Purpose
Studies have shown that women who engage in high levels of physical activity have higher rates of cancer screening, including Papanicalaou (Pap) tests. Because American Indian (AI) women are at high risk for cervical cancer morbidity and mortality, we examined Pap screening prevalence and assessed whether physical activity was associated with screening adherence among AI women from 2 culturally distinct regions in the Northern Plains and the Southwest.
Methods
A total of 1,979 AI women at least 18 years of age participating in a cross-sectional cohort study reported whether they received a Pap test within the previous 3 years. Physical activity level was expressed as total metabolic equivalent (MET) scores and grouped into quartiles. We used binary logistic regression to model the association of Pap testing and MET quartile, adjusting for demographic and health factors.
Findings
Overall, 60% of women received a Pap test within the previous 3 years. After controlling for covariates, increased physical activity was associated with higher odds of Pap screening (OR = 1.1 per increase in MET quartile; 95% CI = 1.1, 1.2).
Conclusions
This is the first study to examine physical activity patterns and receipt of cancer screening in AIs. While recent Pap testing was more common among physically active AI women, prevalence was still quite low in all subgroups. Efforts are needed to increase awareness of the importance of cervical cancer screening among AI women.
However, the case mortalities for colorectal and prostate cancers among AI men in the Northern Plains exceed those for US men of all racial/ethnic populations by 59% and 48%, respectively.Recent studies have linked obesity with cancer, including colorectal and prostate cancer. [3][4][5] In the United States, 67% of all adult men and 77% of AI adult men are overweight/obese.6 Obesity is associated with decreased access to care and lower rates of some cancer screening behaviors. 7,8 The influence of obesity on receipt of colorectal cancer screening tests, however, is inconsistent but appears to vary with sex and test type. In 2 available studies on prostate specific antigen (PSA) testing, men with a higher body mass index (BMI) were more likely than their lighter counterparts to have had recent PSA testing. 10,11 Rurality is another barrier to health care access and cancer screening. 12,13 Rural residents are more likely to experience poor health and chronic conditions than their urban counterparts.
One in three Americans will be diabetic by 2050, and the rate of diabetes is disproportionately high among Native Americans, especially among Native elders age 55 and older. Early identification and prevention strategies have been regarded as the cornerstone of preventative medicine. The objective of the authors’ research was to identify factors related to diabetes and their interactions specifically among Native elders and develop a simple prediction model which can be used by healthcare professionals while interacting with Native elders in remote or rural areas. Data from a survey of 18,078 Native American elders was used in their study. After eliminating outliers using Pearson’s residuals and Cook’s distance, the area under the receiver operating characteristic curve was 0.7812 for men and 0.7230 for women. The results from the authors’ analysis provide additional perspective on how diabetes affects Native elders thus helping healthcare providers and policy makers when dealing with these community members.
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