Preventive care in older cancer survivors

J Geriatr Oncol. 2015 Mar;6(2):85-92. doi: 10.1016/j.jgo.2014.12.003. Epub 2014 Dec 24.

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).

Conclusion: 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.

Keywords: Cancer; Preventive medicine; Survivors.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Bone Density
  • Breast Neoplasms / diagnostic imaging*
  • Case-Control Studies
  • Colonoscopy / statistics & numerical data
  • Colorectal Neoplasms / diagnosis*
  • Cross-Sectional Studies
  • Early Detection of Cancer / statistics & numerical data
  • Female
  • Humans
  • Influenza Vaccines / therapeutic use*
  • Influenza, Human / prevention & control*
  • Logistic Models
  • Male
  • Mammography / statistics & numerical data
  • Mass Screening / statistics & numerical data
  • Medicare
  • Neoplasms*
  • Osteoporosis / diagnostic imaging*
  • Preventive Health Services / statistics & numerical data
  • Sex Factors
  • Survivors / statistics & numerical data*
  • United States

Substances

  • Influenza Vaccines