Multisectoral Collaborations to Increase the Use of Recommended Cancer Screening and Other Clinical Preventive Services by Older Adults

Kietzman, Kathryn G.; Toy, Peggy; Bravo, Rosana; Duru, O. Kenrik; Wallace, Steven P.

doi:10.1093/geront/gnz004

Cited by 12 publications

(15 citation statements)

References 20 publications

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“…Research suggests that among Latinos, sociodemographic factors and language may influence social linkages; thus, Spanish‐speaking Hispanics residing in high‐income neighborhoods may not fully benefit from place‐based health benefits commonly associated with wealthier neighborhoods 34 . It is also likely that older adult Hispanics residing in low‐income neighborhoods may benefit from greater access to health care safety net resources for low‐income and underserved populations 35‐37 …”

Section: Discussionmentioning

confidence: 99%

Inequitable access to surveillance colonoscopy among Medicare beneficiaries with surgically resected colorectal cancer

Sanchez

Shankaran

Unger

et al. 2020

Cancer

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BackgroundAfter colorectal cancer (CRC) surgery, surveillance with colonoscopy is an important step for the early detection of local recurrence. Unfortunately, surveillance colonoscopy is underused, especially among racial/ethnic minorities. This study assesses the association between patient and neighborhood factors and receipt of surveillance colonoscopy.MethodsThis retrospective, population‐based cohort study used Surveillance, Epidemiology, and End Results–Medicare linked data (2009‐2014). Beneficiaries with surgically resected stage II or III CRC between the ages of 66 and 85 years were identified, and multivariable logistic regression was used to assess the effect of factors on receipt of colonoscopy.ResultsOverall, 57.5% of the patients received initial surveillance colonoscopy. After adjustments for all factors, Blacks and Hispanics had lower odds of receiving colonoscopy than non‐Hispanic Whites (NHWs; 29.6% for Blacks; P = .002; 12.9% for Hispanics; P > .05). NHWs with Medicaid coverage had 35% lower odds of surveillance colonoscopy than NHWs without Medicaid coverage. Minority patients with Medicaid were more likely to receive colonoscopy than their racial/ethnic counterparts without Medicaid coverage (P > .05). Hispanics residing in neighborhoods with incomes of ≥$90,000 had significantly lower odds of surveillance colonoscopy than Hispanics residing in neighborhoods with incomes of $0 to $30,000.ConclusionsReceipt of initial surveillance colonoscopy remains low, and there are acute disparities between Black and NHW patients. The association between factors that assess a patient's ability to access colonoscopy and actual receipt of colonoscopy suggests inequitable access to surveillance colonoscopy within and across racial/ethnic groups.

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Section: Discussionmentioning

confidence: 99%

Inequitable access to surveillance colonoscopy among Medicare beneficiaries with surgically resected colorectal cancer

Sanchez

Shankaran

Unger

et al. 2020

Cancer

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“…Many older adults do not receive the recommended screening tests for cancer and other clinical preventive services (Jensen, Salloum, Hu, Ferdows, & Tarraf, 2015; White et al, 2017). Linkages between communities and health care providers can reduce barriers to accessing such services (Kietzman, et al, 2019). Socioeconomic factors may influence the receipt of health services and cancer risk behaviors through pathways that have not been fully explored (Tucker-Seeley & Thorpe, 2019).…”

Section: Opportunities For Cancer Prevention During Older Adulthoodmentioning

confidence: 99%

“…In April 2017, the National Association of Chronic Disease Directors and the Division of Cancer Prevention and Control at CDC convened a meeting of multidisciplinary experts to explore this question. The collection of papers in this supplement grew out of those discussions (Cancer Prevention during Older Adulthood Writing Group, 2019; Holman, Ding, Freeman, & Shoemaker, 2019; Hooker, Mejia, Phibbs, Tan, & Stevens, 2019; Kietzman, Toy, Bravo, Duru, & Wallace, 2019; Martin, et.al., 2019; Prohaska & Peters, 2019; Rudd, 2019; Schoenborn, Boyd, Lee, Cayea, & Pollack, 2019; Tucker-Seeley & Thorpe, 2019; Warner et al, 2019). Each paper addresses this question from a unique perspective.…”

mentioning

confidence: 99%

Cancer Risk Among Older Adults: Time for Cancer Prevention to Go Silver

et al. 2019

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Over two-thirds of all new cancers are diagnosed among adults aged ≥60 years. As the number of adults living to older ages continues to increase, so too will the number of new cancer cases. Can we do more as a society to reduce cancer risk and preserve health as adults enter their 60s, 70s, and beyond? Cancer development is a multi-step process involving a combination of factors. Each cancer risk factor represents a component of cancer causation, and opportunities to prevent cancer may exist at any time up to the final component, even years after the first. The characteristics of the community in which one lives often shape cancer risk-related behaviors and exposures over time, making communities an ideal setting for efforts to reduce cancer risk at a population level. A comprehensive approach to cancer prevention at older ages would lower exposures to known causes of cancer, promote healthy social and physical environments, expand the appropriate use of clinical preventive services, and engage older adults in these efforts. The collection of articles in this supplement provide innovative insights for exciting new directions in research and practice to expand cancer prevention efforts for older adults. This brief commentary sets the stage for the papers that follow.

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“…Preventive Services Task Force, 2018). Continuing this discussion, Peggy Toy emphasized the importance of collaborations across community sectors (e.g., health departments, community-based organizations, clinics, and businesses) to increase awareness and use of clinical preventive services in underserved communities, and an example of this collaboration is described in this supplement issue (Kietzman, Toy, Bravo, Duru, & Wallace, 2019).…”

Section: Provide Evidence-based Clinical and Community Preventive Servicesmentioning

confidence: 99%

Highlights From an Expert Meeting on Opportunities for Cancer Prevention Among Older Adults

Epel¹,

Green

Jeste

et al. 2019

The Gerontologist

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This paper provides highlights from an expert meeting to explore opportunities to reduce cancer risk and promote health at older ages. Factors that increase cancer risk among older adults include exposure to carcinogens from multiple sources, chronic conditions such as obesity and diabetes, and unhealthy behaviors. Emerging research points to chronic social stressors -social isolation, loneliness, and financial hardship -as being linked to accelerated biological aging and increased cancer risk later in life. Older adults may disproportionately encounter these stressors as well as barriers to preventive health care services, accurate health information, and environments that promote health. Researchers can use existing cohort studies of older adults to deepen our understanding of the relative benefit of modifying specific behaviors and circumstances. The evidence points to the value of comprehensive, transdisciplinary approaches to promote health and reduce cancer risk across the entire lifespan, extending through older adulthood. Clinical encounters with older adults provide opportunities for psychosocial and behavioral screening and counseling. In the presence of multiple morbidities, preventive health services may offer greater health benefits than cancer-screening tests. Strategies that involve families and caregivers, promote positive attitudes about aging, and engage many different community sectors have the potential to prevent or delay the development of cancer at older ages.

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Multisectoral Collaborations to Increase the Use of Recommended Cancer Screening and Other Clinical Preventive Services by Older Adults

Cited by 12 publications

References 20 publications

Inequitable access to surveillance colonoscopy among Medicare beneficiaries with surgically resected colorectal cancer

Inequitable access to surveillance colonoscopy among Medicare beneficiaries with surgically resected colorectal cancer

Cancer Risk Among Older Adults: Time for Cancer Prevention to Go Silver

Highlights From an Expert Meeting on Opportunities for Cancer Prevention Among Older Adults

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