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In Reply: Drs Shenson and Alderman suggest there is a mismatch between the strong public enthusiasm for cancer screening we reported and a low observed screening rate reported by others. The dismal statistic they cite—"fewer than 12% of US women aged 50 years or older are up to date with recommended preventive services"—is misleading. It refers to the proportion of women up to date on all of 6 preventive services (colorectal, cervical, and breast cancer screening; cholesterol testing; flu and pneumonia vaccinations). In fact, according to year 2000 data from the US Centers for Disease Control and Prevention, median compliance with mammography and Papanicolaou testing recommendations were 76% and 87%, respectively, across the 50 States (rates of colorectal cancer were substantially lower, with a median 31% of women 50 and older up to date).¹ While we agree that facilitating access to screening for those who want it is an important . . . [Full Text of this Article]

Steven Woloshin, MD, MS; Lisa M. Schwartz, MD, MS; H. Gilbert Welch, MD, MPH
VA Outcomes Group
Department of Veterans Affairs Medical Center
White River Junction, VT

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