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CDC To Track Prevention Progress with Monthly ’Vital Signs’

 |  By cclark@healthleadersmedia.com  
   July 06, 2010

Although the percentage of Americans who receive recommended breast and colon cancer screening has risen, millions are not getting the tests that could save thousands of lives, officials for the Centers for Disease Control and Prevention said today in the first in a monthly series of reports called “CDC Vital Signs.“

One in three people in the U.S. has not been screened for colon cancer, or 22 million people, and 19% of women between the ages of 50 to 74, or 7 million women, have not had a mammogram in the last two years, Thomas Frieden, MD, CDC director, said in a news briefing last week.

Colorectal cancer is the second leading cause of cancer death in the U.S. and the leading cause of cancer death among non-smokers, yet 32,000 lives could be saved if every adult 50 years of age and older got tested regularly for colorectal cancer. Frieden added that about 12,000 lives are saved each year as a result of mammography.

Having health insurance coverage seemed to make significant differences in whether people got recommended screening. For example, 65.7% of people surveyed who had insurance had received a fecal occult blood test within the last year or a lower endoscopy within the last 10 years, compared with 35.6% who did not have health insurance.

Likewise for mammography, 83.8% of women who had health insurance received recommended screening mammogram, versus 56.3% of women who did not have health insurance.

Frieden says much more progress could be made if health payers would reorganize their coverage, for example, exempting beneficiaries from having to make co-payments for those tests.

Frieden and Marcus Plescia, MD, Director of the CDC’s Division of Cancer Prevention and Control said during the briefing that understanding the reasons behind the wide geographic variation in screening is a public health target. For example, the highest colorectal cancer screening prevalence of 74% was noted in northeastern states Maine, Delaware, and Massachusetts, but the lowest were in central states, such as Oklahoma, Arkansas, and Idaho, 53% or 54%.

In breast cancer, screening was lower for women with less than a high school education and women in low-income brackets. “Lack of insurance appears to be one of the primary reasons for racial and ethnic differences in colon and breast cancer screening rates,” the CDC says.

The agency’s press release estimated that 30,000 people died last year because they weren’t screened for colon or breast cancer, which could have been removed before it had spread. But at the news briefing, Frieden stepped back from that number saying that number was controversial, because some metastatic cancer cases are discovered in people in age brackets older than those recommended for screening.

Future editions of new monthly report will highlight issues in obesity, tobacco and alcohol use, access to healthcare, motor vehicle safety, HIV and AIDS, teen pregnancy, infant mortality, as well as cardiovascular health, asthma, and food safety. As health reform provisions are put into practice and as more Americans have health benefits, the CDC hopes to see disease numbers decline as screenings increase.

“In each area we have a large burden of disease and a lot of things we can do to make a difference to prevent illness, prevent death, save money, and drive down our healthcare costs,” Frieden says. “Are we making progress or are we not?”

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