A contemporary framework of health equity applied to gynecologic cancer care: A Society of Gynecologic Oncology evidenced-based review

Temkin, Sarah M.; Rimel, B.J.; Bruegl, Amanda; Gunderson, Camille C.; Beavis, Anna; Doll, Kemi M.

doi:10.1016/j.ygyno.2017.11.013

Cited by 62 publications

(47 citation statements)

References 84 publications

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“…However, disparities in cervical cancer screening in the United States persist by race, class, region, and sexual orientation . There are well‐documented disparities by socioeconomic status and race in both cervical cancer screening and survival rates . For example, across studies, black women tended to report higher rates of screening than white women, but cervical cancer incidence and mortality rates are higher among black women than white women.…”

Section: Introductionmentioning

confidence: 99%

Health Care‐Related Correlates of Cervical Cancer Screening among Sexual Minority Women: An Integrative Review

Greene¹,

Meghani²,

Sommers³

et al. 2018

J Midwife Womens Health

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Introduction: Sexual minority women (SMW; lesbian, bisexual, nonheterosexual women) may have lower rates of cervical cancer screening than heterosexual women. Health care-related factors may explain some of the variation in cervical cancer screening rates among SMW. We aimed to synthesize published evidence of health care-related correlates of cervical cancer screening among SMW. Methods:We searched PubMed, CINAHL, and PsycINFO databases for English-language studies published between January 2000 and March 2017 that 1) assessed sexual identity or the sexual partners of female participants, 2) included cervical cancer screening as a main outcome of interest, and 3) measured at least one health care-related variable in addition to cervical cancer screening. We excluded articles that 1) reported on non-US samples or 2) did not report original research. We reviewed the sample, methods, and findings of 17 studies. We then summarized current knowledge about health care-related factors across 3 categories and generated recommendations for clinical practice and future research.Results: Several health care-related factors such as previous contraception use, having a primary care provider, knowledge of screening recommendations, and disclosing sexual orientation to providers were consistently positively associated with cervical cancer screening. Three groups of factors-previous health care use, health care provider-related factors, and belief-related factors-account for a substantial part of the variation in cervical cancer screening among SMW.Discussion: Several gaps in knowledge remain that could be addressed by recruiting more diverse samples of SMW with improved generalizability. Clinicians and clinical institutions can address factors associated with low rates of screening among SMW by preventing sexual orientation-based discrimination, inviting sexual orientation disclosure, and offering cervical cancer screening to SMW at a variety of health care encounters. Future research should examine how the location of care and health care provider type affect SMW's cervical cancer screening behaviors and should test the effectiveness of health care interventions designed to address sexual orientation-related disparities.

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Section: Introductionmentioning

confidence: 99%

Health Care‐Related Correlates of Cervical Cancer Screening among Sexual Minority Women: An Integrative Review

Greene¹,

Meghani²,

Sommers³

et al. 2018

J Midwife Womens Health

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“…Initially it was hypothesized that the increased rate of minor complications among the NI/SP patients in this cohort could be attributed to the large proportion of rural patients in North Carolina who lack access to primary care. 16 Further analysis, however, revealed equal distribution of complication rates based on rural residency (data not shown). Data regarding other possible explanations for this discrepancy, such as access to transportation and geographic distance to treatment facilities, were not available for this cohort but should be considered in future studies.…”

Section: Discussionmentioning

confidence: 89%

“…Data regarding other possible explanations for this discrepancy, such as access to transportation and geographic distance to treatment facilities, were not available for this cohort but should be considered in future studies. 16 There were several limitations to the current study. This study was a preliminary exploratory study that warrants a multicenter institutional investigation with a larger, morediverse population.…”

Section: Discussionmentioning

confidence: 92%

The Effect of Insurance Status on Surgical Outcomes in Gynecologic Cancer Patients

PfisterAbbey

PerroneNicholas

FarnanLaura

et al. 2019

Journal of Gynecologic Surgery

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Objective: The aim of this research was to determine the impact of insurance status on 30-day surgical outcomes for the treatment of gynecologic cancer. Materials and Methods: A retrospective cohort study of surgically treated gynecologic oncology patients in a large, prospective, cancer-survivorship cohort from April 2010 to August 2016 was performed. Inclusion criteria were: (1) diagnosis of gynecologic cancer; (2) surgical management of the cancer; and (3) documented insurance status. Primary outcomes were any 30-day postoperative complications (Clavien-Dindo score ‡1) and serious 30-day complications (Clavien-Dindo score ‡2). Exposure of interest was insurance status at time of diagnosis, classified as private (PRI), public (PUB), or no insurance/self-pay (NI/SP). Relative risks (RRs) of postoperative complications were estimated using log binomial regression. Results: Overall, 458 patients met the inclusion criteria, of which 67% (n = 307) had PRI, 25% (n = 116) had PUB, and 8% (n = 35) had NI/SP. After adjusting for body mass index, cancer stage, and surgical approach, there was no difference in risk of any complications between NI/SP and PUB

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“…The most common is uterine cancer (53%) [3][4][5], followed by ovarian (25%) [6,7], cervical (14%) [8][9][10], vaginal and vulvar cancers [11][12][13], with more rare neoplastic forms, such as trophoblastic tumours [14]. About 20% of gynaecological cancer affects women under 40 years of age, who often have not completed parity or are before their first pregnancy [15][16][17][18][19][20]. In these patients, fertility preservation represents a unique point of paramount importance.…”

Section: Introductionmentioning

confidence: 99%

Fertility preservation in women affected by gynaecological cancer: the importance of an integrated gynaecological and psychological approach

Rosa¹,

Garzon²,

Gullo³

et al. 2020

ecancer

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Gynaecological cancer treatment significantly affects the fertility of women in reproductive age. Surgery, chemotherapy and radiotherapy are the mainstays of ovarian, cervical and endometrial cancers and anatomically or functionally impact the uterus and ovaries. Moreover, the sexual function and psychological wellbeing of patients are highly weakened after a cancer diagnosis: depression, anxiety and impairment of quality of life represent a relevant concern for patient care. The potential loss of fertility could be more distressing than cancer itself. For this reason, it is of paramount importance to try to preserve fertility in women affected by gynaecological cancers. Recently, tailored fertility preservation therapies have been developed to meet the childbearing demand from more than half of women between 18 and 40 years with a diagnosis of cancer. Currently, fertility preservation techniques play a significant role in improving the quality of life of women with gynaecological cancer. In this scenario, we propose a narrative overview of the recent literature about the importance of a multidisciplinary approach in the management of fertility preservation in the case of gynaecological cancers.

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A contemporary framework of health equity applied to gynecologic cancer care: A Society of Gynecologic Oncology evidenced-based review

Cited by 62 publications

References 84 publications

Health Care‐Related Correlates of Cervical Cancer Screening among Sexual Minority Women: An Integrative Review

Health Care‐Related Correlates of Cervical Cancer Screening among Sexual Minority Women: An Integrative Review

The Effect of Insurance Status on Surgical Outcomes in Gynecologic Cancer Patients

Fertility preservation in women affected by gynaecological cancer: the importance of an integrated gynaecological and psychological approach

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