Preventive services use among female survivors of adolescent and young adult cancer

Abstract

Purpose

Examine preventive services utilization among female survivors of adolescent and young adult (AYA) cancer compared with women without cancer in the USA.

Methods

A total of 1017 women diagnosed with cancer at AYA ages (15–39 years) who were at least 5 years since diagnosis were identified from 2008 to 2012 Medical Expenditure Panel Surveys. A comparison group without cancer was matched on age and other characteristics. General preventive services included dental, medical, blood pressure, and cholesterol checkups, and flu shots in the previous year. Cancer-related services included pap smear and mammography. Preventive services and covariates (demographics, socioeconomics, and health status) were compared between groups using χ ² tests. Ordinal logistic regression identified covariates associated with general preventive services use.

Results

Female survivors reported dental checkups less often (57.8 vs. 72.4 %, p < 0.001) than the comparison group and checked their blood pressure (90 vs. 86.7 %, p = 0.045) and cholesterol (67.5 vs. 61.7 %, p = 0.045) more often. No differences were found in flu shots, medical checkups, and cancer-related services. Survivors without insurance were less likely to use general preventive services (odds ratio [OR] = 0.2, 95 % confidence interval [CI] 0.12–0.35, p < 0.001). Older survivors (OR = 3.09, 95 % CI 1.69–5.62, p < 0.001) and those who speak Spanish or other languages at home (OR = 3.19, 95 % CI 1.33–7.67, p = 0.01) were more likely to use general prevention than their counterparts.

Conclusion

Overall, female survivors were as likely as the comparison group to use preventive services, except dental services, blood pressure, and cholesterol checks.

Implications for Cancer Survivors

Survivors may require support to use recommended preventive services more effectively, especially the younger and uninsured who may be at greater risk for underuse.

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