Inadequate screening may cause delay in cancer diagnosis

Potentially deadly cancers such as colorectal, breast and cervical cancer are all too often detected in the late stages of the disease, and improper adherence to routine screening guidelines may be partially to blame, according to the CDC report “Surveillance of Screening-Detected Cancers (Colon and Rectum, Breast and Cervix) — United States, 2004-2006.” Late-stage colorectal cancer incidence rates increased with age and were highest among African Americans. Late-stage breast cancer was most common among African American women and those between the ages of 70 and 79. Late-stage cervical cancer was found to be most prevalent in Hispanic women and those between the ages of 50 and 79. “A combination of genetics and insufficient access to health care is what’s causing this increased rate of late-stage cancer diagnosis in minorities,” says ACSH’s Dr. Gilbert Ross, and the latter is “something public health authorities need to address.” Marcus Plescia, director of the Division of Cancer Prevention and Control, says, “This report causes concern because so many preventable cancers are not being diagnosed when treatment is most effective.” But Dr. Ross and ACSH’s Dr. Elizabeth Whelan aptly point out that the cancers cited in the CDC report are not preventable. “Preventing cancer has to do with avoiding known cancer causing agents, such as cigarettes, or preventing it with drugs, known as chemoprevention — these are not the subjects of this CDC report,” says Dr. Whelan. “This deals with the needless delay in diagnosis and treatment of cancers in areas where they could have been detected earlier, thereby saving lives.” These preventable deaths would decrease if more doctors advised their patients and public health authorities directed the general population more forcefully and clearly to follow the recommended screening protocols, says Dr. Ross. The U.S. Preventative Services Task Force recommends that men and women aged 50 to 75 with an average risk for colorectal cancer should get either a fecal occult blood test annually, a flexible sigmoidoscopy every five years or a colonoscopy every 10 years. Women of average risk between the ages of 50 and 74 are advised to have screening mammograms every two years, and a routine Pap test for cervical cancer should begin within three years of sexual activity or at age 21 and a routine Pap test for cervical cancer should begin within three years of sexual activity or at age 21. “Of course, those with elevated risk need to discuss more frequent screenings with their doctors. And people older than the arbitrary age limits noted here may also have continued screening if they believe it to be in their best interests — again, in consultation with their doctors,” added Dr. Ross.