Each year the American Cancer Society publishes a summary of existing recommendations for early cancer detection, including updates, and/or emerging issues that are relevant to screening for cancer. In last year's article, the guidelines regarding screening for the early detection of prostate, colorectal, and endometrial cancers were updated, as was the narrative pertaining to testing for early lung cancer detection. Although none of the ACS's guidelines were updated in 2001, work is proceeding on an update of screening recommendations for breast and cervical cancer and an update of these guidelines will be announced in the January/February 2003 issue of CA. As in previous issues, we review recommendations for the "cancer-related check-up," in which clinical encounters provide case-finding and health counseling opportunities. Finally, we provide an update of the most recent data pertaining to participation rates in cancer screening by age, gender, and ethnicity from the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System (BRFSS) and National Health Interview Survey (NHIS).

https://onlinelibrary.wiley.com/doi/pdf/10.3322/canjclin.52.1.8

American Cancer Society guidelines for the early detection of cancer.

Number of drugs per 100 population 4 Total number of drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . 400.3 604.3 321.1 502.1 475.6 701.9 Antidepressants (depression and related disorders). . . . . . . 13.8 30.2 9.1 20.0 18.2 40.0 NSAID 6 (pain relief) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.9 30.1 16.0 25.4 23.7 34.7 Antiasthmatics/bronchodilators (asthma, breathing) . . . . . . . 13.0 24.7 11.7 21.4 14.3 27.9 Hyperlipidemia (high cholesterol) . . . . . . . . . . . . . . . . . . . . 5.4 23.7 5.4 24.0 5.4 23.4 Hypertension control drugs, not otherwise specified (high blood pressure) . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.0 23.6 4.1 20.5 7.8 26.6 Nonnarcotic analgesics (pain relief) . . . . . . . . . . . . . . . . . . 14.4 23.6 13.0 21.9 15.7 25.3 Antihistamines (allergies) . . . . . . . . . . . . . . . . . . . . . . . . . 13.7 22.7 10.8 17.3 16.4 27.9 Acid/peptic disorders (gastrointestinal reflux, ulcers). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.0 21.4 9.8 18.3 14.1 24.3 Blood glucose/sugar regulators (diabetes) . . . . . . . . . . . . . 9.5 19.8 8.6 19.1 10.4 20.6 Vitamins/minerals (dietary supplements) . . . . . . . . . . . . . . . 9.2 16.8 3.4 10.3 14.8 23.1 ACE inhibitors (high blood pressure, heart disease). . . . . . . 9.6 16.8 9.0 16.5 10.2 17.0 Narcotic analgesics (pain relief) . . . . . . . . . . . . . . . . . . . . . 11.2 16.7 10.3 13.4 12.2 19.9 Diuretics (high blood pressure, heart disease). . . . . . . . . . . 10.2 16.6 7.8 13.4 12.6 19.6 Penicillins (bacterial infections) . . . . . . . . . . . . . . . . . . . . . 16.6 13.1 15.5 12.6 17.7 13.6 Estrogens/progestins (menopause, hot flashes) . . . . . . . . . . . . . . . . . . . . . 19.8 14.9

/pdf/health-united-states-2005-with-chartbook-on-trends-in-the-33t2w1py7x.pdf

Health, United States, 2005; with chartbook on trends in the health of Americans

BACKGROUND
The American Cancer Society (ACS), the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR) collaborate annually to provide updated information regarding cancer occurrence and trends in the U.S. This year's report features a special section on cancer survival.

METHODS
Information concerning cancer cases was obtained from the NCI, CDC, and NAACCR and information concerning recorded cancer deaths was obtained from the CDC. The authors evaluated trends in age-adjusted cancer incidence and death rates by regression models and described and compared survival rates over time and across racial/ethnic populations.

RESULTS
Incidence rates for all cancers combined decreased from 1991 through 2001, but stabilized from 1995 through 2001 when adjusted for delay in reporting. The incidence rates for female lung cancer decreased (although not statistically significant for delay adjusted) and mortality leveled off for the first time after increasing for many decades. Colorectal cancer incidence rates also decreased. Death rates decreased for all cancers combined (1.1% per year since 1993) and for many of the top 15 cancers occurring in men and women. The 5-year relative survival rates improved for all cancers combined and for most, but not all, cancers over 2 diagnostic periods (1975–1979 and 1995–2000). However, cancer-specific survival rates were lower and the risk of dying from cancer, once diagnosed, was higher in most minority populations compared with the white population. The relative risk of death from all cancers combined in each racial and ethnic population compared with non-Hispanic white men and women ranged from 1.16 in Hispanic white men to 1.69 in American Indian/Alaska Native men, with the exception of Asian/Pacific Islander women, whose risk of 1.01 was similar to that of non-Hispanic white women.

CONCLUSIONS
The continued measurable declines for overall cancer death rates and for many of the top 15 cancers, along with improved survival rates, reflect progress in the prevention, early detection, and treatment of cancer. However, racial and ethnic disparities in survival and the risk of death from cancer, and geographic variation in stage distributions suggest that not all segments of the U.S. population have benefited equally from such advances. Cancer 2004. Published 2004 by the American Cancer Society.

/pdf/annual-report-to-the-nation-on-the-status-of-cancer-1975-3dx8u1hlf5.pdf

Annual report to the nation on the status of cancer, 1975–2001, with a special feature regarding survival

Updates to the American Cancer Society (ACS) guidelines regarding screening for the early detection of prostate, colorectal, and endometrial cancers, based on the recommendations of recent ACS workshops, are presented. Additionally, the authors review the "cancer-related check-up," clinical encounters that provide case-finding and health counseling opportunities. Finally, the ACS is issuing an updated narrative related to testing for early lung cancer detection for clinicians and individuals at high risk of lung cancer in light of emerging data on new imaging technologies. Although it is likely that current screening protocols will be supplanted in the future by newer, more effective technologies, the establishment of an organized and systematic approach to early cancer detection would lead to greater utilization of existing technology and greater progress in cancer control.

https://acsjournals.onlinelibrary.wiley.com/doi/pdf/10.3322/canjclin.51.1.38

American Cancer Society Guidelines for the Early Detection of Cancer: Update of Early Detection Guidelines for Prostate, Colorectal, and Endometrial Cancers: ALSO: Update 2001—Testing for Early Lung Cancer Detection

ContextIn 1998, 33 million US adults aged 18 to 64 years lacked health insurance.
Determining the unmet health needs of this population may aid efforts to improve
access to care.ObjectiveTo compare nationally representative estimates of the unmet health needs
of uninsured and insured adults, particularly among persons with major health
risks.Design and SettingRandom household telephone survey conducted in all 50 states and the
District of Columbia through the Behavioral Risk Factor Surveillance System.ParticipantsA total of 105,764 adults aged 18 to 64 years in 1997 and 117,364 in
1998, classified as long-term (≥1 year) uninsured (9.7%), short-term (<1
year) uninsured (4.3%), or insured (86.0%).Main Outcome MeasuresAdjusted proportions of participants who could not see a physician when
needed due to cost in the past year, had not had a routine checkup within
2 years, and had not received clinically indicated preventive services, compared
by insurance status.ResultsLong-term– and short-term–uninsured adults were more likely
than insured adults to report that they could not see a physician when needed
due to cost (26.8%, 21.7%, and 8.2%, respectively), especially among those
in poor health (69.1%, 51.9%, and 21.8%) or fair health (48.8%, 42.4%, and
15.7%) (P<.001). Long-term–uninsured adults
in general were much more likely than short-term–uninsured and insured
adults not to have had a routine checkup in the last 2 years (42.8%, 22.3%,
and 17.8%, respectively) and among smokers, obese individuals, binge drinkers,
and people with hypertension, elevated cholesterol, diabetes, or human immunodeficiency
virus risk factors (P<.001). Deficits in cancer
screening, cardiovascular risk reduction, and diabetes care were most pronounced
among long-term–uninsured adults.ConclusionsIn our study, long-term–uninsured adults reported much greater
unmet health needs than insured adults. Providing insurance to improve access
to care for long-term–uninsured adults, particularly those with major
health risks, could have substantial clinical benefits.

https://jamanetwork.com/journals/jama/articlepdf/193207/JOC00915.pdf

Unmet Health Needs of Uninsured Adults in the United States

Although the causes and natural histories of breast and cervical cancer are different, the public health responses to these diseases have been similar. Early detection of breast cancer and primary prevention of cervical cancer are possible through community-based screening programs; however, early detection of both breast and cervical cancer is less common among low-income women (defined as up to 250% of poverty level, depending on family size). This report presents morbidity and mortality data regarding breast and cervical cancer, screening recommendations, an update on the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), and recommended priority activities for the NBCCEDP. The NBCCEDP is a major public health effort to increase breast and cervical cancer screening among uninsured, low-income women.

J K Bobo

Papers

Implementing Recommendations for the Early Detection of Breast and Cervical Cancer Among Low-Income Women

Implementing recommendations for the early detection of breast and cervical cancer among low-income women.