Preventive care in older cancer survivors

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.