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APHA Scientific Session and Event Listing

Denis Nash, PhD, MPH¹, Christina Chan, MPH², Deborah Horowitz, MPH¹, and David Vlahov, PhD². (1) International AIDS Care and Treatment Programs and Department of Epidemiology, Columbia University, 722 West 168th Street, Office #507, New York, NY 10032, (212)342-5434, dsh2104@columbia.edu, (2) Center for Urban Epidemiologic Studies, New York Academy of Medicine, 1216 Fifth Avenue, New York, NY 10029

Background: Breast and cervical cancer screening are routinely recommended for women; however data are sparse on factors associated with joint screening behaviors.

Objectives: To describe factors associated with receiving both, one, or neither screening test among women Ан50.

Methods: Using data from the NYC Community Health Survey, we compared characteristics of women Ан50 (n=2,059) who needed 1) Pap smear only; 2) mammography only; or 3) both screening procedures, with women who received both tests. Analyses were performed using logistic regression.

Results: 73% of women had both screening tests, 7% needed Pap smear only, 10% needed mammography only, and 10% needed both. Logistic regression showed needing Pap smear only was more likely among women >60 compared with younger women and among women from Queens than from Manhattan. Needing mammography only was more common among women without a personal doctor than with one and less common among uninsured women relative to the privately insured. In addition to the above two factors, needing both tests was more common among current smokers compared with never smokers, among women from Manhattan than from the Bronx, and among non-Hispanic white women compared with racial/ethnic minorities.

Conclusions: Predictors of each screening outcome appear qualitatively different. Changes in provider practices and targeted education may improve Pap screening, while policy initiatives to expand access for the uninsured may increase mammography. The surprising racial/ethnic related outcome for women needing both tests requires further examination. To achieve optimal preventive care, co-screening should be considered.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Identify the different factors associated with Pap and mammography screening among older urban women.
• Articulate the usefulness of examining related health behaviors jointly.
• Discuss possible strategies to increase screening rates for both tests among older urban women.

Keywords: Cancer Screening, Urban Women's Health Issues

Presenting author's disclosure statement:

Not Answered