Photo Credit: Andrii Yalanskyi
Physician’s Weekly spoke with several experts to better understand why women avoid health screenings and what physicians can do to reduce this gap in care.
A report revealed a significant “Screening Action Gap” among U.S. women. Despite recognizing the importance of health screenings, 2 in 5 women, or 43%, skip or delay them, posing risks for preventable health issues. This gap is particularly concerning for screenings related to breast, cervical, and colorectal cancers, which collectively result in over 70,000 deaths among U.S. women annually.
The survey, conducted by Gallup for Hologic, involved 4,001 women and uncovered several key issues, including a lack of information about necessary screenings, insufficient communication with healthcare providers, and emotional health barriers that prevent women from prioritizing their health. Caregivers, especially those with children at home, face additional challenges, with 75% finding it difficult to prioritize their health.
Physician’s Weekly (PW) spoke with Emily Conant, MD, vice chair of faculty development, University of Pennsylvania Health System, Sally Friedewald, MD, vice chair of women’s imaging, Northwestern University, and Julie Khani, corporate vice president of government affairs and corporate communications, Hologic, to better understand why women skip these vital screenings and what physicians can do to reduce this gap in care.
PW: Can you share your thoughts on the importance of regular health screenings for women?
Dr. Friedewald: Beginning at age 40, we know that yearly screening of women with mammography saves the most lives. So, we want to ensure that women get regularly screened, preferably yearly, and continue to do so as long as they’re in good health. Patients who are at higher risk should be assessed beginning at age 25, and then if they are considered high risk, then they should potentially have earlier screening in addition to mammography as well as supplemental screening with other tests such as MRIs.
Dr. Conant: If there’s a first degree relative with breast cancer or a determination of high risk, then it’s all about the early detection. Finding cancers at an earlier stage is important for women to have better outcomes. We’re moving towards personalized screening. Everyone should be screened, but we want to look at the individual woman and decide what’s best for her regarding supplemental screening.
Khani: One of the findings from the Hologic Gallup US survey was that 90% of women in the US say health screenings are important to them, but 43% say they have either skipped or delayed a recommended screening. It was most evident in screenings for breast, cervical, and colorectal cancer. That’s particularly troubling because, in some cases, such as cervical cancer, we have the tools to eradicate this deadly disease.
What are the most common reasons health screenings are skipped or delayed?
Dr. Friedewald: There are a lot of varying guidelines in the media, which can be confusing for patients if they’re not familiar with when to start screening, but also anxiety about the actual test itself. Sometimes, patients don’t have time to get to a breast center to get screened, or they have pain or discomfort with the test. That’s what the survey discovered.
Dr. Conant: Access, or the feeling of having access, varies greatly by population. Over time, we need things like mobile vans for mammography. It’s also important to have screening sites in different communities with public transportation, free parking, and hours that make it accessible. We found in the past with surveys that many women are concerned that they don’t have anyone to take care of their kids if they’re involved in childcare during the day. So, weekends and after-work hours help reach out to a broader community to make access possible.
How do you address the anxiety and fear that some patients experience regarding these screenings?
Dr. Friedewald: Anxiety is probably the most common trait that we see in patients. We try to allay their fears by discussing the benefits, but I like to explain to patients that they control their health. If they feel that they are doing something for themselves and that they’re taking control of their healthcare, then it relieves some of their anxiety about coming in because then they know if they catch an abnormality early, then we have the greatest chance of curing them of breast cancer.
Dr. Conant: Improving information and educating patients is so important. Outreach to different patient groups, giving talks, being approachable so that they’re educated and understand, and then I have to give a huge accolade to our technologists in our breast area who are so good at making women comfortable once they get in there and answer questions. Outreach, accessibility, and important attention to the patients from the people who care for them during the screening, recall, and biopsy is crucial.
