title: Preventive care in older cancer survivors.
abstract: OBJECTIVE
  To study factors that influence receipt of preventive care in older cancer survivors.
  
  
  METHODS
  We analyzed a nationally representative sample of 12,458 older adults from the 2003 Medicare Current Beneficiary Survey. Factors associated with non-receipt of preventive care were explored among cancer and non-cancer survivors, using logistic regression.
  
  
  RESULTS
  Among the cancer survivors, 1883 were diagnosed >1 year at survey completion. A cancer history was independently associated with receipt of mammogram (AOR = 1.57, 95% CI = 1.34-1.85), flu shot (AOR = 1.33, 95% CI = 1.16-1.53), measurement of total cholesterol in the previous six months (AOR = 1.20, 95% CI = 1.07-1.34), pneumonia vaccination (AOR = 1.33, 95% CI = 1.18-1.49), bone mineral density (BMD) testing (AOR = 1.38, 95% CI = 1.21-1.56), and lower endoscopy (AOR = 1.46, 95% CI = 1.29-1.65). However, receipt of preventive care was not optimal among older cancer survivors with only 51.2% of the female cancer survivors received a mammogram, 63.8% of all the cancer survivors received colonoscopy, and 42.5% had BMD testing. Among the cancer survivors, factors associated with non-receipt of mammogram included age ≥85 years (AOR = 0.43, 95% CI = 0.26-0.74), and scoring ≥three points on the Vulnerable Elders Survey-13 (AOR = 0.94, 95% CI = 0.80-1.00). Factors associated with non-receipt of colonoscopy included low education (AOR= 0.43, 95% CI = 0.27-0.68) and rural residence (AOR = 0.51, 95% CI = 0.34-0.77). Factors associated with non-receipt of BMD testing included age ≥70 (AOR = 0.59, 95% CI = 0.39-0.90), African American race (AOR = 0.51, 95% CI= 0.27-0.95), low education (AOR = 0.23, 95% CI = 0.14-0.38), and rural residence (AOR = 0.43, 95% CI = 0.27-0.70).
  
  
  CONCLUSIONS
  Although older cancer survivors are more likely to receive preventive care services than other older adults, factors other than health status considerations (e.g., education, rural residence) are associated with non-receipt of preventive care services.
authors.affiliation: James Wilmot Cancer Center, University of Rochester, Rochester, NY, USA.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Lowenstein
authors.affiliation: James Wilmot Cancer Center, University of Rochester, Rochester, NY, USA.
authors.forename: Jennifer Andreozzi
authors.initials: JA
authors.lastname: Ouellet
authors.affiliation: Department of Medicine, Section of Geriatrics and Palliative Medicine, The University of Chicago, Chicago, IL, USA.
authors.forename: William
authors.initials: W
authors.lastname: Dale
authors.affiliation: James Wilmot Cancer Center, University of Rochester, Rochester, NY, USA.
authors.forename: Lin
authors.initials: L
authors.lastname: Fan
authors.affiliation: James Wilmot Cancer Center, University of Rochester, Rochester, NY, USA. Electronic address: supriya_mohile@urmc.rochester.edu.
authors.forename: Supriya
authors.initials: S
authors.lastname: Gupta Mohile
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D016022:Case-Control Studies; D003113:Colonoscopy / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007252:Influenza Vaccines / Q000627:therapeutic use*; D007251:Influenza, Human / Q000517:prevention & control*; D016015:Logistic Models; D008297:Male; D008327:Mammography / Q000706:statistics & numerical data; D008403:Mass Screening / Q000706:statistics & numerical data; D006278:Medicare; D009369:Neoplasms; D010024:Osteoporosis / Q000000981:diagnostic imaging*; D011314:Preventive Health Services / Q000706:statistics & numerical data; D012737:Sex Factors; D017741:Survivors / Q000706:statistics & numerical data*; D014481:United States
chemical_list: D007252:Influenza Vaccines
keywords: Cancer; Preventive medicine; Survivors