Prevalence and associated factors of cancer screening: Why are so many older Mexican American women never screened?

Objectives. The aim of this study was to identify patterns of mammogram and Papanicolaou (Pap) screenings among Mexican American women ages 67 and over. Methods. Data on 1,403 Mexican American women from the Hispanic Established Population for the Epidemiological Study of the Elderly, a cohort study of community-dwelling Mexican Americans ages 65 years or over from the southwestern United States, were analyzed. Results. Mexican American women age 75 or older were less likely to ever have had breast or cervical screening than women ages 67 to 74, even controlling for sociodemographic, cultural, and selected health factors. Overall, fewer medical conditions and never having had a hysterectomy were found to be associated with a decreased chance of ever having had a mammogram or a Pap test. Women who lacked insurance coverage and had fewer doctor visits were less likely to ever have had a mammogram, whereas women with low education, low acculturation, and lower cognitive status scores were less likely to ever have had a Pap test. Conclusions. If these results withstand more detailed studies (e.g., with the addition of important variables such as awareness), better communication with health professional doctors and improvement of access to heath care services should increase rates of both maimmogram and Pap screenings. (C) 2001 American Health Foundation and Academic Press.