By Dr. Anthony Policastro
We have all gone through episodes of “shoulda, woulda, coulda”. It is usually when we reflect on a missed opportunity.
In most cases, those types of decisions cause an inconvenience. Sometimes they cause a financial loss. However, there are some serious medical situations like that.
Cancer is the second leading cause of death in the United States. Colorectal cancer results in over 50,000 deaths per year. Breast cancer results in over 40,000 deaths per year. Cervical cancer results in over 4,000 deaths per year.
There are screening procedures for all of these. Current recommendations are that colorectal cancer should have screening done between the ages of 45 and 75 years. There are several types of screening procedures for this. They include testing stool for blood like Cologuard and colonoscopies.
Mammography for breast cancer should be done every other year for women between the ages of 40 and 74. Pap smears for cervical cancer should be done every three years in women between the ages of 30 and 65 years of age.
These recommendations are all very straightforward. Therefore, we would expect 100 percent of individuals would follow the recommendations.
Unfortunately, that is not the case. In 2021 only 72.2 percent of eligible individuals had colorectal cancer screening. Only 75.7 percent of eligible women had mammograms. Only 75.2 percent of eligible women had Pap smears.
Colorectal cancer detected by screening has a five-year survival of 91 percent. If it is recognized after symptoms occur, survival drops to 73 percent. If it is recognized after metastases have occurred, it is about 17 percent.
For breast cancer, five-year survival is 86 percent if it is picked up by screening. That drops to 66 percent when picked up by other methods. If there are metastases, it drops to about 28 percent.
For cervical cancer, five-year survival when picked up by screening is above 95 percent. If picked up by other methods, it drops to 60 percent. If there are metastases, it drops to about 17 percent.
The bottom line here is that about 70-75 percent of the population gets proper screening. The other 25-30 percent might one day wake up and say: “shoulda, woulda, coulda”.