percent in 2002 to 63 percent in 2008. Eighty-one percent of women 50-74 years old received recommended mammography screening for breast cancer in 2008. The findings indicated that more than 22 million men and women have not had a potentially life-saving screening test for colorectal cancer and about 7 million women age 50 to 74 have not had a recent mammogram.

"It's encouraging to see more adults getting recommended cancer screenings," said Dr. Thomas Frieden, CDC director. "But we have more to do, especially when it comes to getting more people screened for colorectal cancer, which kills more American non-smokers than any other cancer. Tragically, one in three people who should be screened for colorectal cancer have not yet done so; and rates are even lower among Hispanics and blacks."

The report on two of the nation's deadliest cancers, published online at, used the most recent data available from the state-level 2008 Behavioral Risk Factor Surveillance Survey to determine the number of people receiving the recommended colorectal cancer and breast cancer screenings. Each month, CDC Vital Signs will provide the most recent, comprehensive data on one of twelve key indicators of important health topics.

Colorectal cancer is the second leading cause of cancer deaths in the United States, after lung cancer. Breast cancer is the most commonly found cancer and the second leading cause of cancer deaths among U.S. women.

Significant findings include:

Colorectal Cancer Screening

  • Insured adults had higher screening rates than those uninsured – 66 percent compared to 36 percent.
  • State colorectal cancer screening prevalence varied from 53 percent in Oklahoma to 74 percent in Massachusetts.
  • Highest screening prevalence was concentrated in northeastern states at 74 percent in 3 states in Maine, Delaware, and Massachusetts. The lowest prevalence occurred in the central and western regions in Oklahoma (53 percent), Arkansas (53 percent), and Idaho (54 percent).
  • The lowest screening prevalence was among the uninsured (36 percent)
  • Screening prevalence continue to be lower among all racial and ethnic minorities except forblacks. Factors linked to low screening prevalence include having a low income (48 percent), less than a high school education (46 percent), and not having health insurance (36 percent).

Breast Cancer Screening

  • Eighty-one percent of women aged 50-74 years reported having a mammogram within the past two years.
  • American Indian and Alaska Native women reported the lowest prevalence for mammography screening (70 percent).
  • Screening prevalence was lower among women with less than a high school education (73 percent), and for women with low income (69 percent).
  • Mammography screening prevalence was lowest in the western states in Nevada (72 percent), Mississippi (72 percent), and Idaho (73 percent).
  • Insured women had a 28 percentage-point higher screening prevalence than uninsured women (84 percent versus 56 percent). Even among women with health insurance, 16 percent were not up-to-date with mammograms.

Achieving Higher Cancer Screen Rates

The studies show that physician recommendations and health insurance coverage are strongly associated with people getting recommended cancer screenings. Lack of insurance appears to be one of the primary reasons for racial and ethnic differences in colon and breast cancer screening rates.

The new studies indicate that physician recommendation for screening remains an important but underused motivator for cancer screenings. The report concludes that improving cancer screening benchmarks in clinical practice must be a higher priority for new health care methods. One example of new practice methods is the patient-centered medical home, a team-based approach led by a personal physician who provides continuous and coordinated care throughout a patient's lifetime.

The report also noted that the Affordable Care Act is likely to reduce financial barriers to screening by expanding insurance coverage and eliminating cost sharing. Additionally, it suggests that the field of public health can expand surveillance, outreach, case management, and quality assurance to improve colorectal and breast cancer screening outcomes of the U.S. population.

Importance of Cancer Screening

In 2006, more than 139,000 new cases of colorectal cancer were diagnosed and more than 53,000 people died from this disease. Colorectal cancer screening tests can find precancerous polyps so they can be removed before they turn into cancer, thus preventing the disease. Screening can also detect colorectal cancer at an early stage, when treatment can be highly effective.

In 2006, more than 191,000 women were diagnosed with invasive breast cancer and more than 40,000 died from the disease. Mammograms are the best method to detect breast cancer early when it is easier to treat and before it is big enough to feel or cause symptoms.

For more information on the Centers for Disease Control and Prevention, visit

© 2010 Health Resources Publishing