Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, MS-MF76, Atlanta, GA 30341. Email:
National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia.
Prev Chronic Dis. 2020 Oct 8;17:E123. doi: 10.5888/pcd17.200039.
The US Preventive Services Task Force (USPSTF) recommends select preventive clinical services, including cancer screening. However, screening for cancers remains underutilized in the United States. The Centers for Disease Control and Prevention leads initiatives to increase breast, cervical, and colorectal cancer (CRC) screening. We assessed the number of avoidable deaths from increased screening, according to USPSTF recommendations, for CRC and female breast and cervical cancers.
We used model-based estimates of avoidable deaths for the lifetime of single-year age cohorts under the current and increased use of screening scenarios (data year 2016; analysis, 2018). We calculated prevented cancer deaths for each 1% increase in screening uptake and extrapolated to current level of screening (2016), current level plus 10 percentage points, and increasing screening to 90% and 100% of the eligible population.
Increased use of screening from current levels to 100% would prevent an additional 2,821 deaths from breast cancer, 6,834 deaths from cervical cancer, and 35,530 deaths from CRC over a lifetime of the respective single-year cohort. Increasing use of CRC screening would prevent approximately 8.5 times as many deaths as the equivalent increase in use of breast cancer screening (women only), although twice as many people (men and women) would have to be screened for CRC.
A large number of deaths could be avoided by increasing breast, cervical, and CRC screening. Public health programs incorporating strategies shown to be effective can help increase screening rates.
美国预防服务工作组(USPSTF)建议选择预防性临床服务,包括癌症筛查。然而,在美国,癌症筛查的利用率仍然很低。疾病控制与预防中心牵头开展了多项倡议,以增加乳腺癌、宫颈癌和结直肠癌(CRC)的筛查。我们评估了根据 USPSTF 建议,增加 CRC 以及女性乳腺癌和宫颈癌筛查的可避免死亡人数。
我们使用基于模型的估计数来评估终生各年龄段人群(数据年份为 2016 年;分析年份为 2018 年)在当前和增加筛查情况下的可避免死亡人数。我们计算了每增加 1%的筛查参与率所预防的癌症死亡人数,并将其外推至当前的筛查水平(2016 年)、当前水平加上 10 个百分点以及将筛查率提高到 90%和 100%的符合条件人群。
从当前水平增加到 100%的筛查使用率将在各年龄段人群的一生中额外预防 2821 例乳腺癌死亡、6834 例宫颈癌死亡和 35530 例 CRC 死亡。增加 CRC 筛查的使用将预防的死亡人数约为增加乳腺癌筛查(仅限女性)相同比例的 8.5 倍,尽管需要对 CRC 进行筛查的人数(男性和女性)是乳腺癌筛查的两倍。
通过增加乳腺癌、宫颈癌和 CRC 筛查,可以避免大量死亡。纳入已证明有效的策略的公共卫生计划可以帮助提高筛查率。