In a recent article,1 we examined the relationship between living arrangement and preventive care use among community-dwelling persons aged 65 years and older in the United States by analyzing the 2002–2005 Medical Expenditure Panel Survey. Of the 6 preventive services examined, we defined adherence to recommended colorectal cancer screening (either fecal occult blood test within the past year or sigmoidoscopy within the past 5 years) 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 years and suggested that persons aged between 76 and 85 years should consider their own health status, prior screening results, and life expectancy in their decisions to be screened.2,3 We therefore performed additional analysis on colorectal cancer screening similar to that described in the original article but now restricted to persons aged between 65 and 75 years.
After we controlled for age, gender, race, education, income, health insurance, comorbidities, self-reported health, physical function status, and residence location, we found that elderly persons who lived with a spouse only had similar odds (odds ratio [OR] = 1.027; P = .747) of getting colorectal cancer screening as did those living alone, whereas elderly persons who lived with an adult offspring regardless of the presence of a spouse had significantly lower odds (adult offspring only, OR = 0.629; P = .007; adult offspring and a spouse, OR = 0.621; P = .007).
These findings did not change the conclusions of the original paper and also provide evidence that elderly persons’ living arrangement is a significant factor associated with their timely use of colorectal cancer screening according to the latest USPSTF guidelines. Interventions to improve colorectal cancer screening may need to target elderly persons in all living arrangements but especially those living with adult offspring.
Acknowledgments
No sources of funding were used for the original work upon which this letter is based. During part of the original work and the writing of this letter, D. T. Lau was supported by a K-01 career development award from the National Institute on Aging (5K01AG027295 02).
Human Participant Protection
Institutional review board approval was obtained from Northwestern University for the original work upon which this letter is based.
References
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