title: Challenges in meeting Healthy People 2020 objectives for cancer-related preventive services, National Health Interview Survey, 2008 and 2010.
abstract: BACKGROUND
  Healthy People (HP) is the US program that formulates and tracks national health objectives for the nation. The National Health Interview Survey (NHIS) is a designated data source for setting and evaluating several HP targets in cancer. We used data from the 2008 and 2010 NHIS to provide a benchmark for national performance toward meeting HP 2020 cancer-related objectives.
  
  
  METHODS
  HP 2020 cancer screening, provider counseling, and health care access objectives were selected. For each objective, NHIS measures for the overall population and several sociodemographic subgroups were calculated; the findings were compared with established HP 2020 targets.
  
  
  RESULTS
  From 2008 to 2010, rates of breast and cervical cancer screening declined slightly while colorectal cancer screening rates increased by 7 percentage points. Rates of cancer screening and provider counseling were below HP targets. Meeting HP targets seems less likely for subgroups characterized by low income, no health insurance, or no usual source of care. Meeting HP targets for access to health services will require an increase of 18 percentage points in the proportion of persons under age 65 with health insurance coverage and an increase of 10 percentage points in the proportion aged 18 to 64 with a usual source of care.
  
  
  CONCLUSIONS
  Whether HP objectives for cancer screening and health care access are met may depend on implementation of health care reform measures that improve access to and coordination of care. Better integration of clinical health care and community-based efforts for delivering high-quality screening and treatment services and elimination of health disparities are also needed.
authors.affiliation: National Cancer Institute, Bethesda, Maryland.
authors.forename: Martin L
authors.initials: ML
authors.lastname: Brown
authors.affiliation: 9606 Medical Center Dr, MSC 9762, Bethesda, MD 20892-9762.E-mail: KlabundC@mail.nih.gov.
authors.forename: Carrie N
authors.initials: CN
authors.lastname: Klabunde
authors.affiliation: National Cancer Institute, Bethesda, Maryland.
authors.forename: Kathy A
authors.initials: KA
authors.lastname: Cronin
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Mary C
authors.initials: MC
authors.lastname: White
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Lisa C
authors.initials: LC
authors.lastname: Richardson
authors.affiliation: Information Management Services, Inc, Calverton, Maryland.
authors.forename: Timothy S
authors.initials: TS
authors.lastname: McNeel
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006297:Health Services Accessibility; D006306:Health Surveys; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data*; D009369:Neoplasms / Q000517:prevention & control*; D044469:Racial Groups; D012959:Socioeconomic Factors; D014481:United States