title: Routine preventive services for older women: a composite measure highlights gaps in delivery.
abstract: BACKGROUND
  We used a composite measure to examine the delivery of routine clinical preventive services to U.S. women aged 50-64 years and > or =65 years in 2004.
  
  
  METHODS
  We analyzed state data from the 2004 Behavioral Risk Factor Surveillance System (BRFSS) and created a composite measure that included screening of women > or =50 years for colorectal cancer, cervical cancer, breast cancer, vaccination against influenza, and, for women aged > or =65 years only, pneumococcal vaccination. The composite measure quantified the percentage of women who were up-to-date (UTD) according to recommended schedules for these services.
  
  
  RESULTS
  Approximately 23% of women aged 50-64 years and 32.5% of women aged > or =65 years were UTD in 2004. Results varied by education, race/ethnicity, marriage status, insurance status, and health status. There was also considerable geographic variation in state-specific UTD estimates, ranging from 16.7% (California) to 38.4% (Minnesota) for women aged 50-64 years and from 25.7% (Indiana) to 48.5% (Minnesota) for women aged > or =65 years.
  
  
  CONCLUSIONS
  Although rates for some individual services were > or =75%, the percentage of women aged 50-64 years and > or =65 years UTD on all routinely recommended cancer screenings and vaccinations was low, with <1 in 3 being UTD.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA. jcr2@cdc.gov
authors.forename: Julie
authors.initials: J
authors.lastname: Bolen
authors.forename: Mary
authors.initials: M
authors.lastname: Adams
authors.forename: Douglas
authors.initials: D
authors.lastname: Shenson
mesh_terms: D040343:Behavioral Risk Factor Surveillance System; D001943:Breast Neoplasms / Q000517:prevention & control; D015179:Colorectal Neoplasms / Q000517:prevention & control; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D015438:Health Behavior; D006297:Health Services Accessibility / Q000458:organization & administration / Q000706:statistics & numerical data*; D006801:Humans; D007252:Influenza Vaccines / Q000627:therapeutic use; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D022242:Pneumococcal Vaccines / Q000627:therapeutic use; D011322:Primary Prevention / Q000458:organization & administration / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control; D016387:Women's Health; D014932:Women's Health Services / Q000458:organization & administration / Q000706:statistics & numerical data*
chemical_list: D007252:Influenza Vaccines; D022242:Pneumococcal Vaccines