a challenge

When given the names of screening tests to detect certain cancers (e.g., mammogram,

fecal occult blood test), the majority of Americans say they have heard of the tests,

and many Americans say they have been screened for cancer. However, most people

aren’t sure at what age they should begin screening or how often they should be

screened. In this HINTS Brief, we explore people’s knowledge about screening tests 

for breast, cervical, and colorectal cancers.

What is the correct age to begin screening for breast and colorectal cancers?

Estimated U.S. Population Percentage

20%

Breast 43% answered correctly

10%

Colon/Rectum 

57% answered incorrectly

54% answered correctly

46% answered incorrectly

30% 40% 50% 60%

Breast

HINTS reveals that 57% of American women do not know that age 40 is the

recommended age to begin getting mammograms. However, the majority of women

(73%) are aware that they should get a mammogram every one to two years once

screening has begun. Among those women who report ever having had a mammogram

(84%), 74% say their last mammogram happened within the recommended screening

interval. Among women over age 35, 75% percent say that their health care provider

has recommended the test within the last year.

Cervix

While 93% of female respondents to HINTS report ever having had a Papanicolau 

(Pap) test to screen for cervical cancer, the majority (79%) are unaware of the change in

guidelines recommending a Pap test every three years for healthy adult women. Most

women (87%) say they have their Pap test as part of their annual exam. Eighty-five

percent of women say that they expect to have their next Pap test within one year, but

67% say that they would agree to have the screening every three years, if recommended

by their health care provider. Although human papillomavirus (HPV) is a major cause

of cervical cancer, most American women (61%) have never heard of it.

Colon/Rectum

Several screening exams are available to detect colorectal cancer, including fecal occult

blood tests (FOBT), double contrast barium enema, sigmoidoscopy, and colonoscopy.

Physicians may present several colorectal cancer screening options to give patients 

a choice, which may improve screening uptake and adherence. Fifty-three percent 

of HINTS respondents over age 45 report that their health care provider has

recommended screening for colorectal cancer.When asked to name tests that detect

colorectal cancer, 40% of HINTS respondents couldn’t name a test.The majority of

respondents (54%) know that colorectal cancer screening should start at age 50.

Communication and

Colorectal Cancer Sc

Information Seeking, Health 

Providers, and the Internet

In a recent study using HINTS data, in

found that several communication-rela

independently contribute to whether 

more or less likely to be up-to-date w

cancer screening. Respondents in the 

considered up-to-date if they had eith

within the past year or endoscopy (co

or sigmoidoscopy) within the past 10 

On average, respondents who said tha

actively sought cancer information, eit

themselves or by asking others to do 

were more likely to be up-to-date wit

cancer screening than respondents wh

active information seekers. Use of the 

searching for both health information 

and cancer information specifically wa

independently associated with being u

Those who were up-to-date with colo

screening had twice the odds of repor

“some” or “a lot” of trust in their hea

provider.These respondents also indic

they would prefer to receive screenin

in the form of personalized reading m

other publications such as magazines.

 Women should begin mammo

screening at age 40 and have 

mammograms every one to t

• Women should begin having 

screen for cervical cancer wit

years of first having sexual in

but no later than age 21. Hea

should repeat the test every t

• Women and men should begi

cancer screening at age 50.

Screening age and frequency recom

may vary for people who are at hig

developing certain cancers because 

history or other risk factors.
When asked at what age people should begin screening for

colorectal cancer, a slight majority (53%) of men and women

aged 40 and older said, correctly, that colorectal cancer

screening should begin at age 50.Among those who answered

incorrectly, differences are pronounced by race/ethnicity.

• 38% of Whites answered incorrectly compared with 79% 

of Hispanics, 75% of African Americans, and 70% of 

American Indians/Alaska Natives.

0.4% 

20.8% 

78.7% 

How Can HINTS Inform Your Work?

The strongest predictor of screening adherence is recommendation by a health care provider. People without access to 

are not receiving these important prompts and therefore must be reached in different ways. While communication con

screening uptake and repetition, multi-faceted interventions that address social barriers such as lack of insurance, usual 

care, and transportation are needed.

• The majority of American women do not know when they should start getting mammograms. Efforts to educate wom

races about starting breast cancer screening at age 40 are needed.

• The majority of American women are not aware that they do not need to get a Pap test every year. Efforts to educat

women aged 18 and older about receiving Pap tests every three years are needed.

• Knowledge of the appropriate age to begin colorectal cancer screening differs by race/ethnicity. However, efforts to e

adults about starting colorectal cancer screening at age 50 are needed.

About HINTS http://hints.cancer.gov

The National Cancer Institute (NCI) fielded the first Health Information National Trends Survey (HINTS) in 2002 and 2003, surveying 6,369 Americans. HIN

to monitor changes in the rapidly evolving field of health communication.The survey data can be used to understand how adults 18 years and older use dif

communication channels to obtain health information for themselves and their loved ones, and to create more effective health communication strategies acro

HINTS Briefs provide a snapshot of noteworthy, data-driven research findings.They introduce population-level estimates for specific questions in the survey 

significant research findings that are a result of analyzing how age, race, and gender influence specific outcomes.

The Briefs are intended to highlight top-level findings derived from analyses reported more thoroughly in other venues and are not meant to be comprehe

Conclusions drawn from the Briefs are limited by the descriptive nature of the data presented and are not intended to replace HINTS-related scientific pu

which inferences may be more confidently derived.

For contact information, complete access to all HINTS data including statistics not included in this Brief (such as statistics for Asian American and Native H

Islander respondents) or to develop your own project using HINTS data, please visit the “Conduct HINTS Research” section of the HINTS Web site.

For More Information on Cancer

• Call the NCI Cancer Information Service at 1-800-4-CANCER

• Visit http://cancer.gov 

• Order NCI publications at https://cissecure.nci.nih.gov/ncipubs/

References Used in This HINTS Brief

CDC Morbidity and Mortality Weekly Report. March 24, 2006

Ling BS, Klein WM, Dang Q. Relationship of communication an

measures to colorectal cancer screening utilization: results fro

J Health Commun. 2006; 1:181-90.

NCI’s Cancer Trends Progress Report 2005, http://progressrep

Guide to Clinical Preventive Services, 2005.AHRQ Publication 

June 2005. Agency for Healthcare Research and Quality, Rock

August 2006 http://www.ahrq.gov/clinic/pocketgd.htm