What women can do to prioritize their health. A doctor explains
By Katia Hetter, CNN
(CNN) — An estimated 72 million women in the United States have skipped or delayed a recommended health screening, according to a new survey. This poll, conducted by Gallup for medical technology company Hologic, found that 90% of women acknowledged the importance of regular health screenings — but more than 40% have skipped or delayed a test.
Women have trouble prioritizing their own health, the survey found, with over 60% of women responding that it was hard to make their own health a priority. The numbers are particularly striking among younger women; 74% of women in Generation Z and 70% of millennials said it was hard to prioritize their health, compared with 52% of baby boomers and 39% of the Silent Generation.
Struck by these numbers, I wanted to speak with CNN wellness expert Dr. Leana Wen to learn more about why they are a cause for concern. What are the preventive screenings that younger women should receive? And what steps can women take to prioritize their health and well-being? Wen is an emergency physician and adjunct associate professor at George Washington University. She previously was Baltimore’s health commissioner.
CNN: What were the parts of the poll that stand out most to you?
Dr. Leana Wen: I was disheartened, though not surprised, to see that it was so common for women, especially young women, to forgo health screenings. According to the results, most women in the survey mentioned factors such as caring for other family members first, struggling with work and other pressing matters.
This is consistent with my experience as a clinician and a public health official. Unfortunately, too many women focus on their health only after they have been diagnosed with a chronic illness. Our society places too little emphasis on prevention, and there are many barriers in the way of people obtaining preventive care.
CNN: Why are regular health screenings so important for women, including young women?
Wen: This study focused on health screenings for cancer, so let’s start there. One in five women around the world will develop cancer over our lifetimes. Early treatment is key to improving survival rates, and that hinges on early diagnosis. This is why screenings are so important. Cancer screenings are conducted before people develop symptoms.
There is a disturbing global trend of a rise in early-onset cancers, which is defined as cancer cases diagnosed in people younger than 50. Between 1990 and 2019, early-onset cancers increased by 79%. In the US, while people older than 50 have experienced a drop in overall cancer rates between 1995 and 2020, the cancer incidence has increased in people younger than 50.
All of this makes the survey results of young women neglecting their health screenings even more distressing.
According to the survey, 41% of US women delayed or skipped screenings for breast cancer, 35% for cervical cancer and 33% for colorectal cancers.
CNN: What cancer screenings are recommended for younger women?
Wen: Here are the recommendations from the US Preventive Services Task Force.
For breast cancer, the USPSTF recommends that women get screened every other year, starting from age 40 and continuing through age 74. This is a recent change. Previously, the recommendation was to start between age 40 to 50.
For cervical cancer, the task force recommends that women who are ages 21 to 29 get screened every three years with a Pap test that looks at cervical cells. For women ages 30 to 65, the recommendation is to get screened every three years with the Pap test, or every five years with either testing for high-risk human papillomavirus (a virus that could cause cervical cancer) or the virus testing combined with the Pap test.
For colon cancer, the USPSTF recommends that both women and men begin screenings at age 45. This also represents a change in response to the rise in colon cancer among younger individuals; until a few years ago, the recommendation was for colon cancer screenings to start at age 50.
All the above recommendations apply to women at average risk of developing these cancers. Individuals at higher risk by virtue of family history, personal cancer history or other risk factors should speak with their physicians about whether they should start screening at earlier ages and more frequently.
They may also need additional testing; for instance, women with a first-degree relative with breast cancer may be recommended for an MRI in addition to a mammogram and may be referred to genetic testing.
CNN: What else should women know about regular screenings?
Wen: Ideally, every woman has a primary care provider whom they visit every year. These appointments should keep track of what screenings have been done and when to do the next set of screenings.
First, women should know whether they have personal medical circumstances that put them at higher risk compared with other people. Everyone should try to find out their family history of common ailments such as cancer and heart disease. Bring up lifestyle factors that may influence risk factors, such as smoking, drinking alcohol and physical activity.
Second, discuss screening tests. What’s recommended now and why? We’ve spoken today mainly about cancer screening, but there are screenings for other chronic diseases that should be done.
For instance, you should be getting your blood pressure checked at annual visits to screen for hypertension. The USPSTF also recommends screening for diabetes in adults ages 35 to 70 who have a body mass index that places them in the category of overweight or obesity and for high cholesterol in women ages 45 and older who are at increased risk of heart disease.
Third, women should discuss issues regarding their reproductive health. If they want to become pregnant, they should optimize their health in preparation for pregnancy. If they do not, they should discuss contraceptive options. We have not yet discussed screening for sexually transmitted infections, but this is also a part of routine health screening that should be discussed at the annual checkup.
Last but certainly not least, it’s important to discuss mental health issues. Mental health is a crucial determinant of overall health. Women should be sure to discuss concerns such as depression, anxiety and stress with their providers. Many treatment options exist — no one should have to suffer in silence.
CNN: How can women keep track of their screenings and what they need coming up?
The problem is that many women do not have a regular provider. They may also neglect to see that person due to the issues highlighted in the survey — maybe these women are busy with other life circumstances and then only see a provider once something is wrong.
The other issue highlighted in the survey is that providers may not be bringing up the screenings. Women are more likely to be screened if they and their provider have a discussion about the importance of screenings, the poll says. Yet these conversations are sometimes not happening for a variety of reasons.
We need to have a better health care system that ensures access and continuity of care for all people, and clinicians must have adequate time to address crucial issues like prevention during the annual visit.
In the meantime, I recommend that women keep track of what screenings they have received and have an idea of when the next one is due. Bring that list with you when you are going for your annual checkup and ask your doctor if you are up to date.
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