Adults Confused About Health Screenings, Poll Shows 

Most Know Tests Are Needed, But Not Enough Are Following Guidelines

According to a recent Gallup poll, a large percentage of Americans surveyed are confused about health testing and most are not following national guidelines.

While 98 percent of those polled believe screening for cancer or cholesterol does save lives, a much smaller percentage actually go out and get the tests, according to the survey.

The survey also found that physicians are not spending enough time urging people to get tested.

"We've got some work to do," says Dr. Paula Szypko, a spokeswoman for the College of American Pathologists, which sponsored the poll. "We need to not only educate our public about what needs to be done, but push them to try and go ahead and get screenings."

Pollsters Ask About Major Tests

Telephone interviews with nearly 1,500 US adults in late 2003 uncovered serious misconceptions about several common tests aimed at the early detection of disease, pollsters report.

First of all, there seems to be a serious "age gap" in cholesterol screening awareness. While most adults over 40 now get their blood cholesterol checked regularly, most under 40 do not - even though experts advise that all individuals over 20 get tested every five years.

Moreover, 42 percent of men and 29 percent of women under 40 believe they do not need to be tested, the survey found.

As early as adolescence, blood cholesterol levels are linked "to the development of vascular disease in young and middle-aged adults," warns Dr. Michael S. Lauer, a heart expert with the Cleveland Clinic Foundation.

"So the argument is made that by knowing cholesterol levels at a young age, one can potentially change lifestyle habits that might be of benefit later on down the line," Dr. Lauer says.

But are physicians prompting younger patients to get tested? When asked by pollsters whether their physician had suggested getting a cholesterol test, 71 percent of men under 40 and 67 percent of women under 40 replied "no."

Dr. Lauer is not surprised by the finding.

"From the point of view of many doctors, as well as patients, they'd say, 'At this point in my life the risk is very low, so is it really critical that we have to check this right now?'"

But while high cholesterol in youth may not pose an immediate threat, Dr. Lauer believes for some high-risk individuals - the obese, diabetics, and those with a family history of early heart disease - it is important to get checked regularly.

The US public seems confused when it comes to tests for colon cancer as well. Even though 91 percent of men over 50 said they knew they should undergo some form of colon cancer screening, just 54 percent had ever done so, according to the poll.

Current guidelines recommend that all men and women aged 50 and over get stool-based screening annually and undergo full colonoscopy once every 10 years, to check for precancerous polyps in the colon.

"A lot of people said they just did not have time" for screening, Dr. Szypko says. "They just hadn't gotten round to it."

Many others may have an exaggerated idea of the trauma involved in colonoscopy. "It's done under sedation," Dr. Szypko points out, "and people that have it done really don't think it's a big deal - and it can save your life."

Advocates for mammography got better news from the poll. Seventy percent of women over 40 - the recommended age at which to begin screening - said they did, in fact, get a mammogram every year. Many were confused, however, regarding the age at which such screening should begin, with 53 percent guessing the threshold was set at 30 years of age or younger.

Women also expressed confusion about one of the oldest and most reliable early-detection tests of all: the Pap test, used to spot cervical cancer or precancerous lesions of the cervix.

"What was bothersome in our survey was that a lot of women didn't quite know what the Pap test was for," Dr. Szypko notes. "They're having it, but a lot of them think they are being screened for STDs."

In fact, just 48 percent of women surveyed understood the Pap test is specific to cervical cancer, while 13 percent believed it was used to detect STDs or ovarian or uterine cancer.

"That's kind of dangerous," Dr. Szypko says, "because if women think they have an STD they need to talk to their doctor - there are [other] tests that can look for those problems." There are currently no effective early-detection tests for either ovarian or uterine cancer.

Experts Move To Improve Communication

The survey suggests more needs to be done to get patients into physician's offices for tests that can help save their lives.

Computer technology and the Internet may be key, Dr. Lauer said, citing a new initiative that uses e-mails to jog physician memories.

"We have a system here at the Cleveland Clinic that will give [physicians] a reminder that a person is due for a cholesterol check, so you don't have to remember."

Always consult your physician for more information.

Online Resources

College of American Pathologists

Centers for Disease Control and Prevention (CDC)

My Health Test Reminder

National Institutes of Health (NIH)

National Library of Medicine

US Department of Heath and Human Services

May 2004

Adults Confused About Health Screenings, Poll Shows

Pollsters Ask About Major Tests

Experts Move To Improve Communication

What Is a Pathologist?

Pathology Report FAQ

Online Resources

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What Is a Pathologist?

A pathologist is a physician who examines bodies and body tissues, and who is responsible for performing lab tests.

A pathologist helps other physicians reach diagnoses and is an important member of the treatment team.

Pathologists have completed medical school and must have at least four years of advanced medical education in a residency training program to be eligible to take board certification examinations.

Pathologists are board-certified through the American Board of Pathology.

Most pathologists receive training in both clinical and anatomical pathology.

In addition, pathologists can further specialize in certain areas, such as the following:

• dermatopathology - the study of the skin in diagnosing skin diseases. Dermatopathological results can help diagnose common skin diseases, as well as complex immunological diseases.
  
  
• cellular pathology - the study of cellular alterations in disease (also called cytopathology). Cytopathology is often used to diagnose cancer.
  comparative pathology - the study of disease in animals and how it compares in humans.
  
  
• neuropathology - the study of the nervous system. Neuropathology can help diagnose neurological diseases.
  

Pathologists practice in community, university, and government hospitals and clinics, as well as in independent labs, private offices, and other medical facilities.

Pathology Report FAQ

Pathology reports are used by your physician to determine a diagnosis or treatment plan for a specific health condition or disease.

In a small percentage of cases, an inadequate sample is obtained, which means there is not enough blood, tissue, etc., to perform the necessary analysis.

In those cases, a second sample must be obtained. It does not mean that an abnormal finding was present, it simply means a lab analysis was not performed because the sample size was too small.

In most cases, a pathology report contains the following information:

• your name and your individual identifiers such as date of birth or age, patient ID number, social security number, etc.
  the accession number of the case
  
  
• the date and type of the procedure by which the specimen was obtained (blood sample, surgery, biopsy, etc.)
  
  
• your medical history and current clinical diagnosis
  
  
• a gross (obvious) description of the specimen received in the laboratory, before the pathologist examines it
  
  
• a description of what the pathologist sees upon examination of the specimen (this section may be brief or long, depending on the test performed and the type of tissue being examined)
  
  
• the name and signature of the pathologist, as well as the name and address of the lab

By law, you are entitled to a copy of your medical record.

However, in most cases, a copying fee is charged by the medical centers and/or hospitals.

Many physicians and clinics will provide you with a certain number of copies free of charge.

Copies of any pathology reports are very important to keep, as your diagnosis and treatment are often based on them.

Further, understanding the report will help you and your physician (and any future physicians) better understand your condition.

Always consult your physician for more information.