Cancer screening practices among racially and ethnically diverse breast cancer survivors: results from the 2001 and 2003 California Health Interview Survey

Introduction Women treated for breast cancer are at increased risk for developing second or new cancers. This study examined behavioral and health care utilization practices associated with screening behaviors for mammography, Papanicolaou (Pap), home fecal occult blood test (FOBT) and endoscopy (flexible sigmoidoscopy, colonoscopy, proctoscopy) among racially and ethnically diverse female breast cancer survivors (BCS) and women without a cancer history. Methods Data from the 2001 and 2003 California Health Interview Survey (CHIS), a random-digit dial population-based survey of adult respondents was used to examine self-reported screening practices of BCS (n=1,502) and women without a cancer history (n=31,911). Results Compared to women without a cancer history, BCS reported more recent screening for all tests. Among BCS, Hispanics reported lowest screening for routine mammography (84.2% versus 68.9%; P < 0.05) but highest screening for Pap test (95.4% versus 85.4%; P > 0.01). White and Asian BCS reported more endoscopic examinations (58.9% versus 46.5%; P < 0.001; 61.2% versus 38.4%; P < 0.05) than the comparison population. After adjustment for demographic, socioeconomic, and health status differences, screening rates for BCS showed higher mammography use (odds ratio [OR] 1.97; 95% confidence interval [95% CI] 1.58-2.46), Pap test (OR 1.44; 95% CI 1.22-1.70), and endoscopic use (OR 1.35; 95% CI 1.16-1.58), but not higher for FOBT. Conclusions Even though BCS generally had higher cancer screening rates than women without a cancer history, racial/ethnic differences exist among the type of test received. Narrowing these differences is essential to lessen disparities. Implications for cancer survivors The need for screening guidelines for BCS remains a high priority. Survivors would benefit from the frequency of screening for all cancers post-treatment.