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Patterns and Trends in Cancer Screening in the United States

CME ACTIVITY — Volume 15 — July 26, 2018

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Figure 1.
Progress toward meeting Healthy People 2020 cancer screening targets (2), National Health Interview Survey (NHIS) 2008 and 2015 estimates of cancer screening test use based on US Preventive Services Task Force recommendations: Papanicolaou test among women aged 21 to 65 in past 3 years, mammogram among women 50 to 74 within past 2 years, colorectal cancer tests among adults aged 50 to 75 years (fecal occult blood test [FOBT] within past year or flexible sigmoidoscopy past within 5 years and FOBT within past 3 years or colonoscopy within past 10 years). Healthy People 2020 targets represent improvements over 2008 baseline age-adjusted screening levels of 10% for Papanicolaou test, 10% for mammography, and 35% for colorectal cancer testing. Brackets indicate gap between NHIS 2015 reported screening and Healthy People 2020 targets. Abbreviation: NA, not applicable.

Screening Test Prevalence (Predictive Margin) by Year, %
2008 NHIS 2015 NHIS Females 2015 NHIS Males HP2020 Target
Papanicolaou test 84.5 81.3 NA 93.0
Mammogram 73.7 71.7 NA 81.1
Colorectal cancer tests 52.1 63.4 61.9 70.5

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Figure 2.
Trends in use of cancer screening tests among women and men, National Health Interview Survey, 2000–2015 (www.cdc.gov/nchs/nhis/index.htm). A. Prevalence of having a Papanicolaou test within past 3 years among women aged 20 to 65. B. Prevalence of having a mammogram among women aged 50 to 74 within past 2 years. C. Prevalence of having a recent colorectal cancer test among women aged 50 to 75 (for colorectal cancer tests, recent is defined as having a fecal occult blood test [FOBT] in the past year, flexible sigmoidoscopy in past 5 years with FOBT in past 3 years, or colonoscopy in past 10 years). D. Prevalence of having a recent colorectal cancer test, by insurance coverage, among men aged 50 to 75. E. Prevalence of having a PSA test among men aged 50 and older. Estimates were adjusted for age, education, poverty, usual source of care, type of health insurance, race/ethnicity, length of US residency, physician visit in the past year, and among women, OB/GYN visit in the past year. Abbreviations: ED, emergency department; PSA, prostate-specific antigen.

Papanicolaou Test, Year Access to Health Care %
2000 None/emergency department 80.5
2005 None/emergency department 79.4
2008 None/emergency department 78.0
2010 None/emergency department 80.6
2013 None/emergency department 80.2
2015 None/emergency department 78.5
2000 Usual source 87.7
2005 Usual source 86.7
2008 Usual source 86.8
2010 Usual source 85.9
2013 Usual source 84.1
2015 Usual source 83.4
Mammogram, Year %
2000 77.2
2003 75.3
2005 74.5
2008 75.8
2010 75.9
2013 75.9
2015 74.2
Colorectal Cancer, Women, Year %
2000 34.8
2003 38.3
2005 44.8
2008 52.7
2010 59.9
2013 60.1
2015 63.3
Colorectal Cancer, Men, Year Insurance %
2000 Private 35.4
2003 Private 40.9
2005 Private 46.5
20008 Private 55.2
2010 Private 62.6
2013 Private 59.2
2015 Private 63.9
2000 Public 32.9
2003 Public 42.4
2005 Public 43.4
2008 Public 45.4
2010 Public 55.5
2013 Public 58.4
2015 Public 59.4
2000 Uninsured 22.2
2003 Uninsured 29.3
2005 Uninsured 31.6
2008 Uninsured 34.3
2010 Uninsured 36.2
2013 Uninsured 45.5
2015 Uninsured 48.5
PSA Test, Year %
2000 41.8
2003 44.4
2005 42.6
2008 45.6
2010 43.4
2013 36.4
2015 37.3

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