Most Americans do not know when to get cancer screening tests

Aug 3 2006

While most Americans know that mammograms, pap smears, and colonoscopies are screening exams for cancer, the majority of Americans do not know the appropriate age at which initiation of these tests is recommended, according to the latest brief from the Health Information National Trends Survey (HINTS).

HINTS is a nationally representative telephone survey of the general population that was first conducted in 2002-2003 and repeated in 2005. The National Cancer Institute (NCI), part of the National Institutes of Health, developed HINTS to evaluate how the general public accesses and uses information about cancer, and how this information can be delivered most effectively.

"We must significantly increase our efforts to inform all Americans of what cancer screening tests are available so that we can catch cancer in its earliest stages when it is most treatable," said NCI Acting Director John E. Niederhuber, M.D. "We need to get into communities with a renewed education effort."

A recent analysis of HINTS 2005 data found that 57 percent of American women are unaware that they should receive mammograms to screen for breast cancer beginning at age 40. The survey also revealed more positive results: three-quarters of women reported that their health care providers had recommended mammograms, and 74 percent reported having received a mammogram within the recommended timeframe.

A larger majority of women are unaware that they did not need a Pap test every year to screen for cervical cancer; current general guidelines advise women to get Pap tests at least once every three years. A large proportion of women - 87 percent of those who had ever received a Pap test - said they did so as part of an annual exam. Another finding was that 61 percent of women surveyed had never heard of human papillomavirus (HPV), which causes most cases of cervical cancer.

While there are several different tests available to screen for colorectal cancer, including fecal occult blood tests (FOBT), sigmoidoscopy, and colonoscopy, 40 percent of HINTS respondents could not name one when asked. Additionally, 54 percent did know that screening for colorectal cancer is recommended for men and women age 50 or older, according to general recommendations. Knowledge of different screening options is important; research shows that being offered a choice may improve the chance that people get screened and that they continue to get screened as recommended.

For the screening tests surveyed, knowledge of screening recommendations varied by race and ethnicity. When asked when screening for colorectal cancer is recommended, 79 percent of Hispanic respondents did not know the recommended age, compared to 75 percent of African Americans, 70 percent of American Indians/Alaskan Natives, and 38 percent of Whites. Similar levels of misinformation were reported among women of all ethnicities who were asked when it is recommended that they should begin to receive mammograms, with only 32 percent of all women responding that mammograms should begin at age 40. The U.S. Preventive Services Task Force recommends screening mammography, with or without a clinical breast exam, every one to two years for women age 40 and older.

For more information about the Health Information National Trend Survey, go to http://cancercontrol.cancer.gov/hints.