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- Title
Does patient health and hysterectomy status influence cervical cancer screening in older women?
- Authors
Meissner, Helen I.; Tiro, Jasmin A.; Haggstrom, David; Grace Lu-Yao; Breen, Nancy; Lu-Yao, Grace
- Abstract
<bold>Background: </bold>Decisions to screen older patients for cancer are complicated by the fact that aging populations are heterogeneous with respect to life expectancy.<bold>Objective: </bold>To examine national trends in the association between cervical cancer screening and age, health and hysterectomy status.<bold>Design and Participants: </bold>Cross-sectional data from the 1993, 1998, 2000, and 2005 National Health Interview Surveys (NHIS) were used to examine trends in screening for women age 35-64 and 65+ years of age. We investigated whether health is associated with Pap testing among older women using the 2005 NHIS (N = 3,073). We excluded women with a history of cervical cancer or who had their last Pap because of a problem.<bold>Measurements: </bold>The dependent variable was having a Pap test within the past 3 years. Independent variables included three measures of respondent health (the Charlson comorbidity index (CCI), general health status and having a chronic disability), hysterectomy status and sociodemographic factors.<bold>Main Results: </bold>NHIS data showed a consistent pattern of lower Pap use among older women (65+) compared to younger women regardless of hysterectomy status. Screening also was lower among older women who reported being in fair/poor health, having a chronic disability, or a higher CCI score (4+). Multivariate models showed that over 50% of older women reporting poor health status or a chronic disability and 47% with a hysterectomy still had a recent Pap.<bold>Conclusions: </bold>Though age, health and hysterectomy status appear to influence Pap test use, current national data suggest that there still may be overutilization and inappropriate screening of older women.
- Subjects
CERVICAL cancer patients; HYSTERECTOMY; MEDICAL screening; CANCER in women; DISEASES in older women
- Publication
JGIM: Journal of General Internal Medicine, 2008, Vol 23, Issue 11, p1822
- ISSN
0884-8734
- Publication type
journal article
- DOI
10.1007/s11606-008-0775-x