Caregiving associated with selected cancer risk behaviors and screening utilization among women: cross-sectional results of the 2009 BRFSS

Katherine W Reeves,Kathryn Bacon,Lisa Fredman

doi:10.1186/1471-2458-12-685

Abstract

BackgroundInformal caregiving is increasingly common as the U.S. population ages, and there is concern that caregivers are less likely than non-caregivers to practice health-promoting behaviors, including cancer screening. We examined caregiving effects on cancer risk behaviors and breast and cervical cancer screening in the 2009 Behavioral Risk Factor Surveillance System.MethodsWomen age ≥41 with data on breast and cervical cancer screening were included (weighted frequency 3,478,000 women). Cancer screening was classified according to American Cancer Society guidelines. We evaluated the association of caregiving with cancer risk behaviors (obesity, physical activity, alcohol intake, smoking status, and fruit/vegetable consumption) and cancer screening (mammography, clinical breast exam [CBE], and Pap test) using logistic regression overall and with stratification on age (<65, ≥65) or race (white, non-white).ResultsCaregivers had greater odds of being obese, physically active, and current smokers. Subgroup analyses revealed that caregiving was associated with obesity in younger women and whites, and with less obesity in older women. Also, caregiving was associated with smoking only among younger women and non-whites. Caregivers had greater odds of ever having had a mammogram or CBE, yet there was no association with mammogram, CBE, or Pap test within guidelines.ConclusionsCaregiving was associated with some health behaviors that increase cancer risk, yet not with cancer screening within guidelines. Effects of caregiving by age and race require confirmation by additional studies.

Highlights

Informal caregiving is increasingly common as the U.S population ages, and there is concern that caregivers are less likely than non-caregivers to practice health-promoting behaviors, including cancer screening
We restricted our analysis to women age ≥41 from these four states in order to select the population of women for whom the American Cancer Society (ACS) recommendations included both mammography and a Pap test within the past year
Caregiving was significantly associated with ever had a mammogram only among whites, the test of the interaction between race and ever had a mammogram was not statistically significant. In this cross-sectional analysis of the 2009 Behavioral Risk Factor Surveillance System (BRFSS), we found that caregiving was associated with behaviors that increase cancer risk as well as those that reduce cancer risk

Summary

Introduction

Informal caregiving is increasingly common as the U.S population ages, and there is concern that caregivers are less likely than non-caregivers to practice health-promoting behaviors, including cancer screening. We examined caregiving effects on cancer risk behaviors and breast and cervical cancer screening in the 2009 Behavioral Risk Factor Surveillance System. There is recent concern that caregivers are less likely than non-caregivers to practice health-promoting behaviors [1,2,3], which may include seeking cancer screening tests. Of the estimated 43.5 million U.S caregivers in 2009, 54% were aged 50 years or older, and 26% spent ≥20 hours/week performing caregiving activities [5]. Caregivers consistently report more psychological distress, such as depressive symptoms and anxiety, as well as self-reported stress than non-caregivers [6].

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