People who skip cancer screenings more likely to die from other causes
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* Julia Haskins

Adults who forego recommended cancer screenings have higher death rates from non-cancer related causes, suggesting that such people may also skip other health recommendations, a recent study says.

Published in December in *JAMA Internal Medicine* by researchers from the National Cancer Institute, the study followed participants in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial, a large population-based study sponsored by NCI that involves people ages 55 to 74. In the recent study, researchers examined whether skipping cancer screenings was associated with mortality not linked to the disease.

Among the more than 85,000 adults in the study, about 85 percent followed cancer screenings, about 4 percent partially followed them, receiving some screenings, and nearly 11 percent were non-adherent. People who fully followed cancer screenings were more likely to be women, white, college educated and married. They were also less likely to smoke.

Researchers found that within 10 years, mortality unrelated to cancer was 73 percent higher among participants who did not adhere to screenings, compared with their peers who followed all screenings. Mortality was 36 percent higher compared with people who received some screenings. When measured against cancer screenings, there were significant differences in mortality from all causes, even after researchers adjusted for behavioral, demographic and medical characteristics.

The findings suggest that there may be behavior differences among people who do not comply with cancer screenings, according to study co-author Paul Pinsky, PhD, MPH, chief of the Early Detection Research Branch in the Division of Cancer Prevention at the National Cancer Institute.

“It’s sort of a profile of health behaviors that could include just a general noncompliance with medical tests and treatments in real life, not just in the research setting,” he told *The Nation’s Health.*

For both research and clinical practice, it is important to understand how to identify people who do not follow recommendations to determine the best interventions that would get them to undergo cancer screenings, Pinsky said.

“The whole point of this paper is to get people to say this is a big problem,” he said.

The researchers noted that few Americans comply with federal recommendations for disease prevention and many are not meeting targets established by Healthy People 2020. Among the cancer-related objectives for Healthy People 2020 is increasing the proportion of screenings for certain cancers among women and men in the U.S.

The researchers pointed to research showing that failure to follow to chronic disease prevention guidelines is associated with nonadherence to cancer screening guidelines.

“Together, a lifestyle marked by nonadherence to health preventive guidelines and medical tests and treatments may significantly increase mortality risk,” they said.

In an accompanying editorial in the same issue of the journal, Deborah Grady, MD, MPH; and Monica Parks, MD, both of the University of California-San Francisco, noted that patients who take their recommended medications are more likely to seek out other preventive services, such as vaccinations and screenings.

In January, the American Cancer Society released its annual U.S. cancer statistics report, which found that the death rate from cancer in the U.S. has decreased 27 percent over the past 25 years. The association credited the decline in the cancer rate largely to advances in early detection and treatment as well as drops in smoking. There were significant declines in lung, breast, prostate and colorectal cancers identified in the report.

For more information, visit [https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2719426](https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2719426).

*   Copyright The Nation’s Health, American Public Health Association