South Nassau "Truth in Medicine" Poll: Men Lag Behind Women in Cancer Screenings

Greater understanding, follow through on mammogram screenings than prostate / Strong correlation seen between regular screenings and visits to primary care physician

Men are less likely to receive potentially life-saving screenings for cancer, according to the latest South Nassau Truth in Medicine Poll of metro area residents. Women have a greater understanding and follow through on mammogram screenings than there is among men about prostate cancer screenings or among both genders about colon cancer screenings, the poll results show.

Some 74 percent of women age 40 and older reported having a mammogram screening for breast cancer during the past year, the poll found.

But just over one half (53 percent) of men age 40 and over who were polled reported being screened for prostate cancer and only 55 percent believe prostate screening recommendations are clear, while 45 percent found them confusing or were unsure about them.

Some 60 percent of adults 40 and older reported being screened for colon cancer in the last 10 years.

Out of pocket costs also play a role in willingness to get screened. Less than half of adults age 40 and older would pay out of pocket for mammogram, prostate and colon cancer screenings, the South Nassau poll found.

Even among adults who have the means to pay for a screening, 28% would not pay or are unsure if they would pay out of pocket for cancer detection tests.

Attitudes regarding screening practices varied by age, gender and racial lines, the poll showed. White women were nearly 10 percent more likely to be screened for breast cancer (74 percent) than black women (65 percent).

Those with a primary care physician were significantly more likely to be screened for breast, prostate and colon cancer, the poll found. For instance, some 97 percent of male respondents who have been screened for prostate cancer have a primary care physician as opposed to only 72 percent of those men who have not been screened. Some 95 percent of respondents who have been screened for colon cancer also have a primary care doctor while only 81 percent who have not had colon cancer screening have a primary care provider.

Regular screenings can help detect cancer before it has spread and makes it easier to successfully treat patients who do contract the disease. Each year, the American Cancer Society produces a set of guidelines on screenings. Overall, the guidelines on mammography screenings were clearest to respondents with only 18% of all female respondents saying they were either confused or not sure about the age and frequency recommendations. For those women who have not had a mammogram in the past year, 33% believe the recommendations are confusing.

“These poll findings are significant and show we have more work to do to educate men about the importance of getting screened,” said Dr. Michael Herman, South Nassau’s director of urological oncology.

In the case of mammograms, early testing can help detect even the earliest forms of cancer. “One in eight women will develop breast cancer and the risk only increases with age,” added Christine Hodyl, MD, director of breast surgery at South Nassau. “The best outcomes come from informed patients who do their homework and know about their history and risk factors and have regular screenings.”

For women with an average risk of breast cancer, the American Cancer Society recommends the option for women age 40-44 to start screening with a mammography every year. Women age 45-54 should have mammograms annually. Women over age 54 could choose screenings every other year. These screenings should begin as early as age 30 for women with higher risk factors.

Finding cancer early and receiving the most state-of-the-art and advanced care is critically important. “The earlier cancer is diagnosed greatly improves a patient’s chance for survival,” said Rajiv Datta, MD, Chair Department of Surgery, Director of the Division of Surgical Oncology and Head and Neck Surgery and Medical Director of Gertrude & Louis Feil Cancer Center at South Nassau.

The South Nassau Truth in Medicine Poll, sponsored by Bethpage Federal Credit Union, surveyed 600 residents of Long Island and New York City as part of South Nassau’s effort to gather data about public attitudes on key public health topics and help spur public education to improve health.

There is a strong drive to encourage more patients to find and visit primary care physicians. The Centers for Medicare and Medicaid Services recently launched a comprehensive primary care initiative aimed at strengthening and improving primary care.

“A primary care provider is responsible for all of your major health screenings,” said Aaron E. Glatt, MD, Chair, Department of Medicine; Chief, Infectious Disease & Hospital Epidemiologist at South Nassau. “Your relationship with your primary care doctor is meaningful in that it helps him or her deliver the health and wellness information that is specifically tailored to you, your history and your risk factors.”

Men were far less likely than women to comply with guidelines for annual screenings. Among women age 50-64, 86% have had a mammogram screening in the past year, compared to 64% of men in the same age group receiving prostate screenings. Men were also less likely to have annual visits with a primary care physician. When male respondents saw a primary care physician, they were far more likely to be screened for prostate and colon cancer.

The most confusion is among the recommendations for prostate cancer screenings.

The American Cancer Society recommends that men of average risk for prostate cancer be screened starting at age 50 and then either annually or every two years, depending on the man’s PSA, or prostate specific antigen level. For men with higher risk levels, if you have a first-degree relative with a history of prostate cancer, for example, screenings should begin at age 40 or 45 and done annually.

“The recommendations for prostate cancer screening can be confusing and often controversial,” said Herman, MD, director of the urologic oncology program at South Nassau. While women can see both a primary care physician and their gynecologist annually, men are not as likely to make an annual appointment. “There is clearly a need for better education among men about the importance of annual health evaluations with your primary care physician in order to have an engaged conversation and shared decision-making about the appropriate prostate cancer screening.”

Regarding colon cancer screenings where both men and women were interviewed, the poll results showed:

• 60% of adults age 40 and up have been screened in the past 10 years
• Women are more likely to be screened for colon cancer than men
• 27% of respondents are confused by or unsure about the recommendations for colon cancer screenings
• 21% of respondents do not believe or are unsure if everyone over age 50 should be screened every 5-10 years
• Attitudes also vary among race and socioeconomic class
  

“Colon cancer screenings are the least controversial, but clearly remain an area where we need to do a better job educating patients about the importance and need to be screened,” said Dr. Glatt. “This is a potentially fatal disease that can be prevented to a very large extent by appropriate age and risk factor screening.”

As people age, they are more likely to have a primary care physician, but are often less likely to receive annual screenings. When women age 40-64 who have not been screened for breast cancer were asked why, 71% of them said they did not currently need the screening even though only 16% of this same group says the recommendations for screenings are confusing or are unsure about them. Of men in the same age group, 52% had not been screened for prostate cancer and 44% of men in this age group think the recommendations for prostate screenings are confusing or are unsure about them.

The South Nassau Truth in Medicine Poll was conducted via both landlines and cell phones from September 27th-October 4th with 600 adults age 40 and older in New York City and on Long Island. The poll was conducted as part of the hospital’s mission of improving education around critical public health issues. The poll was conducted by a nationally recognized, independent polling firm, LJR Custom Strategies, which has offices in Washington, DC and New Orleans, LA. LJR has conducted more than 2,000 studies for a broad spectrum of health care, business, education, cultural, and political clients in almost every state in the country and around the world.

“The South Nassau ‘Truth in Medicine’ Poll is meant to shine a light on public health issues that deserve more attention,” said Richard J. Murphy, South Nassau’s President & CEO. “We could all benefit from a proper and more detailed education on the guidelines for breast, prostate and colon cancer.”

Overall, adults who are not being screened indicate it is primarily because they think they do not need a screening. It has little to do with fear of the procedure or the results and logistics, such as travel or access to the screening, are also less of an impediment.

“There remain variations in the cancer screening guidelines. Make an informed decision with your doctor and evaluate your risk factors. The best approach for screening a patient is a personalized plan that evaluates the risk factors of an individual patient,” said Dr. Datta.

This is South Nassau’s fourth in a series of public health polls, and the second time it has been presented with Bethpage. The ultimate goal of the Truth in Medicine Poll is to educate the public about health issues so they can take better care of themselves and seek out appropriate medical care when needed. Three earlier polls gauged public attitudes about going to work with the flu, the dangers of antibiotic overuse and attitudes regarding autism and social interactions with those who have not been vaccinated.

Designated a Magnet® hospital by the American Nurses Credentialing Center (ANCC) for outstanding nursing care, South Nassau® Communities Hospital is one of the region’s largest hospitals, with 455 beds, more than 900 physicians and 3,500 employees. Located in Oceanside, NY, the hospital is an acute-care, not-for-profit teaching hospital that provides state-of-the-art care in cardiac, oncologic, orthopedic, bariatric, pain management, mental health and emergency services.

In addition to its extensive outpatient specialty centers, South Nassau provides emergency and elective angioplasty, and offers Novalis Tx™ and Gamma Knife® radiosurgery technologies.  South Nassau operates the only Trauma Center on the South Shore of Nassau County verified by the American College of Surgeons as well as Long Island’s only free-standing, 9-1-1 receiving Emergency Department in Long Beach. South Nassau also is a designated Stroke Center by the New York State Department of Health and Comprehensive Community Cancer Center by the American College of Surgeons, and is an accredited center of the Metabolic and Bariatric Surgery Association and Quality Improvement Program.

In addition, the hospital has been awarded the Joint Commission’s gold seal of approval for disease-specific care for hip and knee replacement, heart failure, bariatric surgery, wound care and end-stage renal disease. For more information, visit www.southnassau.org.