Occupational differences in cancer control: Comparing adherence to cancer screening recommendations by working Floridians to other US workers (NHIS 1997-2010)

Introduction: Preventive health behaviors, such as cancer screening often differ by education and income-level which are directly related to occupation. We examined cancer screening disparities by occupational sectors and US geographical regions among working aged adults (≥18yrs)in the US. Methods: Using NHIS cancer control modules (1997-2010) we investigated adherence to mammogram, Papanicolaou and Prostate Specific Antigen screening recommendations, comparing Floridians to the rest of the US. We made comparisons by employment and further investigated disparate screening behaviors by four broad occupational sectors (i.e. white-collar, blue-collar, farm, and service). Results: There were few differences in screening by employment status. Compared to the rest of the US (Weighted Prevalence: 78.9%; 95% Confidence Interval: 68.5%-86.6%), Florida (24.4%; 3.8%-72.5%) reported low adherence to mammogram recommendations. Employed and white-collar workers demonstrated >77% adherence to Papanicolaou smear recommendations, while blue-collar (54.7%; 19.2%-86.0%) and service workers (61.9%; 34.1%-83.6%) in Florida fared >10% worse than other workers in similar occupational or regional categories. All employment categories exceeded the Healthy People 2010 goal of 70% for mammogram compliances but none met the goal of 90% for recommended Papanicolaou smears. Discussion: Large disparities in screening practices exist across occupational categories. This suggests the need for targeted interventions promoting cancer screening behaviors in the workplace. Blue-collar workers may be in need of special attention regarding the message of cancer and adherence to screening practices, particularly those living in Florida. Addressing this cancer screening issue may support improved worker health and take the population closer to the Healthy People 2020 screening goals.