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Identifying factors associated with disability-related differences in breast cancer screening (United States)

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Abstract

Objective: The purpose of this study was to identify factors that could explain breast cancer underutilization among women age 40 and older with disabilities. Methods: The data are part of the 1996 Medical Expenditure Panel Survey (MEPS), a nationally representative sample of medical care use and expenditures in the United States. Two different definitions of disability were used: limitations in activities of daily living (ADL) and limitations in instrumental activities of daily living (IADL). Annual mammography was used as the outcome measure. The data are restricted to noninstitutionalized women at least 40 years of age. Results: Crude odds ratios showed that women with long-term limitations in their ADLs or IADLs were less likely to be screened for breast cancer compared to those without such limitations. These associations remained while controlling for possible confounders and were observed among women age 40 or older, those 50–69, and among women 70 years of age and older. Conclusions: Reasons for the underutilization of breast cancer screening among women with long-term disabilities remain elusive. Future studies need to examine additional factors in order to improve screening use, especially among women with long-term disabilities who are 50–69 years of age, for whom screening has been shown to be beneficial in terms of reduced risk of mortality from breast cancer.

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References

  1. Calle EE,Terrell DD (1993) Utility ofthe National Death Index for ascertainment of mortality among Cancer Prevention Study II participants. Am J Epidemiol 137: 235-241.

    Google Scholar 

  2. Cook J,Owen P,Senner J, et al. (1998) Self-reported use of mammography and insurance status among women aged greater than or equal to 40 years. MMWR 47: 825-830.

    Google Scholar 

  3. Pope A,Tarlov A (1991) Disability in America: toward a national agenda for prevention. Washington, DC: National Academy Press, pp. 41-75.

    Google Scholar 

  4. Blustein J,Weiss L (1998) The use ofmammog raphy by women aged 75 and older: factors related to health, functioning, and age. J Am Geriatr Soc 46: 941-946.

    Google Scholar 

  5. Chan L,Doctor J,MacLehose R, et al. (1999) Do Medicare patients with disabilities receive preventive services? A populationbased study. Arch Phys Med Rehabil 80: 642-646.

    Google Scholar 

  6. Burack R,Gurney J,McDaniel A (1998) Health status and mammography use among older women. J Gen Intern Med 13: 366-372.

    Google Scholar 

  7. Iezzoni LI,McCarthy EP,Davis RB,Siebens H (2000) Mobility impairments and use ofscreening and preventive services. Am J Public Health 90: 955-961.

    Google Scholar 

  8. Schootman M,Fuortes LJ (1999) Breast and cervical carcinoma: the correlation ofactivity limitations and rurality with screening, disease incidence, and mortality. Cancer 86: 1087-1094.

    Google Scholar 

  9. Nelson L,Brown R,Gold M,Ciemnecki A,Docteur E (1997) Access to care in Medicare HMOs. Health Aff 16: 148-156.

    Google Scholar 

  10. Andersen RM (1995) Revisiting the behavioral model and access to medical care: does it matter? J Health Soc Behav 36: 1-10.

    Google Scholar 

  11. Cohen S (1997) Sample Design of the 1996 Medical Expenditure Panel Survey Household Component. Rockville: AHCPR.

    Google Scholar 

  12. Smith RA,Mettlin CJ,Johnston,Davis K,Eyre H (2000) American Cancer Society guidelines ofthe early detection of cancer. CA Cancer J Clin 50: 34-49.

    Google Scholar 

  13. National Cancer Institute (2001) Screening for Breast Cancer (Physician Data Query System), cancernet.nci.nih.gov.

  14. Benson V, Marano M (1994) Current Estimates from the National Health Interview Survey, 1992. Series 10. Hyattsville: National Center for Health Statistics.

    Google Scholar 

  15. US Preventive Services Task Force (1996) Guide to Clinical Preventive Services, 2nd edn. Alexandria: International Medical Publishing.

    Google Scholar 

  16. Nystrom L,Andersson I,Bjurstam N, et al. (2002) Long-term effects ofmammograp hy screening: updated overview ofthe Swedish randomised trials. Lancet 359: 909-919.

    Google Scholar 

  17. Duffy SW,Tabar L,Chen HH, et al. (2002) The impact of organized mammography service screening on breast carcinoma mortality in seven Swedish counties: a collaborative evaluation. Cancer 95: 458-469.

    Google Scholar 

  18. Gulitz E,Bustillo-Hernandez M,Kent EB (1998) Missed cancer screening opportunities among older women. Cancer Pract 6: 289-295.

    Google Scholar 

  19. American Geriatrics Society (2000) Breast cancer screening in older women. J Am Geriatr Soc 48: 842-844.

    Google Scholar 

  20. McCarthy E,Burns R,Freund K, et al. (2000) Mammography use, breast cancer stage at diagnosis, and survival among older women. J Am Geriatr Soc 48: 1226-1266.

    Google Scholar 

  21. Advisory Committee on Cancer Prevention (2000) Recommendations on cancer screening in the European Union. Eur J Cancer 36: 1473-1478.

    Google Scholar 

  22. Coebergh JWW,Janssen-Heijnen MLG,Post PN,Razenberg PPA (1999) Serious co-morbidity among unselected cancer patients newly diagnosed in the Southeastern part ofThe Netherlands in 1993-1996. J Clin Epidemiol 52: 1131-1136.

    Google Scholar 

  23. Blackman DK,Bennett EM,Miller DS (1999) Trends in selfreported use ofmammogram s (1989-1997) and Papanicolaou tests (1991-1997)-Behavioral Risk Factor Surveillance System. MMWR 48: 1-22.

    Google Scholar 

  24. Kerlikowske K,Salzmann P,Phillips K,Cauley J,Cummings S (1999) Continuing screening mammography in women aged 79 to 79 years: impact on life expectancy and cost-effectiveness. JAMA 282: 2156-2163.

    Google Scholar 

  25. Mandelblatt J,Yabroff K,Lawrence W, et al. (2000) Screening mammography in elderly women. JAMA 283: 3202-3204.

    Google Scholar 

  26. Mandelblatt J,Yabroff K (2000) Breast and cervical cancer screening for older women: recommendations and challenges for the 21st century. J Am Med Womens Assoc 55: 210-215.

    Google Scholar 

  27. Balducci L (2000) Geriatric oncology. Challenges for the new century. Eur J Cancer 36: 1741-1754.

    Google Scholar 

  28. Gordon NP,Hiatt RA,Lampert DI (1993) Concordance ofself-reported data and medical record audit for six cancer screening procedures. J Natl Cancer Inst 85: 566-570.

    Google Scholar 

  29. Thompson B,Taylor V,Goldberg H,Mullen M (1999) Mammography status using patient self-reports and computerized radiology database. Am J Prev Med 17: 203-206.

    Google Scholar 

  30. Paskett ED,Tatum CM,Mack DW, et al. (1996) Validation of self-reported breast and cervical cancer screening tests among lowincome minority women. Cancer Epidemiol Biomarkers Prev 5: 721-726.

    Google Scholar 

  31. Etzi S,Lane DS,Grimson R (1994) The use ofmammograp hy vans by low income women: the accuracy ofself-reports. Am J Public Health 84: 107-109.

    Google Scholar 

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Authors and Affiliations

  1. Division of Health Behavior Research, Departments of Pediatrics and Medicine, Washington University School of Medicine, 4444 Forest Park Parkway, Box 8504, Saint Louis, MO, 63108, USA

    Mario Schootman & Donna B. Jeffe

  2. Alvin J. Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, Saint Louis, MO, USA

    Mario Schootman & Donna B. Jeffe

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  1. Mario Schootman
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  2. Donna B. Jeffe
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Correspondence to Mario Schootman.

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Schootman, M., Jeffe, D.B. Identifying factors associated with disability-related differences in breast cancer screening (United States). Cancer Causes Control 14, 97–107 (2003). https://doi.org/10.1023/A:1023091308625

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