Estimated proportion of cancer deaths not addressed by current cancer screening efforts in the United States

Background It is unclear what proportion of the population cancer burden is covered by current implementation of USPSTF A/B screening recommendations. Objective We estimated the proportion of all US cancer deaths caused by cancer types not covered by screening recommendations or cancer types covered but unaddressed by current implementation. Methods We used 2018–2019 National Center for Health Statistics mortality data, Surveillance, Epidemiology, and End Results registries incidence-based mortality data, and published estimates of screening eligibility and receipt. Results Of approximately 600,000 annual cancer deaths in the US, 31.4% were from screenable cancer types, including colorectal, female breast, cervical, and smoking-associated lung cancers. Further accounting for the low receipt of lung cancer screening reduced the proportion to 17.4%; accounting for receipt of other screening reduced it to 12.8%. Thus, we estimated that current implementation of recommended screening may not address as much as 87.2% of cancer deaths — including 30.4% from individually uncommon cancer types unlikely ever to be covered by dedicated screening. Conclusions The large proportion of cancer deaths unaddressed by current screening represents a major opportunity for improved implementation of current approaches, as well as new multi-cancer screening technologies.