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Elderly women over-screened for cancers with little measurable benefit

DURHAM, N.C. -- Elderly women are receiving a large number of mammograms and Pap smears with limited scientific evidence of advantage, researchers from Duke University Medical Center have reported. Such widespread, general screening in women over age 70 is a misdirected use of health-care funds that might be better utilized in higher-risk, underserved women, they said.

"Cancer screening is important in younger and middle-aged populations because early detection can result in the reduction of long-term health risk," said Truls Ostbye, M.D., lead author on the paper that appears in the November/December 2003 issue of the Annals of Family Medicine. "However, in an older population, while the rates of some cancers increase, the risk of dying from a competing disease increases as well, and overall, this reduces the number of years that can be saved through screening." Ostbye is a professor in the department of community and family medicine at Duke.

Although the use of mammography and Pap smears is lower among older women than middle-aged women, the Duke researchers cite data from two large population studies that show screening is on the rise in this age group.

Researchers examined data from the Health and Retirement Study (HRS) and its companion study, The Asset and Health Dynamics Among the Oldest Old (AHEAD), both of which collected data from 1993 to 2000 on how retirement impacts the health and wealth of both men and women. The studies were funded by the National Institute on Aging. In the HRS study, 5,942 women aged 50 to 61 were interviewed about their health behaviors, disease and disability, and medical care usage. The AHEAD study, which collected similar data, focused on 4,543 women aged 70 years and older.

The data showed that almost 70 percent to 80 percent of women aged 50 to 64 had received mammograms in the last two years, and approximately 75 percent of those same women had received Pap smears during that same time interval.
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Contact: Amy Austell
amy.austell@duke.edu
919-684-4148
Duke University Medical Center
25-Nov-2003


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