Gender disparity in cancer screening, poll finds

A gender disparity is evident in cancer screening throughout the greater metropolitan area with women more likely to seek out the tests than men, according to a new poll.

Doctors at South Nassau Communities Hospital released results of their latest Truth in Medicine survey, a poll of 600 residents of Long Island and New York City.

The research is part of a wide-ranging effort by the hospital to gain a sense of general attitudes toward several key public health concerns.

Earlier this year, the hospital polled residents on attitudes regarding influenza and flu vaccination; childhood vaccines and antibiotic use.

Cancer screening — while important — has become increasingly confusing in recent years as major health agencies and organizations have sent conflicting messages about when the tests best serve people at average risk.

The South Nassau poll found, for instance, that 74 percent of women 40 and older reported having had a mammogram during the past year. By contrast 53 percent of men in the same age range said they underwent the prostate specific antigen — PSA — blood test to screen for prostate cancer.

A lower screening percentage among men is no accident because “there is no unanimous opinion in the medical community regarding the benefits of prostate cancer screening,” according to the nonprofit Prostate Cancer Foundation.

The U.S. Preventive Services Task Force recommended against the PSA in 2012 but softened that stance earlier this year in a draft recommendation. The task force is an independent panel of 16 medical experts appointed by the U.S. Department of Health and Human Services

Panelists now purport in their draft guidelines that men 55 to 69 should discuss the potential “benefits and harms” of screening with their clinicians. The task force is against screening for men 70 and older.

“There’s no question that there is controversy and confusion,” said Dr. Aaron Glatt, who chairs the department of medicine at South Nassau. He added that current recommendations regarding mammograms and prostate cancer screenings are likely to change.

Clearly, patients would be greatly aided by “evaluation based on family history, age and other factors,” when it comes to PSA screening, Glatt said.

The task force contends that screening “offers a small potential benefit of reducing the chance of dying of prostate cancer.”

Many men will experience potential harms of screening, panelists wrote in their draft recommendations, which include false-positive results requiring an additional work-up, overdiagnosis and overtreatment.

But in a statement Tuesday, South Nassau’s director of urology said the 53 percent screening figure reported in the poll suggested a need to get a stronger screening message out to local men.

“These poll findings are significant and show we have more work to do to educate men about the importance of getting screened,” Dr. Michael Herman said.

For women, screening messages have been confusing as well.

The American Cancer Society suggests there should be a choice for those between the ages of 40 and 44 on starting screening at that time. However, the cancer society recommends annual mammograms between the ages of 45 and 54.

Women 55 and older “should switch to mammograms every two years, or continue yearly screening,” according to cancer society experts. Decisions on which path women should choose at 55 depend on their degree of risk, which includes individual and familial factors, doctors say.

Despite confusing messages to the public, South Nassau said its poll found a stark racial divide between black and white women regarding mammograms. White women were nearly 10 percent more likely to be screened for breast cancer, the poll found.

About 60 percent of metropolitan area residents 40 and older reported having been screened for colorectal cancer within the past year, according to South Nassau’s poll.

Cost also played a role in screening, survey results suggested: Fewer than half of adults age 40 and older said they would pay out-of-pocket for a mammogram, PSA or colonoscopy.

Respondents with a primary care physician, however, were substantially more likely to be screened for breast, prostate and colorectal cancer, the poll found.