title: The effect of comorbid illness on receipt of cancer screening by older people.
abstract: OBJECTIVE
  To identify associations between the type and number of diagnoses and receipt of screening for breast, cervical, and colorectal cancer by older people.
  
  
  METHODS
  Sixth annual follow-up of a community-based survey with 4,162 participants aged 65 and older at baseline in 1986.
  
  
  METHODS
  Piedmont area of North Carolina.
  
  
  METHODS
  Two thousand two hundred twenty-five subjects with a mean age of 79 who responded in 1992.
  
  
  METHODS
  Self-reported receipt of clinical breast examination, mammography, Papanicolaou (Pap) smear, and fecal occult blood testing (FOBT) within the 2 years before the survey.
  
  
  RESULTS
  Hip fracture was associated with lower rates of mammography (odds ratio (OR) = 0.53, 95% confidence interval (CI) = 0.32-0.87) and cognitive impairment with lower rates of FOBT (OR = 0.71, 95% CI = 0.54-0.94). Hypertension was associated with higher rates of breast examination (OR = 1.56, 95% CI = 1.18-2.07), Pap smear (OR = 1.41, 95% CI = 1.09-1.83), and FOBT (OR = 1.37, 95% CI = 1.12-1.66) and a trend toward increasing rates of mammography (OR = 1.28, 95% CI = 0.98-1.69). The presence of three or more comorbid conditions was associated with an increased rate of mammography (OR = 1.35, 95% CI = 1.06-1.71), breast examination (OR = 1.46, 95% CI = 1.12-1.89), and Pap smear (OR = 1.31, 95% CI = 1.04-1.65).
  
  
  CONCLUSIONS
  With few exceptions, the presence of comorbid conditions is not associated with a decreased rate of receipt of screening. In fact, hypertension and the presence of a higher number of comorbid conditions are associated with a higher rate of receipt of cancer screening. This finding may be due to an increase in the frequency of office visits increasing the opportunity for cancer screening.
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology; D003072:Cognition Disorders / Q000453:epidemiology; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D005833:Genital Neoplasms, Female / Q000175:diagnosis / Q000453:epidemiology; D006620:Hip Fractures / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008327:Mammography / Q000706:statistics & numerical data*; D015999:Multivariate Analysis; D009657:North Carolina / Q000453:epidemiology; D009780:Occult Blood; D016017:Odds Ratio; D065006:Papanicolaou Test; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D014626:Vaginal Smears / Q000706:statistics & numerical data*