NEW YORK (Reuters Health) - Poor but healthy older women are at greater risk of missing out on breast cancer screening that could benefit them than are their wealthier counterparts, a new study demonstrates.
By Anne Harding
NEW YORK (Reuters Health) - Poor but healthy older women are at greater risk of missing out on breast cancer screening that could benefit them than are their wealthier counterparts, a new study demonstrates.
Among women 65 and older who were unlikely to die in the next five years, 82 percent of those with a net worth over $100,000 had received a mammogram in the past two years, compared to 68 percent of women with a net worth below $10,000, Dr. Brie Williams and colleagues from the University of California at San Francisco found.
And richer women were more likely to get testing that they didn't need; 48 percent of wealthier women with at least a 50 percent chance of dying over the next five years had had a mammogram, compared to 32 percent of poorer women.
!ADVERTISEMENT!Unnecessary tests can be harmful, Williams noted in an interview with Reuters Health; dangers include complications from the procedures performed to follow up on false positive tests, unnecessary treatment, or even time taken away from enjoying the limited time one has left to live.
"Their time with their physician or their health care provider would probably be better spent improving their known health problems," explained Williams.
She and her colleagues looked at 4,222 women with Medicare insurance to determine the role of net worth and prognosis in receiving mammography screening. They gauged prognosis with a series of questions on the women's age, smoking status, whether they had certain illnesses such as cancer or heart failure, and their functional ability.
Overall, 68 percent of the women in the study reported having had a mammogram in the past two years. Across the board, the wealthier women were more likely to have had the test. The richest women with the worst prognoses were nearly twice as likely to have been screened for breast cancer as the poorest, sickest women.
The current study wasn't designed to show why poorer women were less likely to receive screening, the researcher said; however, it's possible that they are less likely to have supplemental Medicaid insurance, or that costs for transportation to appointments may be more of a burden. "It could be that wealthier women more frequently know what their options are in terms of medical interventions," Williams added.
She and her colleagues are planning further research to better understand the role of wealth in making health care screening decisions for older adults.
SOURCE: Archives of Internal Medicine, March 10, 2008.
