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 screening 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, Ecuadorian) and three black groups (U.S., Caribbean, and Haitian) was performed. Outcome measures included "ever" and "recent" self-reported use of mammography, clinical breast examination (CBE), and Pap smears. Logistic regression models assessed the predictors of screening use.


RESULTS
Having a regular source of care significantly predicted all screening use for both elderly and nonelderly, controlling for ethnicity, sociodemographics, health status, access to care, proportion of life in the United States, and cancer attitudes. Elderly women (>/=65 years) 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 CBE use. Interestingly, there was a trend for health status to act differently in predicting Pap smear use for the two age groups. For younger women, being in poor health increased the odds of Pap smear screening, while for elderly 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.
Mandelblatt
J S
JS
Department of Medicine, Lombardi Cancer Center, Institute for Health Care Policy and Research, Georgetown University School of Medicine, Washington, DC 20007, USA.
Gold
K
K
O'Malley
A S
AS
Taylor
K
K
Cagney
K
K
Hopkins
J S
JS
Kerner
J
J
D000069:Acculturation; D000328:Adult; D001741:Black or African American / Q000145:classification / Q000523:psychology / Q000706:statistics & numerical data; D000367:Age Factors; D000368:Aged; D001294:Attitude to Health / Q000208:ethnology; D001943:Breast Neoplasms / Q000517:prevention & control* / Q000523:psychology; D005260:Female; D015438:Health Behavior / Q000208:ethnology*; D019538:Health Care Surveys; D006630:Hispanic or Latino / Q000145:classification / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D009519:New York City; D012494:Sampling Studies; D012933:Social Identification; D013223:Statistics as Topic; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control* / Q000523:psychology; D016387:Women's Health