Cancer Screening In Older Women Research Articles

Breast cancer screening in older women: a dual site intervention study Northeast/Southeast USA

Breast cancer screening in older women: a dual site intervention study Northeast/Southeast USA

Government cuts funds for breast cancer screening in older women.

FUNDING FOR breast cancer screening for women over 65 was cut by 40 per cent last year, according to figures discovered by the chair of the parliamentary all-party breast cancer group.

Improving Compliance With Breast Cancer Screening in Older Women

To compare three approaches for improving compliance with breast cancer screening in older women. Randomized controlled trial using three parallel group practices at a public hospital. Subjects included women aged 65 years and older (n = 803) who were seen by residents (n = 66) attending the ambulatory clinic from October 1, 1989, through March 31, 1990. All provider groups received intensive education in breast cancer screening. The control group received no further intervention. Staff in the second group offered education to patients at their visit. In addition, flowsheets were used in the "Prevention Team" group and staff had their tasks redefined to facilitate compliance. Medical records were reviewed to determine documented offering/receipt of clinical breast examination and mammography. A subgroup of women without previous clinical breast examination (n = 540) and without previous mammography (n = 471) were analyzed to determine the effect of the intervention. During the intervention period, women without a previous clinical breast examination were offered an examination significantly more often in the Prevention Team group than in the control group, adjusting for age, race, and comorbidity and for physicians' gender and training level. The patients in the Prevention Team group were offered clinical breast examination (31.5%) more frequently than those in the patient education or control groups, but this was not significant after adjusting for the above covariates. Likewise, mammography was offered more frequently to patients in the Prevention Team and in the patient education group than to patients in the control group, after adjusting for the factors above using logistic regression. The results provide support for patient education and organizational changes that involve nonphysician personnel to enhance breast cancer screening among older women, particularly those without previous screening.

Improving compliance with breast cancer screening in older women. Results of a randomized controlled trial

Improving compliance with breast cancer screening in older women. Results of a randomized controlled trial

The extent of breast cancer screening in older women

Women 65 and older present a unique challenge to health professionals, particularly with respect to breast cancer screening. These women are at the highest risk for developing breast cancer; they represent 50% of all newly diagnosed breast cancers. This group represents 60% of the breast cancer deaths, however, demonstrating how serious a disease breast cancer is in the 65-and-older age group. Moreover, the 65-and-older population cohort is growing rapidly. By 2010, it is estimated that greater than 15% of the population will be older than 65, and, as is the case now, the majority of this group will be women. Therefore, preventing breast cancer deaths in older women is a very significant and pressing issue. Ironically, most studies have reported that screening for breast cancer is less widespread in women older than 65 than in those younger than 65. Regional surveys emphasize a number of barriers, some of which seem to be age-specific--a lower level of knowledge about the usefulness and benefit of mammography, particularly in the absence of symptoms; less of a sense of personal vulnerability; fewer screening recommendations from family, friends, or physicians; and more problems with access (cost, transportation). To improve breast cancer screening rates in older women, sound health education interventions are needed to improve knowledge of and belief and attitudes regarding mammography. These should be targeted not only to older women, but also to their physicians and/or primary care givers. In addition, specific attention should be given to those barriers that are particularly burdensome for the elderly: cost, transportation problems, and loss of mobility.

Breast and cervical cancer screening in older women: The San Diego medicare preventive health project

Background. This study presents rates and correlates of cancer screening, including mammography, clinical breast exam, breast self-examination, and Pap tests, in older women. Age was the predictor of main interest. Results. Among a sample of female Medicare beneficiaries ages 65 and older, who were members of a health maintenance organization, there was a significant, inverse relationship between age and mammography adherence, while controlling for health status, physician utilization, education, and income. The proportions of subjects ages 65–74 and 75+ never having had a mammogram were 17 and 32%, respectively, and the proportions having had annual mammograms were 40 and 28%, respectively. Pap test frequency showed a trend toward an inverse relationship with age, controlling for demographic and health-related variables. In the youngest age group (65–69), 52% had annual Pap tests, whereas in the oldest group (80+), only 36% had annual Pap tests. Age did not predict frequency of clinical breast exam, and the relationship of age to breast self-examination was inconclusive. The role of the physician in promoting cancer screening is discussed.

Cervical cancer screening in older women

Although some controversy exists, the Papanicolaou (Pap) smear for cervical cancer screening is widely accepted as an effective mechanism for cancer control. An issue of interest to clinicians and behavioral scientists is the underrepresentation of elderly women in populations screened. It is important for nurses to understand the issues, and hypothesized reasons behind this phenomenon, in order to develop interventions to counteract it. The authors examine this problem from a number of behavioral and clinical perspectives and discuss nursing interventions to improve cervical cancer screening in older women.

Cervical cancer screening in older women

Although some controversy exists, the Papanicolaou (Pap) smear for cervical cancer screening is widely accepted as an effective mechanism for cancer control. An issue of interest to clinicians and behavioral scientists is the underrepresentation of elderly women in populations screened. It is important for nurses to understand the issues, and hypothesized reasons behind this phenomenon, in order to develop interventions to counteract it. The authors examine this problem from a number of behavioral and clinical perspectives and discuss nursing interventions to improve cervical cancer screening in older women.

Breast Cancer Screening in Older Women: Practices and Barriers Reported by Primary Care Physicians

Annual mammography, in combination with clinical breast examinations, can reduce mortality from breast cancer. However, surveys of both patients and physicians suggest that mammography is underutilized. This study examined whether physicians' reported breast cancer screening practices and barriers to mammography varied with patients' age. Data from 576 primary care physicians (internal medicine, family/general practice, and obstetrics/gynecology) who participated in a mailed statewide survey were analyzed. Physicians reported screening elderly women significantly less often than younger women, regardless of family history of breast cancer. With the exception of medical specialty, physicians' demographic and practice characteristics were not associated with reported screening practices. However, physicians' knowledge and beliefs about breast cancer in older women were associated with reported screening practices. When analyzing barriers to ordering mammography, cost to the patient was viewed as a barrier for women of all ages, and pain was viewed as a greater barrier for younger women; otherwise, physicians consistently believed that their elderly patients faced considerably more barriers compared with younger women. Further investigation is required to examine why primary care physicians report age-related differences in both breast screening and barriers to mammography.

Age group differences in the use of breast cancer screening tests. The effects of health care utilization and socioeconomic variables.

The age-related decline in the use of breast cancer screening tests, specifically periodic mammography and physical breast examinations by a doctor, is especially problematic given that breast cancer risk increases with age. Survey data (N = 3,507) from the Awareness of Breast Cancer Project are used to compare the effects of socioeconomic variables and usual health care use variables on recent use of breast cancer screening tests in women 50 to 75 years of age on Long Island, New York. Having annual checkups and seeing an obstetrician/gynecologist for routine health care are the best predictors of recent mammography and breast physical exams for all women. Income level and education are not independent predictors of recent screening for women over 65. The implications of the effect of primary care practioners on periodic breast cancer screening in older women are discussed.

Barriers to breast cancer screening in older women

Williams, Roma D. RN-C, PhD1; Edwards, Karethy DrPH, RN2; Hane, Nancy RN, MS3 Author Information