A worrying new trend has emerged in global health care: fewer women are undergoing cancer screenings.

According to the latest Hologic Global Women’s Health Index, the percentage of women reporting cancer tests has reached its lowest level in four years. This comes at a time when global cancer cases are projected to reach 32.6 million annually by 2045, making prevention, early detection and access to health care more critical than ever.

Newsweek discussed the Year 4 findings—based on surveys conducted in 2023, with nearly 146,000 women and men aged 15 or older across 142 countries and territories—with oncologist Dr. Sarah Cate.

“Not knowing means you won’t get the correct treatment earlier and in the case of breast cancers, the earlier it is diagnosed, the less likely you are to need chemotherapy,” she said. “Many women also simply don’t make time for themselves, since they are working and often caring for children or parents.”

As the chief of breast surgery at Stamford Health in Connecticut, Cate has heard the reasons why some women may opt against mammograms for breast cancer and Pap smears for cervical cancer.

“There is a lot of fear and misinformation surrounding screening,” she told Newsweek. “I hear it regularly in the clinic. Things like ‘I’d rather not know,’ or ‘But if I find cancer, I’ll need chemotherapy.'”

As people get older, their risk of developing cancer increases, according to the National Cancer Institute. Fewer than 25 cases per 100,000 individuals occur in those under age 20, but by the time people reach their late 40s, about 350 out of every 100,000 will develop cancer.

“The risk of all cancers increases as we age,” Cate told Newsweek. “This is thought to be secondary to our bodies’ loss of the ability to repair daily damage to DNA and other factors such as prolonged exposure to toxins like cigarette smoke and alcohol.”

Yet, only 10 percent of women reported being tested for cancer in the past year, according to 2023 data shared on January 21 by Gallup. This represents a decline from 12 percent in 2020 and 2021. The downward trend began in 2022, but became statistically significant in 2023.

“The Year 4 findings from the Hologic Global Women’s Health Index highlight a concerning decline in cancer testing among women, particularly those over the age of 40,” states the report.

While regular screenings can’t prevent cancer, they can aid in early detection, which leads to better survival rates.

Cate told Newsweek: “The earlier a cancer is found, the less likely you are to die from it. Screening is our only way to find cancers early, as by the time most cancers have symptoms, they are higher stages.”

While research indicates that cancer diagnoses are increasing among younger adults, most new cases in the coming decades are still expected to be among older individuals, particularly those aged 65 and older.

“The American Cancer Society lowered the age for screening colonoscopy from age 50 to age 45,” she said. “Mammography should start at 40 for average-risk women, and even younger for patients with a family history of breast cancer or a genetic mutation. Annual skin examinations are also really important for detecting skin cancers.”

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