Preventing Chronic Disease | Challenges in Meeting Healthy People 2020 Objectives for Cancer-Related Preventive Services, National Health Interview Survey, 2008 and 2010 - CDC

full-text ►

Preventing Chronic Disease | Challenges in Meeting Healthy People 2020 Objectives for Cancer-Related Preventive Services, National Health Interview Survey, 2008 and 2010 - CDC

Challenges in Meeting Healthy People 2020 Objectives for Cancer-Related Preventive Services, National Health Interview Survey, 2008 and 2010

Navigate This Article

• Abstract
• Introduction
• Methods
• Results
• Discussion
• Acknowledgments
• Author Information
• References
• Tables

Martin L. Brown, PhD; Carrie N. Klabunde, PhD; Kathy A. Cronin, PhD; Mary C. White, ScD; Lisa C. Richardson, MD, MPH; Timothy S. McNeel

Suggested citation for this article: Brown ML, Klabunde CN, Cronin KA, White MC, Richardson LC, McNeel TS. Challenges in Meeting Healthy People 2020 Objectives for Cancer-Related Preventive Services, National Health Interview Survey, 2008 and 2010. Prev Chronic Dis 2014;11:130174. DOI: http://dx.doi.org/10.5888/pcd11.130174.

PEER REVIEWED

Abstract

Introduction
Healthy People (HP) is the US program that formulates and tracks national health objectives for the nation. The National Health Interview Survey (NHIS) is a designated data source for setting and evaluating several HP targets in cancer. We used data from the 2008 and 2010 NHIS to provide a benchmark for national performance toward meeting HP 2020 cancer-related objectives.

Methods
HP 2020 cancer screening, provider counseling, and health care access objectives were selected. For each objective, NHIS measures for the overall population and several sociodemographic subgroups were calculated; the findings were compared with established HP 2020 targets.

Results
From 2008 to 2010, rates of breast and cervical cancer screening declined slightly while colorectal cancer screening rates increased by 7 percentage points. Rates of cancer screening and provider counseling were below HP targets. Meeting HP targets seems less likely for subgroups characterized by low income, no health insurance, or no usual source of care. Meeting HP targets for access to health services will require an increase of 18 percentage points in the proportion of persons under age 65 with health insurance coverage and an increase of 10 percentage points in the proportion aged 18 to 64 with a usual source of care.

Conclusion
Whether HP objectives for cancer screening and health care access are met may depend on implementation of health care reform measures that improve access to and coordination of care. Better integration of clinical health care and community-based efforts for delivering high-quality screening and treatment services and elimination of health disparities are also needed.

Author Information

Corresponding Author: Carrie N. Klabunde, PhD, 9606 Medical Center Dr, MSC 9762, Bethesda, MD 20892-9762. Telephone: 240-276-6734. E-mail:KlabundC@mail.nih.gov.

Author Affiliations: Martin L. Brown, Kathy A. Cronin, National Cancer Institute, Bethesda, Maryland; Mary C. White, Lisa C. Richardson, Centers for Disease Control and Prevention, Atlanta, Georgia; Timothy S. McNeel, Information Management Services, Inc, Calverton, Maryland.

Top of Page

References

1. Department of Health, Education, and Welfare, Public Health Service. Healthy people: the Surgeon General’s report on health promotion and disease prevention. Washington (DC): Government Printing Office, 1979.
2. Healthy people 2010 final review. Hyattsville (MD): National Center for Health Statistics; 2012. http://www.cdc.gov/nchs/data/hpdata2010/hp2010_final_review.pdf. Accessed April 4, 2013.
3. About Healthy People. Introducing Healthy People 2020. Washington (DC): US Department of Health and Human Services; 2012. http://www.healthypeople.gov/2020/about/default.aspx. Accessed April 4, 2013.
4. Klabunde CN, Cronin KA, Breen N, Waldron WR, Ambs AH, Nadel MR. Trends in colorectal cancer test use among vulnerable populations in the United States. Cancer Epidemiol Biomarkers Prev 2011;20(8):1611–21. CrossRef PubMed
5. Sabatino SA, Coates RJ, Uhler RJ, Breen N, Tangka F, Shaw KM. Disparities in mammography use among US women aged 40–64 years, by race, ethnicity, income, and health insurance status, 1993 and 2005. Med Care 2008;46(7):692–700. CrossRef PubMed
6. Swan J, Breen N, Graubard BI, McNeel TS, Blackman D, Tangka FK, et al. Data and trends in cancer screening in the United States: results from the 2005 National Health Interview Survey. Cancer 2010;116(20):4872–81. CrossRef PubMed
7. National Health Interview Survey. About the National Health Interview Survey. Atlanta (GA): Centers for Disease Control and Prevention; 2012. http://www.cdc.gov/nchs/nhis/about_nhis.htm. Accessed April 4, 2013.
8. National Health Interview Survey. Questionnaires, datasets, and related documentation. Atlanta (GA): Centers for Disease Control and Prevention; 2012. http://www.cdc.gov/nchs/nhis/nhis_questionnaires.htm. Accessed April 4, 2012.
9. National Center for Health Statistics. 2008 National Health Interview Survey (NHIS) public use data release. NHIS survey description. Hyattsville (MD): National Center for Health Statistics, Centers for Disease Control and Prevention; 2009. ftp://ftp.cdc.gov/pub/Health_statistics/NCHS/Dataset_Documentation/NHIS/2008/srvydesc.pdf. Accessed April 4, 2013.
10. National Center for Health Statistics. 2010 National Health Interview Survey. NCI public use data release, NHIS survey description. Hyattsville (MD): National Center for Health Statistics, Centers for Disease Control and Prevention; 2011. ftp://ftp.cdc.gov/pub/Health_statistics/NCHS/Dataset_Documentation/NHIS/2010/srvydesc.pdf. Accessed April 4, 2013.
11. US Preventive Services Task Force. Genetic risk assessment and BRCA mutation testing for breast and ovarian cancer. Washington (DC): US Preventive Services Task Force; 2005. http://www.uspreventiveservicestaskforce.org/uspstf05/brcagen/brcagenrs.htm. Accessed April 4, 2013.
12. Health Indicators Warehouse. Genetic counseling for women with a family history of breast and/or ovarian cancer. Hyattsville (MD): National Center for Health Statistics. http://www.healthindicators.gov/Indicators/Genetic-counseling-for-women-with-a-family-history-of-breast-andor-ovarian-cancer-percent_850/National_0/Profile. Accessed April 4, 2013.
13. Definitions for new race and ethnicity categories. Washington (DC): National Center for Educational Statistics, US Department of Education. http://www.nces.ed.gov/ipeds/reic/definitions.asp. Accessed April 4, 2013.
14. Bernstein J. Impact of the economy on health care. Issue brief. Princeton (NJ): The Robert Wood Johnson Foundation; August 2009. http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2009/rwjf44843. Accessed April 4, 2013.
15. Centers for Disease Control and Prevention. Cancer screening in the United States – 2010. MMWR Morb Mortal Wkly Rep 2012;61(3):41–5. http://www.cdc.gov/mmwr/PDF/wk/mm6103.pdf. Accessed April 4, 2013. PubMed
16. HealthCare.gov. Preventive services covered under the Affordable Care Act. Washington (DC): US Department of Health and Human Services. http://www.healthcare.gov/news/factsheets/2010/07/preventive-services-list.html. Accessed April 4, 2013.
17. Wilensky SE, Gray EA. Existing Medicaid beneficiaries left off the Affordable Care Act’s prevention bandwagon. Health Aff (Millwood) 2013;32(7):1188–95. CrossRef PubMed
18. National Prevention, Health Promotion, and Public Health Council. Annual status report 2013. http://www.surgeongeneral.gov/initiatives/prevention/2013-npc-status-report.pdf. Accessed August 13, 2013.
19. Plescia M, Richardson LC, Joseph D. New roles for public health in cancer screening. CA Cancer J Clin 2012;62(4):217–9. CrossRef PubMed
20. Plescia M, White MC. The national prevention strategy and breast cancer screening: scientific evidence for public health action. Am J Public Health 2013;103(9):1545–8. CrossRef PubMed
21. Yabroff KR, Zapka J, Klabunde CN, Yuan G, Buckman DW, Haggstrom D, et al. Systems strategies to support cancer screening in U.S. primary care practice. Cancer Epidemiol Biomarkers Prev 2011;20(12):2471–9. CrossRef PubMed
22. Rauscher GH, Johnson TP, Cho YI, Walk JA. Accuracy of self-reported cancer-screening histories: a meta-analysis. Cancer Epidemiol Biomarkers Prev 2008;17(4):748–57. CrossRef PubMed
23. Howard M, Agarwal G, Lytwyn A. Accuracy of self-reports of Pap and mammography screening compared to medical record: a meta-analysis. Cancer Causes Control 2009;20(1):1–13. CrossRef PubMed
24. Klabunde CN, Lanier D, Nadel MR, McLeod C, Yuan G, Vernon SW. Colorectal cancer screening by primary care physicians: recommendations and practices, 2006–2007. Am J Prev Med 2009;37(1):8–16. CrossRef PubMed
25. Meissner HI, Klabunde CN, Han PK, Benard VB, Breen N. Breast cancer screening beliefs, recommendations and practices: primary care physicians in the United States. Cancer 2011;117(14):3101–11. CrossRef PubMed
26. Yabroff KR, Saraiya M, Meissner HI, Haggstrom DA, Wideroff L, Yuan G, et al. Specialty differences in primary care physician reports of Papanicolaou test screening practices: a national survey, 2006 to 2007. Ann Intern Med 2009;151(9):602–11. CrossRef PubMed
27. Zapka JM, Klabunde CN, Arora NK, Yuan G, Kobrin S, Smith JL. Physicians’ colorectal cancer screening discussion and recommendation patterns. Cancer Epidemiol Biomarkers Prev 2011;20(3):509–21. CrossRef PubMed
28. Roland KB, Soman A, Benard VB, Saraiya M. Human papillomavirus and Papanicolaou tests screening interval recommendations in the United States. Am J Obstet Gynecol 2011;205(5):447.e1–8. PubMed
29. Trivers KF, Baldwin LM, Miller JW, Matthews B, Andrilla CH, Lishner DM, et al. Reported referral for genetic counseling or BRCA 1/2 testing among United States physicians: a vignette-based study. Cancer 2011;117(23):5334–43. CrossRef PubMed