Variability in Cancer Screening Behaviors: Comparing Florida to other U.S. regions

Introduction: Previous studies have shown differences in cancer screening behavior by region, occupation, and race-ethnicity. We investigated differences in adherence to recommended cancer screening, comparing Florida to the rest of the United States. Methods: Following American Cancer Society guidelines, we measured rates of adherence to mammography, Papanicolaou (pap) and Prostate Specific Antigen (PSA) tests using National Health Interview Survey data (2003-2010). We compared Florida to the rest of the Southeast, the Northeast, Midwest, and the West separately. Results: After controlling for age and sociodemographic factors, at 69.6%, Floridians had higher rates of recommended PSA screening compared to the rest of South (prevalence = 63.8%; 95% CI = 62.2% – 65.3%) , Northeast (64.4%; 61.8% – 66.8%), Midwest (64.1%; 62.2% – 65.9%), and West (61.6%; 59.6% – 63.5%). However, the Northeast reported the highest recommended mammograms (77.9%; 76.8%-79.0%) and Pap-tests (76.6%; 75.6%-77.5%) respectively. Blue-collar workers were less likely to report adherence across all US regions. Hispanics in Florida were less likely to adhere to Pap-tests recommendations as compared to the rest of the US (all race/ethnicities). Across the regions the uninsured were up to 25% less likely to report having recommended screening than the insured. Discussion: Health insurance is strongly associated with adherence to recommended screening. Floridians are more compliant with recommended PSA screening compared to the rest of the US, but need to improve adherence to recommended mammograms and Pap-tests. Blue-collar workers may benefit from tailored health messages regarding adherence to cancer screening practices.