Have you been screened?
Q: Is an ounce of prevention really worth a pound of cure?
A: Yes, but ounce for ounce, we don't do nearly the level of preventive work we should do in our health care system. Millions of Americans don't like to be tested. The consequences could be deadly.
A new study from the Center on an Aging Society says that although early detection and intervention can save money and lives—many people who need preventive care don't get it. Three groups of people in this country are less likely to use screening services:
1) those who don't have health insurance
2) those with low incomes
3) those who live in rural areas
Although tests can screen for specific conditions, such as cancer, or for risk factors like high cholesterol, many Americans don't even get an annual physical. One-third of the seniors on Medicare have not had an annual medical exam. The number is much worse for people under the age of 65 with no insurance. Only three in ten of the uninsured have had a check-up. The same is true for people who have no regular doctor. People with a regular doctor tend to have higher incomes and higher rates of health insurance.
The Aging Society study found that only one-third of the uninsured men between the ages of 50 and 64 had gone for a prostate exam in the last two years. Contrast that with 77% of the men who were over the age of 65 and on Medicare. Less than half (43%) of uninsured women between the ages of 40 and 64 had gone for a mammogram exam in the last two years, while 63% of women on Medicare over age 65 did have a mammogram.
Even people with health insurance don't take advantage of screening programs. More than 2 million men with insurance between the ages of 50 to 64 have never had a prostate screening. 4 million insured women age 40 to 64 have never had a mammogram. People on Medicare may not even know that many of these preventive screenings are covered—because such tests have only been covered by Medicare since 1997. Many people don't go for screenings because they are afraid of what the tests will show, or they're afraid of the cost of treatment afterwards.
The study shows that whites are more likely than blacks to be screened for cancer. City residents get screened more than rural residents, married people more than single people. Certain kinds of cancer are more acceptable for screening (prostate cancer, breast cancer and cervical cancer) while others have lower screenings (colorectal and skin cancer.) Skin cancer is the most common form of cancer, yet only one in five adults have ever been checked for it. Two-thirds of Americans have never been tested for HIV, the AIDS virus.
Part of the low use of screening tests may be because many doctors don't ask their patients about risk-related behaviors like smoking, lack of exercise, use of alcohol, drugs, or sexually transmitted diseases. An ounce of prevention may be a good thing—but early screenings are one of the most underused services in our health care system. We have no one to blame but ourselves for these unhealthy statistics.