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OBJECTIVE: To identify and assess differences in cancer screening patterns among women 55-64, 65-74, 75-84, and over 84 years of age. METHODS: Nationally representative data reported in the 1990 Health promotion and Disease Prevention Supplement to the National Health Interview Survey of 28,584,574 women were analyzed secondarily. The dependent variables were a knowledge of breast self-examination, over having had a mammogram, and a Papanicolaou smear within the last 3 years. Independent variables were age and various sociodemographic, health-status, and health-belief measures. RESULTS: More than half (58%) of the women had ever had a mammogram, and of these, 91% had had between one and five mammograms. Over a third (35%) of those who had not had a mammogram attributed the omission to a lack of a recommendation by a physician. Almost half (45%) had had a breast examination by a physician within the last year, and 84% knew how to examine their own breasts. Approximately 87% had a Papanicolaou smear with the last 3 years. Age, race, education, and living in a large city were significantly associated with all three screening measures, but prevalent health beliefs were significantly associated only with breast-cancer screening. CONCLUSION: Lack of mammogram screening in a substantial number of women, attributed to lack of physician recommendation, decreased screening in the older age groups, and the negative association of three screening tests with race and residence in a large city suggest that new interventions are needed by health care providers and the public health community to increase older women's use of effective cancer screening techniques.
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