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Research and Practice: Denys T. Lau and James B. Kirby The Relationship Between Living Arrangement and Preventive Care Use Among Community-Dwelling Elderly Persons Am J Public Health 2009; 0: AJPH.2008.151142v1 [Abstract] [PDF]

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Living Arrangement and Colorectal Cancer Screening in Elders Aged 65-75: Updated USPSTF Guidelines

Denys T. Lau, James B. Kirby   (24 May 2009)

Living Arrangement and Colorectal Cancer Screening in Elders Aged 65-75: Updated USPSTF Guidelines 24 May 2009
Denys T. Lau, Assistant Professor Northwestern University, Feinberg School of Medicine, James B. Kirby Send letter to journal: Re: Living Arrangement and Colorectal Cancer Screening in Elders Aged 65-75: Updated USPSTF Guidelines d-lau{at}northwestern.edu Denys T. Lau, et al.	In this article, we examined the relationship between living arrangement and preventive care use among community-dwelling persons aged 65 and older in the United States by analyzing the 2002 to 2005 Medical Expenditure Panel Survey. Of the six preventive services examined, we defined adherence to recommended colorectal cancer screening according to the then current 2002 United States Preventive Service Task Force (USPSTF) guidelines. In October 2008, the USPSTF revised its recommendations to advise against colorectal cancer screening in persons older than 85 and suggest that persons between 76 and 85 years old should consider their own health status, prior screening results, and life expectancy in their decisions to be screened. We therefore performed additional analysis on colorectal cancer screening similar to the original article but now restricted to persons between the ages of 65 and 75. Controlling for age, gender, race, education, income, health insurance, comorbidities, self-reported health, physical function status, and residence location, we found that elderly persons who live with a spouse only had similar odds (O.R.=1.027; p = 0.747) of getting colorectal cancer screening as compared to those living alone, whereas elderly persons who live with an adult offspring regardless of the presence of a spouse had significantly lower odds (adult offspring only [O.R.=0.629; p = 0.007]; adult offspring and a spouse [O.R.=0.621; p = 0.007]). These findings did not change the conclusions of the original paper and also provide evidence that living arrangement is a significant factor associated with the timely use of colorectal cancer screening in elderly persons. Interventions to improve colorectal cancer screening may need to target elderly persons in all living arrangements but especially those living with adult offspring. Sincerely, Denys T. Lau, Ph.D. Buehler Center on Aging, Health & Society Department of Medicine, Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University Chicago, IL James B. Kirby, Ph.D. Center for Financing, Access, and Cost Trends Agency for Health Care Research and Quality Rockville, MD.