Breast and cervix cancer screening among multiethnic women: Role of age, health, and source of care

Objective. The aim of this study was to evaluate the relationships between age, health status, access to care, and breast and cervical cancer screenin g among multiethnic elderly and nonelderly women. Methods. A structured telephone survey of a quota sample of 1,420 New York City women from four Hispanic groups (Columbian, Dominican, Puerto Rican, E cuadorian) and three black groups (U.S., Caribbean, and Haitian) was perfor med. Outcome measures included "ever" and "recent" self-reported use of mam mography, clinical breast examination (CBE), and Pap smears. Logistic regre ssion models assessed the predictors of screening use. Results. Having a regular source of care significantly predicted all screen ing use for both elderly and nonelderly, controlling for ethnicity, sociode mographics, health status, access to care, proportion of life in the United States, and cancer attitudes. Elderly women (greater than or equal to 65 y ears) were significantly less likely to have ever had (OR = 0.79, 95% CI 0. 65-0.96) and to have recently had (OR = 0.67, 95% CI 0.57-0.79) Pap smears than younger women, controlling for the other variables; being elderly also tended to be an independent predictor of ever and recent mammography and C BE use. Interestingly, there was a trend for health status to act different ly in predicting Pap smear use for the two age groups. For younger women, b eing in poor health increased the odds of Pap smear screening, while for el derly women, being in good health increased the odds of screening. Conclusions. Elderly women reported being screened less than younger women; interactions between health status and age need further exploration. (C) 1 999 American Health Foundation and Academic Press.