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Overscreening for Cancer Common Among Older Adults

FRIDAY, Aug. 7, 2020 -- Almost half of older U.S. adults report being screened for colorectal, cervical, or breast cancer beyond recommended upper age limits, particularly women living in metropolitan areas, according to a study published online July 27 in JAMA Network Open.

Jennifer L. Moss, Ph.D., from Penn State University in Hershey, and colleagues used data from the 2018 Behavioral Risk Factor Surveillance System to assess the prevalence of overscreening for colorectal, cervical, and breast cancer among older adults as well as differences in overscreening by metropolitan status. Overscreening was defined as screening after the recommended upper age limit for several cancer types: colorectal (75 years), cervical (65 years), or breast (74 years).

The researchers found that overall, 59.3 percent of men were overscreened for colorectal cancer; 56.2 percent of women for colorectal cancer; 45.8 percent of women for cervical cancer; and 74.1 percent of women for breast cancer. Among women, overscreening was more common in metropolitan areas for colorectal cancer (adjusted odds ratio [aOR], 1.23), cervical cancer (aOR, 1.20), and breast cancer (aOR, 1.36) compared with nonmetropolitan areas. There were also associations seen between overscreening for cervical and breast cancer and having a usual source of care compared with not (e.g., cervical cancer: aOR, 1.87; breast cancer: aOR, 2.08); good, very good, or excellent self-reported health versus fair or poor self-reported health (cervical cancer: aOR, 1.21; breast cancer: aOR, 1.47); an educational attainment greater than a high school diploma compared with a high school diploma or less (cervical cancer: aOR, 1.14; breast cancer: aOR, 1.30); and being married or living as married compared with other marital status (cervical cancer: aOR, 1.36; breast cancer: aOR, 1.54).

"Interventions to reduce overscreening among older adults are needed at the levels of patients, health care professionals, communities, and systems to reduce patient harms and costs and to increase health care efficiency," the authors write.

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Posted: August 2020

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