Racial Disparities Vary by Patient Life Expectancy in Screening for Breast, Prostate, and Colorectal Cancers

  • Nancy L. SchoenbornEmail author
  • Jin Huang
  • Cynthia M. Boyd
  • Craig E. Pollack
Concise Research Report


Although clinical practice guidelines recommend against routine breast, prostate, and colorectal cancer screenings in older adults with less than 10-year life expectancy, a large proportion of these older adults continue to receive screening [1]. Consequently, growing efforts aim to reduce screening in this population. While prior studies have shown racial disparities in the receipt of cancer screening [2], whether the rates of over-screening, as defined by screening in those with limited life expectancy, differs among different racial groups is unknown. This information is important to target interventions to reduce over-screening and prevent unintended harms that may further exacerbate existing disparities. We aimed to describe the rates of breast, prostate, and colorectal cancer screening by race and life expectancy in a nationally representative cohort of older adults.


Using data from the first wave of the National Health and Aging Trends Study (NHATS) in 2011...


Author Contributions

Dr. Schoenborn had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Study concept and design: Schoenborn, Huang, Boyd, Pollack

Data analysis and interpretation: Schoenborn, Huang, Boyd, Pollack

Preparation and review of the manuscript: Schoenborn, Huang, Boyd, Pollack

Funding Information

Dr. Schoenborn was supported by a career development award from the National Institute on Aging (K76AG059984). Dr. Boyd was supported by 1K24AG056578 from the National Institute on Aging. The funding sources had no role in the design, methods, subject recruitment, data collections, analysis, and preparation of the paper.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they do not have a conflict of interest. Dr. Pollack has stock ownership in Gilead Pharmaceuticals. We do not believe this has resulted in any conflict with the design, methodology, or results presented in this manuscript. Dr. Cynthia Boyd received a small payment from UptoDate for having co-authored a chapter on Multimorbidity, we do not believe this has resulted in any conflict with the design, methodology, or results presented in this manuscript.


  1. 1.
    Royce TJ, Hendrix LH, Stokes WA, et al. Cancer screening rates in individuals with different life expectancies. JAMA Intern Med. 2014 Oct;174(10):1558-65.CrossRefGoogle Scholar
  2. 2.
    Gray TF, Cudjoe J, Murphy J, Thorpe RJ Jr., Wenzel J, Han HR. Disparities in cancer screening practices among minority and underrepresented populations. Semin Oncol Nurs. 2017;33(2):184-198.CrossRefGoogle Scholar
  3. 3.
    Cruz M, Covinsky K, Widera EW, et al. Predicting 10-year mortality for older adults. JAMA. 2013;309(9):874-876.CrossRefGoogle Scholar
  4. 4.
    Kressin NR, Groeneveld PW. Race/ethnicity and overuse of care: a systematic review. Milbank Q. 2015;93(1):112-38.CrossRefGoogle Scholar
  5. 5.
    Chetty R, Stepner M, Abraham S, et al. The association between income and life expectancy in the United States, 2001-2014. JAMA. 2016;315(16):1750-66.CrossRefGoogle Scholar

Copyright information

© Society of General Internal Medicine 2019

Authors and Affiliations

  1. 1.The Johns Hopkins University School of MedicineBaltimoreUSA
  2. 2.The Johns Hopkins University School of Public HealthBaltimoreUSA

Personalised recommendations