Why women skipping or delaying health checkups is a cause for concern

CNN
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About 72 million women in the United States have skipped or delayed a recommended physical exam, according to a new survey. The poll, conducted by Gallup for medical technology company Hologic, found that 90% of women agree that regular checkups are important, but more than 40% have skipped or delayed a checkup.

Women struggle to prioritize their health, according to the survey, with more than 60% saying it was difficult to prioritize their health. The numbers are particularly stark among younger women: 74% of Gen Z women and 70% of millennials said it was difficult to prioritize their health, compared to 52% of baby boomers and 39% of the Silent Generation.

Struck by these numbers, I spoke with CNN wellness expert Dr. Leana Wen to learn more about why they’re a cause for concern. What preventive checkups should young women get? And what steps can women take to prioritize their health and wellness? Wen is an emergency room physician and assistant professor at George Washington University. She previously served as Baltimore’s health commissioner.

CNN: What parts of the poll stood out to you the most?

Dr. Leana Wen: I was disheartened, but not surprised, to find that it was so common for women, especially young women, to forgo health checkups. According to the results, most women surveyed cited factors such as caring for other family members first, work-related challenges, and other pressing issues.

This finding is consistent with my experience as a clinician and public health official. Unfortunately, too many women do not become interested in their health until after they are diagnosed with a chronic condition. Our society places too little emphasis on prevention, and many barriers prevent people from getting preventive care.

CNN: Why are regular health checkups so important for women, including young women?

Magnifying glass: This study focused on cancer screenings. So let’s start there. One in five women worldwide will develop cancer in their lifetime. Early treatment is essential to improving survival rates, and that relies on early diagnosis. That’s why screenings are so important. Cancer screenings are done before people develop symptoms.

There is a worrying global trend of increasing early-onset cancers, that is, cancer cases diagnosed in people under the age of 50. Between 1990 and 2019, early-onset cancers increased by 79%. In the United States, while people over the age of 50 experienced a decline in overall cancer rates between 1995 and 2020, cancer incidence increased among people under the age of 50.

All of this makes the survey’s findings that young women are neglecting their health checkups even more worrying.

According to the survey, 41% of American women have delayed or skipped screenings for breast cancer, 35% for cervical cancer and 33% for colorectal cancer.

CNN: What cancer screenings are recommended for younger women?

Magnifying glass: Here are the recommendations from the U.S. Preventive Services Task Force.

For breast cancer, the USPSTF recommends that women get screened every two years, starting at age 40 and continuing until age 74. This is a recent change. Previously, the recommendation was to start between ages 40 and 50.

For cervical cancer, the task force recommends that women ages 21 to 29 get screened every three years with a Pap test, which looks at cervical cells. For women ages 30 to 65, the recommendation is to get screened every three years with a Pap test, or every five years with a high-risk human papillomavirus test (a virus that can cause cervical cancer) or a viral test combined with a Pap test.

For colon cancer, the USPSTF recommends that women and men begin screenings at age 45. This also represents a change in response to the increase in colon cancer in younger individuals; until a few years ago, the recommendation was to begin colon cancer screenings at age 50.

All of the above recommendations apply to women at average risk of developing these cancers. People at higher risk because of family history, personal history of cancer, or other risk factors should talk to their doctor about whether they should start screening earlier and more frequently.

They may also need additional testing; for example, women with a first-degree relative with breast cancer may be recommended an MRI in addition to a mammogram and may be referred for genetic testing.

CNN: What else should women know about regular screenings?

Magnifying glass: Ideally, every woman should have a primary care physician whom she sees every year. These appointments should allow her to track the tests performed and to know when to have the next series of tests.

First, women should know if they have any personal health conditions that put them at higher risk than others. Everyone should try to learn their family history of common diseases such as cancer and heart disease. Address lifestyle factors that can influence risk factors, such as smoking, alcohol consumption and physical activity.

Second, let’s talk about screening tests. What is recommended today and why? We’ve talked mostly about cancer screening today, but there are screening tests for other chronic diseases that should be done.

For example, you should have your blood pressure checked at your annual checkups to screen for high blood pressure. The USPSTF also recommends screening for diabetes in adults ages 35 to 70 who have a body mass index that places them in the overweight or obese category and for high cholesterol in women ages 45 and older who are at increased risk for heart disease.

Third, women should discuss issues related to their reproductive health. If they want to become pregnant, they should optimize their health in preparation for pregnancy. If they do not want to, they should discuss contraceptive options. We have not yet discussed screening for sexually transmitted infections, but this is also part of the routine health screenings that should be covered during the annual health checkup.

Finally, it’s important to discuss mental health issues. Mental health is a huge factor in overall health. Women should make sure to discuss depression, anxiety, and stress issues with their doctor. There are many treatment options available—no one should have to suffer in silence.

CNN: How can women keep track of their exams and what they need going forward?

The problem is that many women do not have a regular GP. They may also neglect to see this person because of the problems highlighted in the survey. Perhaps these women are busy with other life circumstances and only see a doctor when something is wrong.

Another problem the survey highlighted is that health care providers aren’t necessarily bringing up the topic of screening. Women are more likely to get screened if they and their health care provider discuss the importance of screening, the survey found. Yet those conversations sometimes don’t happen for a variety of reasons.

We need a better health care system that ensures access and continuity of care for all, and clinicians need to have enough time to address critical issues like prevention during the annual visit.

In the meantime, I recommend that women keep track of the tests they have had and have an idea of ​​when their next appointment is due. Bring this list with you to your annual exam and ask your doctor if you are up to date.