PREVALENCE AND CORRELATES OF BREAST AND CERVICAL-CANCER SCREENING AMONG OLDER WOMEN

Objective: To identify and assess differences in cancer screening patt erns among women 55-64, 65-74, 75-84, and over 84 years of age. Method s: Nationally representative data reported in the 1990 Health Promotio n and Disease Prevention Supplement to the National Health Interview S urvey of 28,584,574 women were analyzed secondarily. The dependent var iables were a knowledge of breast self-examination, ever having had a mammogram, and a Papanicolaou smear within the last 3 years. Independe nt variables were age and various sociodemographic, health-status, and health-belief measures. Results: More than half (58%) of the women ha d ever had a mammogram, and of these, 91% had had between one and five mammograms. Over a third (35%) of those who had not had a mammogram a ttributed the omission to a lack of a recommendation by a physician. A lmost half (45%) had had a breast examination by a physician within th e last year, and 84% knew how to examine their own breasts. Approximat ely 87% had a Papanicolaou smear within the last 3 years. Age, race, e ducation, and living in a large city were significantly associated wit h all three screening measures, but prevalent health beliefs were sign ificantly associated only with breast-cancer screening. Conclusion: La ck of mammogram screening in a substantial number of women, attributed to lack of physician recommendation, decreased screening in the older age groups, and the negative association of all three screening tests with race and residence in a large city suggest that new intervention s are needed by health care providers and the public health community to increase older women's use of effective cancer screening techniques . (C) 1997 by The American College of Obstetricians and Gynecologists.