According to a recent report from the CDC (Centers for Disease Control & Prevention), more than 10,000 people in the U.S. die every year because they didn’t get screened for breast or colon cancer. The good news is that more people are getting screened than ever before, but still more than a third of people who should get screened are not.
Based on a state-wide Behavioral Risk Factors Surveillance Survey in 2008, researchers found that colon cancer screenings increased from 52% of those who should get tested in 2002, to 63% in 2008. There are some income and racial disparities, with hispanics and people with low incomes and little formal education less likely to be screened. Screening rates among African-Americans have improved for colorectal cancer. Although screening rates have improved, Dr. Marcus Plescia, director of the CDC’s division on cancer prevention and control says, “Rates are still not where they should be for a test that can make such a difference.”
Unfortunately, the Surveillance Survey found vast differences in rates of colorectal and breast cancer screening for people with insurance compared to those who are uninsured. The report found that only 36% of people without insurance got screened for colorectal cancer; 66% of insured people got screened. For breast cancer screening, 84% of women with insurance got mammograms compared with only 56% of women with no insurance. Currently more than 46 million Americans have no health insurance. That’s more than 15% of the population.
For screenings that have a large impact on outcomes, that is a difference that matters. The American Cancer Society estimates than many tens of thousands of lives could be saved if everyone got screened. They estimate that colon cancer screening alone could save 30,000 lives every year.
The problem with lack of insurance is about more than just not having the tests paid for. After all, many states have programs to offer routine cancer screening to low income and uninsured people. But most uninsured people don’t have regular access to doctors and don’t get the regular reminders of the importance of routine screening. Reminders matter! A study by the Kaiser Permanente Center for Health Research found that automated phone reminders increased colon screening by 30%. Unfortunately, the uninsured fall outside the system of regular reminders.
Fifteen percent of the U.S. population doesn’t get the regular kick in the butt that most of us get from our doctors and insurance companies. And even if they get the message on their own and want to get the exams, 15% of the U.S. population may not be able to afford the test, or may not know about or qualify for state programs. That’s a lot of people and a lot of lives.