Age-related disparities in cancer screening: Analysis of 2001 Behavioral Risk Factor Surveillance System data

Anthony F Jerant, Peter Franks, J. Elizabeth Jackson, Mark P. Doescher

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

PURPOSE: Although few studies have explored age-related health care disparities, some researchers have asserted such disparities uniformly disfavor the elderly and are largely attributable to ageism in the health care system. We compared age-related patterns of screening for colorectal cancer with those for breast and prostate cancer in persons aged 50 years and older. METHODS: We analyzed data for all adults aged 50 years and older (N = 88,213) in the 2001 Behavioral Risk Factor Surveillance System (BRFSS), a nationally representative, telephone-administered survey of personal health behaviors. Main outcome measures were adjusted prevalence by 5-year age-groups of colorectal cancer screening using fecal occult blood testing, flexible sigmoidoscopy, or colonoscopy for men and women; rates of mammography screening for women; and rates of prostate-specific antigen (PSA) screening for men. RESULTS: After adjustment for race/ethnicity, education level, income, health insurance, and self-rated health, predicted reported colorectal cancer screening (all modalities) increased significantly from when patients reached age 50 years until 70 to 74 years (66.0%, standard error [SE] 0.8%), remained constant until age 80 years, and then declined. The age-related gain in colorectal cancer screening was confined to whites among patients older than 60 years. Reported PSA screening increased until age 75 to 79 years (79.3%, SE 1.1%) and then declined, whereas reported mammography screening peaked at age 55 to 59 years (83.3%, SE 1.2%) and then declined. CONCLUSIONS: Significant age-related disparities appear to exist for both evidence-based and non-evidence-based cancer-screening interventions. The issue of age-related disparities in cancer screening is complex, with the direction of disparity favoring the elderly for some services yet disfavoring them for others.

Original languageEnglish (US)
Pages (from-to)481-487
Number of pages7
JournalAnnals of Family Medicine
Volume2
Issue number5
DOIs
StatePublished - Sep 2004

Fingerprint

Behavioral Risk Factor Surveillance System
Early Detection of Cancer
Colorectal Neoplasms
Mammography
Prostate-Specific Antigen
Ageism
Healthcare Disparities
Sigmoidoscopy
Occult Blood
Health Behavior
Colonoscopy
Health Insurance
Telephone
Health Status
Prostatic Neoplasms
Age Groups
Research Personnel
Outcome Assessment (Health Care)
Breast Neoplasms
Delivery of Health Care

Keywords

  • Health care surveys
  • Health services accessibility
  • Health services for the aged
  • Mass screening
  • Preventive health services

ASJC Scopus subject areas

  • Family Practice

Cite this

Age-related disparities in cancer screening : Analysis of 2001 Behavioral Risk Factor Surveillance System data. / Jerant, Anthony F; Franks, Peter; Jackson, J. Elizabeth; Doescher, Mark P.

In: Annals of Family Medicine, Vol. 2, No. 5, 09.2004, p. 481-487.

Research output: Contribution to journalArticle

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abstract = "PURPOSE: Although few studies have explored age-related health care disparities, some researchers have asserted such disparities uniformly disfavor the elderly and are largely attributable to ageism in the health care system. We compared age-related patterns of screening for colorectal cancer with those for breast and prostate cancer in persons aged 50 years and older. METHODS: We analyzed data for all adults aged 50 years and older (N = 88,213) in the 2001 Behavioral Risk Factor Surveillance System (BRFSS), a nationally representative, telephone-administered survey of personal health behaviors. Main outcome measures were adjusted prevalence by 5-year age-groups of colorectal cancer screening using fecal occult blood testing, flexible sigmoidoscopy, or colonoscopy for men and women; rates of mammography screening for women; and rates of prostate-specific antigen (PSA) screening for men. RESULTS: After adjustment for race/ethnicity, education level, income, health insurance, and self-rated health, predicted reported colorectal cancer screening (all modalities) increased significantly from when patients reached age 50 years until 70 to 74 years (66.0{\%}, standard error [SE] 0.8{\%}), remained constant until age 80 years, and then declined. The age-related gain in colorectal cancer screening was confined to whites among patients older than 60 years. Reported PSA screening increased until age 75 to 79 years (79.3{\%}, SE 1.1{\%}) and then declined, whereas reported mammography screening peaked at age 55 to 59 years (83.3{\%}, SE 1.2{\%}) and then declined. CONCLUSIONS: Significant age-related disparities appear to exist for both evidence-based and non-evidence-based cancer-screening interventions. The issue of age-related disparities in cancer screening is complex, with the direction of disparity favoring the elderly for some services yet disfavoring them for others.",
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