Despite ACA, Americans still skip cancer screenings

May 11, 2015

Even though cancer screenings have become more available because of the Affordable Care Act, the percentage of adults getting certain cancer screenings has not increased significantly since 2010.

Even though the Affordable Care Act (ACA) eliminated cost sharing for breast, cervical and colorectal (CRC) cancer screening for many, the percentage of adults undergoing screenings  has not increased and, in some cases, it has actually decreased, according to a new report by the Centers for Disease Control (CDC).

The government program HealthyPeople 2020 sets targets for cancer screening tests based on the most recent U.S. Preventative Services Task Force (USPSTF) guidelines. The CDC used the 2013 National Health Interview Survey (NHIS), the most recent available, to examine the rate of breast, cervical, and CRC screening.  Compared to the 2010 results, progress was “not observed” in 2013.

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According to the survey, mammography and CRC tests remained fairly stable since 2010, while Pap test use declined.

There seemed to be two dividing lines that may explain the lower screening rates. First, those without health insurance or those without a regular healthcare provider were more likely than those with insurance to skip screenings. Second, women in higher income and education brackets were more likely than women in lower brackets to have been screened for breast and cervical cancer.

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The survey revealed that the percentage of women in the highest education and income brackets exceeded the target for breast cancer screening; the percentage of women with privately-held insurance was also on target. The percentage of people aged 65-75 screened for CRC was near the target value set by the USPSTF.

The NHIS is an annual survey of a “nationally representative sample of the civilian, non-institutionalized population.” From the 2013 survey, the response rate for adults was 61.2 percent, and this data was used to examine recent screenings of the above cancers.

The USPSTF recommends breast cancer screenings for women between the ages of 50 and 74 every two years, Pap tests for women between the ages of 21 and 65 every three years, and fecal occult blood tests (FOBT) every year, sigmoidoscopy and FOBT every five years or colonoscopy tests every 10 years for those between the ages of 50 and 75.