Introduction

Spousal caregiving can be psychologically and physically demanding on the individual; finding ways to support the health of spousal caregivers is important for their individual health and for ensuring population health. We investigated whether spousal caregiving was associated with lower completion rates of mammograms, pap smears, and colorectal cancer screenings among U.S. middle-aged and older adults.

Methods

Data were drawn from the 2016 wave of the Health and Retirement Study (n=15,236 married adults aged ≥50, n=513 spousal caregivers). Spousal caregiving was defined as providing ≥14 hours of assistance per week to a spouse. Generalized linear models with binomial distributions were constructed to estimate risk ratios and risk differences for each cancer screening. Final models were adjusted for age, race, education, self-reported health status, health insurance, wealth, and, in colorectal cancer models, gender. 

Results

An excess of 5 spousal caregivers per 100 did not complete a mammogram over the prior two years compared to non-caregivers (RD: -0.05, 95% CI: -0.12, 0.02). An excess of 7 caregivers per 100 did not complete a pap smear over the prior two years (RD: -0.07, 95% CI: -0.17, 0.02), and an excess of 2 caregivers per 100 did not complete a colorectal cancer screening over the prior four years (RD -0.02, 95% CI: -0.08, 0.03) compared to non-caregivers. Spousal caregivers were 6% less likely to complete a mammogram (RR: 0.94, 95% CI: 0.85, 1.04), 13% less likely to complete a pap smear (RR: 0.87, 95% CI: 0.73, 1.04), and 4% less likely to complete a colorectal cancer screening (RR: 0.96, 95% CI: 0.85, 1.08) than non-caregivers.

Conclusion

Spousal caregivers are completing cancer screenings at lower rates than non-caregivers; this is partly explained by the characteristics of being a spousal caregiver. Vigilance on the completion of cancer screenings among spousal caregivers by healthcare and public health professionals is one way to care for a vulnerable group of adults.