American journal of preventive medicine
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Our objective is to describe the clinical findings from a nurse-practitioner-based breast and cervical cancer screening program for poor, elderly, black women. We designed a cross-sectional descriptive study set at an urban public hospital medical clinic. All women 65 years of age and older were eligible to be screened. ⋯ Interestingly, one-fifth of women with a hysterectomy had an intact cervix, including one with cervical neoplasia. Nearly one-third of women with abnormal Paps or mammograms failed to complete follow-up. Success of screening programs for the elderly will depend on the risk group targeted, careful examination, degree of sensitivity and specificity of the tests, and acceptability of follow-up diagnosis and treatment.
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National studies have documented an excessive rate of cigarette smoking in black men; however, a 1987 survey conducted in two urban areas in South Carolina documents a high rate of smoking in young white men with fewer than 12 years of education (67%; 95% confidence interval [CI] = 58.3, 75.7). Differences in smoking rates by educational level were significant only for those younger than 40. Young blacks were less likely to smoke and smoked fewer cigarettes than whites. ⋯ Television, physicians, and radio were all seen as likely sources of health information to prevent heart disease, but newspapers were less likely to be cited by those younger than 40 or by those with fewer than 12 years of education. Reported physician counseling for smoking cessation did not differ significantly by race, sex, or educational level of the patient, but reported counseling was higher for individuals with a personal history of cardiovascular disease (odds ratio [OR] = 2.32, CI = 1.27, 4.25) and somewhat lower for the elderly. We highlight the population burden of cigarettes, a predictor of the eventual disease burden attributable to smoking, as a useful priority measure for smoking intervention efforts.