Importance of Regular Screenings for Early Disease Detection

THE IMPORTANCE OF REGULAR SCREENINGS FOR EARLY DISEASE DETECTION Carolyn Hayes, Emily Huston, Holly Hand, Carrie Druetzler, Jessica Darnell Role of Health Screenings Health screenings are medical procedures or tests that are used in asymptomatic populations to evaluate an i...

THE IMPORTANCE OF REGULAR SCREENINGS FOR EARLY DISEASE DETECTION Carolyn Hayes, Emily Huston, Holly Hand, Carrie Druetzler, Jessica Darnell Role of Health Screenings Health screenings are medical procedures or tests that are used in asymptomatic populations to evaluate an individual’s risk/likelihood of developing a disease or disorder1 Not diagnostic but rather used to identify subset of population who should undergo further diagnostic testing to determine absence or presence of a disease2 Main goal of screenings is early detection→this is key to improving treatment outcomes and reducing morbidity/mortality1 Good screening tests should target diseases that1: – cause significant morbidity/mortality – are prevalent in the population Hypertension 3 Major risk factor for CVD (which is the leading cause of death in the US) Long-term this can lead to increased risk for heart disease, kidney failure, stroke, and premature mortality Cancer 4 One of the leading causes of death globally (second to heart disease in the US) – ~20 million new cancer cases and 10 million cancer-related deaths annually worldwide Many grow slowly and may not show obvious symptoms until they have progressed significantly Screenings can help detect breast, cervical, prostate, colon, and lung cancer Diabetes 5 Affects more than 30 million people in US Type 2 Diabetes may go undetected for years due to mild/vague symptoms in the early stages Untreated this can lead to severe complications (i.e. heart disease, kidney failure, nerve damage) Recommended Screenings Breast Cancer6 Colon Cancer Monthly Self-Exams Average Risk8 ○ Regular screenings from age 45-75 Average Risk ○ Age 75+ shared decision making ○ Age 40-74 biennial screening with provider mammography ○ Frequency of screenings is based ○ Age 75+ shared decision upon the method of screening chosen making with provider High Risk9 High Risk7 ○ Those with 1st degree relative ○ Start annual screening should begin screening 10 years prior to age of relative’s diagnosis mammography at age 30 Recommended Screenings Prostate Cancer10 Hypertension11 Age 55-69 Average Risk ○ Shared decision making with ○ Age 18-39 every 3-5 years ○ Age 40+ annually physician Higher Risk Age 70+ ○ Age 40+ with risk factors Risk factors such as older age, annually African American descent and Confirm any in office blood family history should be taken into pressure measurement (OBPM) account when making personal with non-clinical setting measurements decision Recommended Screenings Type I Diabetes12 Type II Diabetes13 Recognizing the need for Age 35-70 screening ○ Overweight or obese Importance of identifying the ○ Glucose test every 3 years with disease before symptoms appear normal results Early consensus recommends Detection of pre-diabetes screening between ages 2-6 ○ Weight reduction interventions Not exclusively a childhood diagnosis and not exclusively familial  Early Detection Importance Early Detection: screenings, treatment outcomes, survival rates14 Early detection screenings such as genetic testing, self-examinations, some available at-home screenings, and education allows for proactivity. Treatment for diseases like breast cancer, colon cancer, hypertension, and diabetes are more effective when detected early. Due to the increase in the outcome of treatment, survival rates also increase with early detection. In some cases, this can be substantial… BRCA1 is a gene linked with breast and ovarian cancer. A family history of breast cancer or ovarian cancer could grant the need to have genetic testing performed for precautionary measures. Upon detection of this gene at an early stage, one is able to act accordingly in regards to next step treatment. BRCA1 detection with double mastectomy surgery can reduce the risk of breast cancer by 90-95%. Challenges to Ensuring Access to Regular Health 15 Screenings Barriers & Possible Solution Financial Policy Change Public Health Program Sliding Scale Fee Lack of Awareness and Education Health Education Campaigns Health Profession’s Role  Geographic Barriers Mobile screening units Telemedicine Partnership with Local organization Cultural and Linguistic Barriers Cultural Competency Training Interpreter Services Community Health Workers  Psychosocial Barriers (Fear, Stigma, or Misinformation) Normalization and de-stigmatization Patient Support Systems Time and Convenience Barriers Flexible Time Simplified Appointment Schedule Workplace Screening Disability or Special Needs Accessible Facilities Specialized Screenings Encouraging Preventative Care As we mentioned, screenings and adequate care for chronic conditions may not always be accessible, so timely intervention is key! Many diseases (such as cancer) do not show signs or symptoms until they are advanced, meaning more invasive and life altering treatments Assessing risk early on, and making lifestyle changes can save patients millions of dollars in healthcare costs What can we as providers do? ○ Education! ○ Finding support systems ○ Encouragement Questions! →At what age should you begin annual mammograms if you have high risk factors? →Name one of the 3 ways we can overcome geographical barriers. → Describe some lifestyle modifications you might recommend to help prevent Diabetes Mellitus II? →Name some risk factors for prostate cancer. Bonus! → I am a 60 year old male establishing care for the first time in my life. Give me an example of how you would educate/encourage me to be screened for some high risk disease processes →Which screenings should I do? → What can we do in the Primary Care setting to determine References 1.Givler DN. Health screening. StatPearls [Internet]. February 19, 2023. Accessed January 29, 2025. https://www.ncbi.nlm.nih.gov/books/NBK436014/. 2. Screening tests for common diseases. Johns Hopkins Medicine. October 11, 2024. Accessed January 29, 2025. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/screening-tests-for-common- diseases#:~:text=Screening%20tests%20are%20not%20considered,presence%20or%20absence%20of%20disease. 3. Guirguis-Blake J, Evans C, Webber E, Perdue L, Weyrich M. Screening for hypertension in adults: Updated evidence report and systematic review for the US Preventive Services Task Force | Cardiology | JAMA | jama network. JAMA Network. April 24, 2021. Accessed January 30, 2025. https://jamanetwork.com/journals/jama/fullarticle/2779191. 4. Moleyar-Narayana P. Cancer screening. StatPearls [Internet]. May 31, 2024. Accessed January 29, 2025. https://www.ncbi.nlm.nih.gov/books/NBK563138/. 5. Vasavada A. Diabetes mellitus screening. StatPearls [Internet]. October 31, 2022. Accessed January 29, 2025. https://www.ncbi.nlm.nih.gov/books/NBK554615/. 6. Breast cancer: Screening. Recommendation: Breast Cancer: Screening | United States Preventive Services Taskforce. April 30, 2024. Accessed January 25, 2025. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer- screening. 7. Breast cancer screening for elevated-risk women. Breast Cancer Screening For Elevated Risk Women. Accessed January 25, 2025. https://www.acr.org/-/media/ACR/Files/Breast-Imaging-Resources/Care-Toolkit/Provider-Breast-Cancer-Risk-Assessment- Handout.pdf. 8. Colorectal cancer: Screening. US Preventive Services Taskforce. May 18, 2021. Accessed January 25, 2025. https://www.uspreventiveservicestaskforce.org/uspstf/document/ClinicalSummaryFinal/colorectal-cancer-screening.  References 9. Jones V. Colorectal cancer screening: At what age should I get a colonoscopy? MD Anderson Cancer Center. June 6, 2023. Accessed January 29, 2025. https://www.mdanderson.org/cancerwise/colorectal-cancer-screening--at-what-age-should-i-get-a- colonoscopy.h00-159619434.html#:~:text=High%2Drisk%20groups%20should%20start,as%20early%20as%20age%2010. 10. Prostate cancer: Screening. Recommendation: Prostate Cancer: Screening | United States Preventive Services Taskforce. May 8, 2018. Accessed January 25, 2025. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/prostate-cancer- screening. 11. Hypertension in adults: Screening. Recommendation: Hypertension in Adults: Screening | United States Preventive Services Taskforce. April 27, 2021. Accessed January 25, 2025. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/hypertension-in-adults-screening. 12. Moore DJ, Leibel NI, Polonsky W, Rodriguez H. Recommendations for Screening and Monitoring the Stages of Type 1 Diabetes in the Immune Therapy Era. Int J Gen Med. 2024;17:3003-3014. Published 2024 Jul 9. doi:10.2147/IJGM.S438009 13. Prediabetes and type 2 diabetes: Screening. Recommendation: Prediabetes and Type 2 Diabetes: Screening | United States Preventive Services Taskforce. August 24, 2021. Accessed January 25, 2025. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/screening-for-prediabetes-and-type-2-diabetes. ‌14. Dillner J. Early detection and prevention. Mol Oncol. 2019;13(3):591-598. doi:10.1002/1878-0261.12459 15. Wolters Kluwer. Five key barriers to healthcare access in the United States. Wolters Kluwer. Published July 27, 2022. https://www.wolterskluwer.com/en/expert-insights/five-key-barriers-to-healthcare-access-in-the-united-states