I'm Dr. John Iskander, welcome to CDC Beyond the Data.
Today I'm here with Dr. Marcus Plescia, Director of the Division
of Cancer Prevention and Control at CDC.
So, Dr. Plescia, for today's Grand Rounds
about Cancer Screening, can you begin
by reminding our audience what cancer screenings are
recommended and who they're recommended for?
Yeah, sure, so there are three cancer screenings
that we place the most focus on because we feel
like there's very good evidence for them.
Breast cancer screening for the most part on women age 40 to 75.
Colon cancer screening in all adults age about 50 to 75
and then cervical cancer screening in women over the age
of 21.So those are the core programs we are focusing on,
those are the programs that CDC actually does work in.
Okay, so breast, cervical and colon cancer.
So on a population wide basis how are we doing
with those screenings and what are some
of the issues we need to address?
Well, we're doing all right.
We do very well with cervical cancer screening.
We have participation rates anywhere from 80
to 90 percent depending on which data sources you look at.
So, I think that's been a big public health success.
We've done pretty well with breast cancer screenings,
screening rates anywhere from 70 to 80 percent again depending
on the data source you look at.
I think we could do a little bit better there
but we've made a lot of progress.
Colon cancer screening we're really not doing as good as well
as we could be, and those are such good tests as far
as being able to find the disease early
when we can do something about it.
There the rates for screening are, you know, more than a third
of the population not getting screened.
So, participation rates are somewhere around 60 percent.
I think we really could improve that substantially.
Is one of the main issues health insurance
or is it more complicated than that?
Well, health insurance is a huge issue for people.
I mean if you don't have a way to pay
for your care it's a big barrier to being able to get it.
So we're very, very enthusiastic with health reform
and the implementation of the affordable care act.
We're very enthusiastic it's going to make a difference.
But, you know, I think it's important
to realize that's not the only thing we have
to pay attention to, there are a lot of other barriers we know
that among people who have health insurance
and have the usual source of care, we know that a quarter
of women still aren't up to date with their mammograms.
We know that about a third
of people aren't getting colon cancer screening.
Those are people with not just insurance but very good access.
In the Medicare population which has, you know,
reasonably good health insurance through the Medicare program,
you know, there the rates are even worse.
We're seeing a little more than a third of women not up to date
with their mammography tests and really only about a half
of people on medicare being up to date
with colon cancer screening.
So you know I think that the more wide spread insurance is
going to make a big difference.
And we really want to ride that wave
and just push it a little further and look at some
of the other things that are keeping people for participating
in these tests as well.
Okay, so beyond, you know,
better insurance and better access.
What are some of the things that we can do
to raise screening rates and to prevent more cancers.
I get the sense from what you're saying that, you know,
trying harder doing more of the same thing
that we've been doing isn't the answer.
So what are some of the solutions?
That's correct, just trying harder...
I think we need to try harder
but be strategic about how we do it.
So one of the things that we frequently say is
that the most likely predictor
of whether somebody gets a cancer screening test is
if their medical provider recommends it.
So, I think that that is very important,
and we need to continue to work in practice settings,
in the medical care setting to make sure we're looking at ways
to get people prompted when they have contact
with their medical provider system.
But, you know, that's, that's not enough.
We really need to look at ways to go directly to the public.
I mean that is public health's role,
that's public health's job.
We need to look at how we go directly to the public.
And make sure that people understand
and know are empowered about what kind of care they need
and what kind of cancer screenings they need.
And I think that's where we can really get the rates up.
So we need to work carefully
with the medical provider system.
We need to help providers look at ways
to be more effective with this.
But we need to go beyond that as well and not just stop there.
Thank you very much.
Please join us next time for CDC Beyond the Data.