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The impact of health status on physicians' intentions to offer cancer screening to older women.

Publication ,  Journal Article
Heflin, MT; Pollak, KI; Kuchibhatla, MN; Branch, LG; Oddone, EZ
Published in: J Gerontol A Biol Sci Med Sci
August 2006

BACKGROUND: Screening for breast and cervical cancer reduces disease-specific mortality, but high rates of comorbidity and disability among elderly persons may alter the risks and benefits of screening. METHODS: We performed a mail survey of primary care physicians to estimate the impact of health status on physicians' intentions to offer cancer screening to older women. Respondents were asked to read a scenario about an older woman. Each scenario patient was one of three ages (70, 80, or 90) and had one of three levels of comorbidity and disability. Respondents were asked to estimate the likelihood of offering screening with mammography and Pap smear to these patients on a 5-point Likert scale. A logistic regression compared those physicians somewhat or very likely to offer screening with those less likely to do so. Further analyses examined the characteristics of physicians likely to "overscreen" the frailest older women (<5 years median life expectancy) or "underscreen" the healthiest (>10 years median life expectancy). RESULTS: Respondents returned 2003 completed surveys (37.4%). Controlling for age and prior screening, higher levels of comorbidity and disability were associated with a significantly lower likelihood of offering screening for both mammography and Pap smear. Nonetheless, a substantial percentage (30.7%) of physicians indicated a high likelihood of offering a frail 90-year-old woman a mammogram, and 13.4% would offer her a Pap smear. In general, overscreening was more common than underscreening. Female gender was associated with "overscreening" with mammography, whereas male gender and lack of board certification predicted "underscreening." Lack of board certification was associated with "overscreening" with Pap smear. CONCLUSIONS: In addition to age, primary care physicians consider health status in deciding to offer cancer screening to older women. Education and guidelines for cancer screening should more explicitly address the risks of overscreening among frail older women.

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Published In

J Gerontol A Biol Sci Med Sci

DOI

ISSN

1079-5006

Publication Date

August 2006

Volume

61

Issue

8

Start / End Page

844 / 850

Location

United States

Related Subject Headings

  • Vaginal Smears
  • Uterine Cervical Neoplasms
  • United States
  • Physicians, Family
  • Papanicolaou Test
  • Mammography
  • Male
  • Intention
  • Humans
  • Health Status
 

Citation

APA
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MLA
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Heflin, M. T., Pollak, K. I., Kuchibhatla, M. N., Branch, L. G., & Oddone, E. Z. (2006). The impact of health status on physicians' intentions to offer cancer screening to older women. J Gerontol A Biol Sci Med Sci, 61(8), 844–850. https://doi.org/10.1093/gerona/61.8.844
Heflin, Mitchell T., Kathryn I. Pollak, Maragatha N. Kuchibhatla, Laurence G. Branch, and Eugene Z. Oddone. “The impact of health status on physicians' intentions to offer cancer screening to older women.J Gerontol A Biol Sci Med Sci 61, no. 8 (August 2006): 844–50. https://doi.org/10.1093/gerona/61.8.844.
Heflin MT, Pollak KI, Kuchibhatla MN, Branch LG, Oddone EZ. The impact of health status on physicians' intentions to offer cancer screening to older women. J Gerontol A Biol Sci Med Sci. 2006 Aug;61(8):844–50.
Heflin, Mitchell T., et al. “The impact of health status on physicians' intentions to offer cancer screening to older women.J Gerontol A Biol Sci Med Sci, vol. 61, no. 8, Aug. 2006, pp. 844–50. Pubmed, doi:10.1093/gerona/61.8.844.
Heflin MT, Pollak KI, Kuchibhatla MN, Branch LG, Oddone EZ. The impact of health status on physicians' intentions to offer cancer screening to older women. J Gerontol A Biol Sci Med Sci. 2006 Aug;61(8):844–850.
Journal cover image

Published In

J Gerontol A Biol Sci Med Sci

DOI

ISSN

1079-5006

Publication Date

August 2006

Volume

61

Issue

8

Start / End Page

844 / 850

Location

United States

Related Subject Headings

  • Vaginal Smears
  • Uterine Cervical Neoplasms
  • United States
  • Physicians, Family
  • Papanicolaou Test
  • Mammography
  • Male
  • Intention
  • Humans
  • Health Status