Mammography and Papanicolaou smear use by elderly poor black women. The Harlem Study Team.
OBJECTIVE
To describe factors related to the use of mammography and Papanicolaou smears in low-income women aged 65 or more years to guide development of future interventions.


METHODS
A cross-sectional survey.


METHODS
Elderly Black women attending a public hospital medical clinic.


METHODS
Information obtained in a face-to-face interview of a random sample of patients.


RESULTS
Four-hundred and forty-five women (94%) consented to be interviewed; 74% reported a mammogram, and 85% reported a Papanicolaou smear in the past, although these early-detection tests were not obtained with any regularity after age 65. Concordance between self-reported screening use and blind chart review was more than 90%. The major reasons for non-use of both screening tests were that a physician hadn't recommended them or that the women didn't know they needed them. Levels of knowledge about breast and cervix cancer were low; 68% believed bumping or bruising the breast caused cancer, and only 25% knew that cancer risk increased with advancing age. In logistic regression models, health status, provider type, perceived benefit, life satisfaction, and knowledge of test intervals were each significantly associated with mammogram use. Age, health status, education, perceived susceptibility and benefit, life satisfaction, and knowledge of test intervals were independently related to Pap use (P < .05).


CONCLUSIONS
This study illustrates that elderly, poor, minority women who are regular health-care users do use mammography and Pap smear screening services. Incorporating screening into routine primary care and physician and patient education could enhance the use of early cancer detection procedures in this age group.
Mandelblatt
J
J
Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY 10021.
Traxler
M
M
Lakin
P
P
Kanetsky
P
P
Kao
R
R
D001741:Black or African American / Q000523:psychology*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006779:Hospitals, Public; D006801:Humans; D016015:Logistic Models; D008327:Mammography / Q000523:psychology / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000706:statistics & numerical data; D009519:New York City; D010044:Outpatient Clinics, Hospital; D065006:Papanicolaou Test; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D011203:Poverty; D011795:Surveys and Questionnaires; D014626:Vaginal Smears / Q000523:psychology / Q000706:statistics & numerical data*