Cancer screening may have its skeptics, but respondents to a Managed Care reader poll are not among them.
Colorectal, cervical, breast, prostate, and lung care cancer screening were rated as highly beneficial by the 168 respondents to the online survey, although prostate and lung cancer screening were viewed somewhat less favorably than the other three.
About half the respondents indicated that new treatments for early-stage cancer were a result of screening for those five cancers. A much smaller percentage identified the problems often mentioned by screening skeptics—false positives, overdiagnosis, and overtreatment—as consequences of screening.
Ratings of various cancer screenings in terms of their effect on American health
Percent of respondents rating 8, 9, or 10 on a scale of 0–10
0=extremely harmful, 10=extremely beneficial.
A favorable view of the consequences of screening
About half of the respondents identified the development of new treatments for early stage-stage cancers as a consequence of cancer screening. But a sizable minority also identified too many false positives for breast and prostate cancer screening as a consequence.
Medimedia Research conducted the poll from March 31 to April 10. Medimedia Research is part of Medimedia Managed Markets, an Icon plc company. Managed Care is owned by Medimedia Managed Markets.
About one in three of the respondents identified their organizations as being provider organizations (either a medical group or an integrated delivery system). About one in five identified their organization as being a health plan or insurer. Insurers aren’t necessarily anti-screening, but they may be more attuned to its possible harms. The favorable view of screening among the survey respondents may reflect —at least in part—the skew toward provider organizations among the respondents.
Organization type of respondents
The respondents didn't completely exonerate screening. For example, 28% indicated that breast cancer screening resulted in too many false positives, and 22% indicated that it resulted in overdiagnosis.
Similarly, 33% indicated prostate cancer resulted in too many false positives, and 37% said it resulted in overtreatment.
Less than 10% indicated that too many false negatives were a result of cancer screening. However, false negatives were rated as the most harmful of the drawbacks (5.4 on a 1–7 scale), followed by overtreatment (4.7), false positives (4.7), and overdiagnosis (4.5).
False negatives rated as extremely harmful
Scale 1–7, 1=not at all harmful, 7=extremely harmful
Agreement with U.S. Preventive Services Task Force (USPSTF) recommendations was strongest for colorectal screening—59% of the respondents indicated that they strongly agree with the recommendation that screening start at age 50 and continue through age 74. It was weakest for the USPSTF prostate cancer screening recommendations—just 27% indicated strong agreement—although the survey was conducted before the USPSTF issued a new draft recommendation in early April that said prostate cancer screening should be an individual decision.
Level of agreement with USPSTF screening recommendations
Percent of respondents rating 6 or 7 on a scale of 1–7
1=strongly disagree, 7=strongly agree
Cancer screening’s pros and cons are complicated and fiercely debated by experts. Very few (7%) of the survey respondents believe that the American public understands the pros and cons of screening well, and a large group (27%) believes the public has little, if any, understanding of them.
American public's understanding of the pros and cons of cancer screening
Scale 1–7, 1=does not understand at all, 7=understands fully
Source for all charts: MediMedia Research