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The Effect of Comorbid Illness on Receipt of Cancer Screening by Older People

  1. Mitchell T. Heflin MD, MHSc1,2,3,4,
  2. Eugene Z. Oddone MD, MHSc1,
  3. Carl F. Pieper DrPH3,
  4. Bruce M. Burchett PhD3,
  5. Harvey Jay Cohen MD2,3,4

Article first published online: 17 OCT 2002

DOI: 10.1046/j.1532-5415.2002.50456.x

Issue

Journal of the American Geriatrics Society

Journal of the American Geriatrics Society

Volume 50, Issue 10, pages 1651–1658, October 2002

Additional Information

How to Cite

Heflin, M. T., Oddone, E. Z., Pieper, C. F., Burchett, B. M. and Cohen, H. J. (2002), The Effect of Comorbid Illness on Receipt of Cancer Screening by Older People. Journal of the American Geriatrics Society, 50: 1651–1658. doi: 10.1046/j.1532-5415.2002.50456.x

Author Information

  1. 1

    Center for Health Services Research and

  2. 2

    Geriatrics Research, Education and Clinical Center, VA Medical Center, Durham, North Carolina; and

  3. 3

    Center for the Study of Aging and Human Development and

  4. 4

    Division of Geriatrics, Department of Medicine, Duke University Medical Center, Durham, North Carolina.

*Address correspondence to Mitchell T. Heflin, MD, 2511 Blue Zone, Duke South, Duke University Medical Center, Durham, NC, 27710. E-mail: hefli001@mc.duke.edu

Publication History

  1. Issue published online: 17 OCT 2002
  2. Article first published online: 17 OCT 2002

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Keywords:

  • cancer screening;
  • clinical breast exam;
  • comorbid illness;
  • fecal occult blood testing;
  • mammography;
  • older people;
  • Pap smear

OBJECTIVES: To identify associations between the type and number of diagnoses and receipt of screening for breast, cervical, and colorectal cancer by older people.

DESIGN: Sixth annual follow-up of a community-based survey with 4,162 participants aged 65 and older at baseline in 1986.

SETTING: Piedmont area of North Carolina

PARTICIPANTS: Two thousand two hundred twenty-five subjects with a mean age of 79 who responded in 1992.

MEASUREMENTS: Self-reported receipt of clinical breast examination, mammography, Papanicolaou (Pap) smear, and fecal occult blood testing (FOBT) within the 2 years before the survey.

RESULTS: Hip fracture was associated with lower rates of mammography (odds ratio (OR) = 0.53, 95% confidence interval (CI) = 0.32–0.87) and cognitive impairment with lower rates of FOBT (OR = 0.71, 95% CI = 0.54–0.94). Hypertension was associated with higher rates of breast examination (OR = 1.56, 95% CI = 1.18–2.07), Pap smear (OR = 1.41, 95% CI = 1.09–1.83), and FOBT (OR = 1.37, 95% CI = 1.12–1.66) and a trend toward increasing rates of mammography (OR = 1.28, 95% CI = 0.98–1.69). The presence of three or more comorbid conditions was associated with an increased rate of mammography (OR = 1.35, 95% CI = 1.06–1.71), breast examination (OR = 1.46, 95% CI = 1.12–1.89), and Pap smear (OR = 1.31, 95% CI = 1.04–1.65).

CONCLUSIONS: With few exceptions, the presence of comorbid conditions is not associated with a decreased rate of receipt of screening. In fact, hypertension and the presence of a higher number of comorbid conditions are associated with a higher rate of receipt of cancer screening. This finding may be due to an increase in the frequency of office visits increasing the opportunity for cancer screening.

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