274231 Trends in cancer screening adherence and incidence in the U.S. 2000-2010

Wednesday, October 31, 2012

Tainya C. Clarke, MPH, MS , Department of Epidemiology & Public Health, University of Miami, Miller School of Medicine, Miami, FL
Manuel A. Ocasio, BA , Department of Epidemiology & Public Health, University of Miami Miller School of Medicine, Miami, FL
Alberto J. Caban-Martinez, PhD, DO, MPH, CPH , Department of Epidemiology & Public Health, University of Miami, Miller School of Medicine - NIOSH Research Group, Miami, FL
Hosanna Soler-Vila, PhD , Department of Epidemiology and Public Health, University of Miami Miller School of Medicine, Miami, FL
Lora E. Fleming, MD, PhD , European Centre for Environment and Human Health, University of Exeter Medical School, Truro, United Kingdom
Sharon L. Christ, PhD , College of Health and Human Sciences, Purdue University, West Lafayette, IN
Cristina Fernandez, MSEd , Department of Epidemiology and Public Health, University of Miami Miller School of Medicine, Miami, FL
Laura A. McClure, MSPH , Department of Epidemiology & Public Health, University of Miami, Miller School of Medicine, Miami, FL
Stacey L. Tannenbaum, PhD, RD, LD/N , Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL
Diana Kachan, BS , Epidemiology and Public Health, University of Miami, Miller School of Medicine, Miami, FL
Jenelle Lin, BS , Department of Epidemiology and Public Health, University of Miami Miller School of Medicine, Miami, FL
David Lee, PhD , Epidemiology & Public Health, University of Miami, Miami, FL
Kristopher L. Arheart, EdD , Department of Epidemiology & Public Health, University of Miami Miller School of Medicine - NIOSH Research Group, Miami, FL
Background: Cancer is the second deadliest disease in the US; however, over the past decade,there hasbeen a significant decrease in the incidence of advanced cancers. We investigated the association between adherence to cancer screening and reduced late stage diagnoses in the US population. Methods: Using incidence data from the 2000-2008 Surveillance Epidemiology and End Results database, we assessedthe trendsinregional and advanced stage diagnoses of three common cancers. We pooled data from the National Health Interview Survey (2000, 2003, 2005, 2008, 2010) to analyze adherence of recommended cancer screening tests (n=142,019) in the US population. Adherencewas measured within the appropriate age and sex cohorts according to American Cancer Society guidelines. Results: The overall incidence of advanced colorectal cancers decreased by 17.2% and breast by 6.8%between 2000 and 2008. Advanced cervical cancers remained stable. Overall, there was a decrease in adherence to most recommended screening examinationsbetween 2000 and 2010. Colorectal screening increased by 16.6%, representing 2.4 million more persons screened over the decade; mammography adherence decreased by 0.9%, representing an estimated 1.7million fewer mammograms. An estimated 2.5 million fewer women reported having a recommended paptest, reflecting a7.5% decrease. Conclusion: From 2000-2008, cancers with reduced screening adherence or minimal changes in adherence showed smaller improvements in rates of late stage diagnosis when compared to cancers for which the screening adherence increased. Efforts should be made to improve screening rates in order to help reduce late stage cancer diagnoses in the US.

Learning Areas:
Epidemiology
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Public health or related public policy
Public health or related research

Learning Objectives:
1. Describe trends in incidence and mortality of common cancers within the U.S. population using nationally representative data. 2. Explore changes in recommended cancer screening adherence within the U.S. population over the past decade 3. Identify cancers with high incidence of late stage presentation and low screening adherence rates in order to direct targeted interventions and guide public health policies.

Keywords: Cancer, Screening

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am currently a researcher in several cancer epidemiology research groups and am a doctoral student focusing on cancer survivors and cancer preventive behaviors.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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