Americans Unsure of When to Get Cancer Screening Tests

BETHESDA, Maryland—Although most American adults can identify mammography, the Pap test, and colonoscopy as cancer screening tests, they are generally ill informed about the age at which screening should begin and how often they should undergo the examinations. This picture has emerged from a new analysis of data from the 2005 Health Information National Trends Survey (HINTS) conducted for the National Cancer Institute (NC). For example, only 43% of the women surveyed last year knew that the recommended age to begin regular mammograms for breast cancer screening is 40; only 21% knew that the Pap test is recommended once every 3 years (not yearly); and 46% did not know that colorectal cancer screening should begin at age 50.

The survey did yield some encouraging information about breast cancer. "Three-quarters of women report that their health care providers had recommended mammograms, and 74% reported having received a mammogram within the recommended timeframe," NCI said.

Of the 2,815 women surveyed who were 35 or older and who had not had breast cancer, 87% had undergone at least one mammography. Of these, 68% had received their most recent mammogram within 1 year, 15% between 1 and 2 years earlier, 11% between 2 and 5 years, and 5% more than 5 years earlier.

Colorectal Cancer

All 5,559 people surveyed last year were asked if they could think of any tests used to detect colon cancer. Almost one-third (32%) could not name a single test, but 41% mentioned colonoscopy and 15% named the stool blood/fecal occult blood test. Other tests suggested by participants were barium enema (2%), biopsy (1%), digital rectal exam (1%), proctoscopy (0.5%), sigmoidoscopy (0.4%), and endoscopy (0.1%).

Of respondents age 45 or older who had never had colon cancer, 56% said a doctor, nurse, or other health professional had advised them to get a test for the disease. Of this group, 46% said they had used a kit to perform a stool blood test at home, and 54% said they had undergone either a colonoscopy or sigmoidoscopy.

Cervical Cancer

Among the 3,578 women surveyed who had not had cervical cancer, 96% said they had had a Pap smear. Of these, 63% reported having the test within 1 year or less. The other timeframes for the remaining women were 1 to 2 years (19%), 3 to 5 years (6%), and 5 years or more (11%) before the survey. The survey also asked if they knew that a recent change in guidelines recommended a Pap test for healthy adult women every 3 years. Only 21% said they knew of the change.

The women who had never had cervical cancer were asked if they had ever heard of the human papillomavirus (HPV). Only 37% said they had. These women were asked if they thought the virus caused cervical cancer: 47% answered yes, 9% said no, 44% said they did not know, and 0.3% refused to answer. Asked if they thought HPV was sexually transmitted, 64% said yes, 19% said no, 26% said they did not know, and 0.2% refused to answer.

Prostate Cancer

The survey asksed 1,090 men age 45 and older who had not had prostate cancer if they had ever heard of the PSA test: 84% said yes and 75% of these said they had had a PSA test. Asked when their most recent PSA test had occurred, 71% said within a year or less and 14% said between 1 and 2 years earlier. Another 10% dated their test back between 2 and 5 years ago, 4% said more than 5 years ago, and 0.7% didn't know.