Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).
Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).
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DOI：
10.1370/afm.54
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发表时间：
2003-11-01
影响因子：
4.4
通讯作者：
Lee, Ann Marie M
中科院分区：
文献类型：
--
作者：
Ostbye, Truls;Greenberg, Gary N;Lee, Ann Marie M
背景：基于2项全国性的纵向调查，我们希望确定老年妇女接受乳房x光筛查和巴氏涂片检查的自我报告频率，并调查其使用的重要预测因素。方法：本队列研究包括健康与退休研究（HRS）的4波（1994-2000）参与者——5942名年龄在50至61岁之间的女性，以及最年长老年人（AHEAD）的4波（1993-2000）调查——4543名年龄在70岁及以上的女性。1996年和2000年的HRS报告了最近两年内接受乳房x光检查和子宫颈抹片检查的自我报告，1994年和1998年测量了接受情况的预测因子。在AHEAD中，1995年和2000年报告了最近两年内接受乳房x光检查和巴氏涂片检查的自我报告，并在1993年和1998年测量了接受情况的预测指标。结果：在50 - 64岁的女性中，乳房x光检查的接受率稳定在70% - 80%，然后在85 - 90岁的女性中下降到40%左右。对于巴氏试验，50至54岁妇女的比例从75%下降到85至90岁妇女的25%。从1995/1996年到2000年，所有年龄组的乳房x光检查和巴氏涂片检查的比率都有所增加。高等教育、已婚、高收入、不吸烟和剧烈运动始终与较高的接受率相关。结论：尽管乳房x光检查和巴氏涂片检查在老年筛查中的使用有所下降，但最近使用有所增加。鉴于缺乏证据表明对老年群体有效，进行大量且越来越多的测试可能是不合理的。
BACKGROUND: We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys.METHODS: This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998.RESULTS: Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt.CONCLUSIONS: Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.