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J Gen Intern Med. 2008 Nov;23(11):1822-8. doi: 10.1007/s11606-008-0775-x. Epub 2008 Sep 11.

Does patient health and hysterectomy status influence cervical cancer screening in older women?

Author information

  • 1Office of Behavioral and Social Sciences Research, National Institutes of Health, Bethesda, MD 20892-2027, USA. meissneh@od.nih.gov

Abstract

BACKGROUND:

Decisions to screen older patients for cancer are complicated by the fact that aging populations are heterogeneous with respect to life expectancy.

OBJECTIVE:

To examine national trends in the association between cervical cancer screening and age, health and hysterectomy status.

DESIGN AND PARTICIPANTS:

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.

MEASUREMENTS:

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.

MAIN RESULTS:

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.

CONCLUSIONS:

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.

PMID:
18784967
[PubMed - indexed for MEDLINE]
PMCID:
PMC2585656
Free PMC Article

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