Achieving 80% by 2018 Screening Goal Could Prevent 200,000 Colon Cancer Deaths in Less Than 2 DecadesMar 12, 2015
Increasing screening rates to 80% by 2018 would prevent 277,000 new cases of colon cancer and 203,000 deaths within 20 years, according to a new study. Reaching that screening rate is a primary goal of the 80% by 2018 initiative, begun a year ago by the National Colorectal Cancer Roundtable (NCCRT), a national coalition of public, private, and voluntary organizations. The study is co-authored by American Cancer Society Vice President, Surveillance and Health Services, Ahmedin Jemal, DVM, PhD and appears in CANCER, a peer-reviewed journal of the American Cancer Society.
Screening is looking for cancer in people who have no symptoms of the disease. In the case of colon cancer, screening can often find the disease at an early, more treatable stage. It can also prevent some colon cancers altogether. This is because some colon cancer screening tests can find polyps (growths), which can then be removed before they have a chance to become cancerous.
The American Cancer Society recommends colon cancer screening begin at age 50 for people at average risk. But some people have certain risk factors, such as family history or colon problems, that make them more likely to develop colon cancer, and to get it at an earlier age. This may mean they should start screening earlier, or get tested more often than other people. Talking to a doctor is the best way to find out about when to begin screening.
But many people who should be getting screened for colon cancer are not being screened. For the study, the researchers used a computer model to calculate the effects of increasing screening rates from about 58% in 2013 to 80% in 2018. They then compared those to the effects of a scenario in which the screening rate did not increase.
They predicted that increasing screening rates to 80% by 2018 would reduce the rates of new colon cancer cases by 17% and death rates by 19% by the end of 2020. By 2030, colon cancer incidence rates would drop by 22% and death rates would drop by 33%. Those reductions add up to 277,000 new cancers and 203,000 colon cancer deaths prevented from 2013 through 2030.
According to Jemal, the impact of reaching the 80% by 2018 goal would be “huge.” In addition to preventing more than 200,000 deaths from colon cancer, Jemal says the years of life saved would be in the millions.
Breaking down screening barriers
Colon cancer is the third leading cause of cancer death in men and women in the US, and the second leading cause for both sexes combined. The death rate has been dropping for the last 20 years, largely because of increased use of screening. Yet fewer than 6 in 10 American adults (58%) aged 50 to 75 years were up-to-date on screening in 2013. Those less likely to get tested include people with lower education and income, and those who don’t have health insurance.
According to Jemal, screening rates are only 20% for under-insured people and 37% for people with no high school diploma. “In order to achieve the 80% goal, we need to promote screening in all populations, including the most disadvantaged populations with lowest screening rates,” said Jemal. “But we cannot reach the 80% goal by only targeting this segment of the population. Even for people with highest income levels, screening hasn’t reached an optimal level.”
Richard C. Wender, MD, Chair, NCCRT and Chief Cancer Control Officer for the American Cancer Society, said more work needs to be done.
“We already have made great progress in reducing mortality from colon cancer. And this campaign is all about pushing to the finish line,” said Wender. “What’s been exciting about the 80 by 18 goal is it has resonated quickly and it’s resonated powerfully. And it’s good that it’s resonated quickly because the clock is ticking and we really need to move very rapidly if we’re going to achieve this 80% goal. We need to find the way to create equity to make sure that everyone has an equal opportunity to be screened. And so much of the work that we’re doing is targeting lower income people who face screening barriers.”
Public Health Impact of Achieving 80% Colorectal Cancer Screening Rates in the United States by 2018. Published March 12, 2015 in CANCER. First author Reinier G.S. Meester, MS, Erasmus MC University Medical Center, Rotterdam, the Netherlands.