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Cancer screening rates fall in U.S. over last decade, study finds

Fewer Americans are getting screened for cancer, according to a new study, and it may be due in part to the ongoing debate between medical groups over screenings' harms and benefits.

The study looked at U.S. screening rates between 1997 and 2010 for colon (colorectal), breast, cervical and prostate cancers. It found the general public did not meet government screening recommendations for any cancer types over the past decade except colorectal cancer.

The U.S. government's "Healthy People 2010" national disease prevention initiative sets goals of getting a percentage of the eligible population to get screened for cancer, based on guidelines from the independent panel of medical advisors to the government, the U.S. Preventive Services Task Force.

About 54 percent of the general public underwent colorectal screenings, the study showed, exceeding the 50 percent goal of the initiative.

"There is a great need for increased cancer prevention efforts in the U.S., especially for screening as it is considered one of the most important preventive behaviors and helps decrease the burden of this disease on society in terms of quality of life, the number of lives lost and insurance costs," study author Tainya Clarke, a research associate in the department of epidemiology and public health at the University of Miami Miller School of Medicine, said in a written statement.

"But despite this, our research has shown that adherence rates for cancer screenings have generally declined with severe implications for the health outlook of our society," she said.

The researchers also compared the general public's screening habits to those of cancer survivors, who are considered higher risk and thus recommended by treatment guidelines to get screened more frequently.

They found survivors had higher screening rates and underwent the recommended cancer screenings for all types except cervical cancer, which fell to 78 percent over the last decade. An overall decline among cancer survivors who sought cancer screenings over the last three years was reported.

Blue-collar workers were less likely to get screened than white-collar workers, which may be due to decreases in worker insurance rates, the researchers said.

The study was funded by the National Institutes of Health and published Dec. 27 in Frontiers in Cancer Epidemiology and Prevention.

The researchers speculated that ongoing debates among the United States Preventive Services Task Force, American Cancer Society and others over screening guidelines may cause some Americans to skip recommended screening.

The Task Force used to recommend routine mammogram screening for women over 40, which the American Cancer Society still recommends. In 2009, the panel revised its guidelines to say routine mammography should only occur every two years for women ages 50 to 74. The Task Force said the decision to start regular mammograms before age 50 should be an individual one, taking into account a patient's values regarding specific benefits and harms. Mammograms may give false alarms, spurring biopsies and other tests that show no cancer was present.

In 2012, the Task Force also formally recommended against routine PSA screeningfor prostate cancer in healthy older adults. The panel said the risk of the blood test spotting a tumor too slow-growing to ever cause a problem but may result in biopsy or surgery outweighed the cancer preventing benefits of the blood test.

The American Urological Association said it was outraged and the Task Force was doing men a disservice, arguing a PSA test provides useful information about pre-treatment and risk when interpreted correctly.

Dr. Otis Brawley, chief medical officer of the American Cancer Society, told HealthDay that despite the confusion that may arise, he thinks it's important for a patient to know information about risks and benefits and ask their doctors questions.

He also said that screening rates will change for the better because of the Affordable Care Act, which will require health insurance for all Americans.

"The obstacles to getting screening are going to change over the next several years," said Brawley. "So think of this study as more of a look back at what was going on in the last 10 years and not a predictor of what might happen in the next 10 years."

More than 570,000 Americans die in the cancer each year.

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