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Still Screening After All These Years

Keith M. Bellizzi, PhD, MPH; Erica S. Breslau, PhD, MPH; Allison Burness, BSN; William Waldron, MS

Arch Intern Med. 2011;171(22):2031-2037. doi:10.1001/archinternmed.2011.570

Background  While a great deal is known about cancer screening behaviors and trends in young and middle-aged adults, little is known about screening behaviors in older adults from different racial backgrounds. Our goal was to establish prevalence estimates and correlates of cancer screening, including physician recommendation in older (75 years), racially diverse adults.

Methods  Data were analyzed from the National Health Interview Survey—an annual, in-person, nationwide survey used to track health trends in US civilians. The analytic sample included 49 575 individuals, of whom 1697 were 75 to 79 years old and 2376 were 80 years or older. Screening behaviors were examined according to the US Preventive Services Task Force recommendations for breast, cervical, colorectal, and prostate cancer screening.

Results  Among adults aged 75 to 79 years, the percentage screened for cancer was as follows: colorectal, 57%; breast, 62%; cervical, 53%; and prostate, 56%. Among those 80 years or older, rates of screening ranged from a low of 38% for cervical cancer to a high of 50% for breast cancer. Although unadjusted screening prevalence rates differed by race/ethnicity, these differences were accounted for by low education attainment in the multivariate logistic regression model. Physician recommendation for a specific test was the largest predictor of screening. Over 50% of men and women older than 75 years report that their physicians continue to recommend screening.

Conclusion  A high percentage of older adults continue to be screened in the face of ambiguity of recommendations for this group.

Author Affiliations: Department of Human Development and Family Studies, University of Connecticut, Storrs (Dr Bellizzi); Applied Cancer Screening Research Branch, National Cancer Institute, Bethesda, Maryland (Dr Breslau and Ms Burness); and Information Management Services Inc (IMS), Silver Spring, Maryland (Mr Waldron).

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