Purpose: Examine preventive services utilization among female survivors of adolescent and young adult (AYA) cancer compared with women without cancer in the USA.
Methods: A total of 1017 women diagnosed with cancer at AYA ages (15-39 years) who were at least 5 years since diagnosis were identified from 2008 to 2012 Medical Expenditure Panel Surveys. A comparison group without cancer was matched on age and other characteristics. General preventive services included dental, medical, blood pressure, and cholesterol checkups, and flu shots in the previous year. Cancer-related services included pap smear and mammography. Preventive services and covariates (demographics, socioeconomics, and health status) were compared between groups using χ 2 tests. Ordinal logistic regression identified covariates associated with general preventive services use.
Results: Female survivors reported dental checkups less often (57.8 vs. 72.4 %, p < 0.001) than the comparison group and checked their blood pressure (90 vs. 86.7 %, p = 0.045) and cholesterol (67.5 vs. 61.7 %, p = 0.045) more often. No differences were found in flu shots, medical checkups, and cancer-related services. Survivors without insurance were less likely to use general preventive services (odds ratio [OR] = 0.2, 95 % confidence interval [CI] 0.12-0.35, p < 0.001). Older survivors (OR = 3.09, 95 % CI 1.69-5.62, p < 0.001) and those who speak Spanish or other languages at home (OR = 3.19, 95 % CI 1.33-7.67, p = 0.01) were more likely to use general prevention than their counterparts.
Conclusion: Overall, female survivors were as likely as the comparison group to use preventive services, except dental services, blood pressure, and cholesterol checks.
Implications for cancer survivors: Survivors may require support to use recommended preventive services more effectively, especially the younger and uninsured who may be at greater risk for underuse.
Keywords: Cancer survivors; MEPS; Preventive health services; Women’s health.