Cancer Screening Test Use―U.S., 2019

Sabatino, Susan A.; Thompson, Trevor; White, Mary C.; Shapiro, Jean A.; Clarke, Tainya C.; Croswell, Jennifer M.; Richardson, Lisa C.

doi:10.1016/j.amepre.2022.02.018

Cited by 25 publications

(17 citation statements)

References 17 publications

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“…The increased incidence might also reflect suboptimal screening uptake and/or an increasing proportion of women unable to complete diagnostic follow‐up and treatment of precancerous lesions. This is consistent with decreased screening uptake in the United States, which is well documented, 16–18 with declines beginning in the early 2000s, particularly among low‐income uninsured women 19–21 . Recent patterns in follow‐up care and treatment remain unclear.…”

Section: Discussionsupporting

confidence: 59%

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Recent trends in cervical cancer incidence, stage at diagnosis, and mortality according to county‐level income in the United States, 2000–2019

Amboree,

Damgacioglu,

Sonawane

et al. 2024

Intl Journal of Cancer

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Early evidence suggests that declining cervical cancer incidence reversed in low‐income regions in the United States in recent years; however, it is unclear whether there are distinct patterns by race/ethnicity and stage at diagnosis and if the increase has translated into rising mortality. Using Surveillance, Epidemiology, and End Results data, we evaluated trends in hysterectomy‐corrected cervical cancer incidence rates (2000–2019) and mortality rates (2005–2019) by county‐level income and race/ethnicity, with further stratification of incidence by stage at diagnosis. Following a period of decline, hysterectomy‐corrected cervical cancer incidence increased 1.0%/year (95% CI = 0.1% to 4.5%) among Non‐Hispanic White women in low‐income counties. Particularly, a statistically significant 4.4%/year (95% CI = 1.7% to 7.5%) increase in distant‐stage cancer occurred in this group. Additionally, recent increases in cervical cancer mortality (1.1%/year [95% CI = −1.4% to 3.7%]) were observed among this group and Non‐Hispanic Black women in low‐income counties (2.9%/year [95% CI = −2.3% to 18.2%]), but trends were not statistically significant. Among Hispanic women in low‐income counties, distant‐stage cervical cancer incidence increased 1.5%/year (95% CI = −0.6% to 4.1%), albeit not statistically significant. The increasing incidence of distant‐stage cervical cancer and mortality in specific racial/ethnic groups suggests that the recent introduction of higher sensitivity screening tests may not explain increasing trends in low‐income counties. Our findings suggest that the observed rise in cervical cancer incidence may reflect disruptions along the screening and treatment continuum. Future research to further comprehend these trends and continued enhancements in prevention are crucial to combat rising cervical cancer incidence and mortality in low‐income counties in the United States.

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Section: Discussionsupporting

confidence: 59%

“…This is consistent with decreased screening uptake in the United States, which is well documented, [16][17][18] with declines beginning in the early 2000s, particularly among low-income uninsured women. [19][20][21] Recent patterns in follow-up care and treatment remain unclear.…”

Section: Factors Underlying Increased Cervical Cancer Incidence Amongmentioning

confidence: 99%

Recent trends in cervical cancer incidence, stage at diagnosis, and mortality according to county‐level income in the United States, 2000–2019

Amboree,

Damgacioglu,

Sonawane

et al. 2024

Intl Journal of Cancer

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“…We assessed four preventive health measures–colorectal cancer screening (as per the U.S. Preventive Services Task Force recommendation) among women aged 45–75 years, 20 breast cancer screening (mammogram in past 2 years) among women aged 50–74 years, 20 vaccination for influenza, and vaccination for pneumonia among women age ≥65 years; and three behavioral risk factors–smoking, heavy drinking, and no leisure time physical activity. A respondent was determined to be a current smoker if she smoked at least 100 cigarettes in her entire life and smoked every day or some days at the time of the survey.…”

Section: Methodsmentioning

confidence: 99%

Preventive behaviors and behavioral risk factors among gynecologic cancer survivors: Results from the 2020 Behavioral Risk Factor Surveillance System Survey

et al. 2023

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BackgroundMaintaining a healthy lifestyle is an important factor in promoting positive outcomes for gynecologic cancer survivors.MethodsWe examined preventive behaviors among gynecologic cancer survivors (n = 1824) and persons without a history of cancer in a cross‐sectional analysis, using data from the 2020 Behavioral Risk Factor Surveillance System survey (BRFSS). BRFSS is a cross‐sectional telephone‐based survey of U.S. residents 18 years of age and older, which collects information about health‐related factors and use of preventive services.ResultsThe prevalence rates of colorectal cancer screening were respectively 7.9 (95% CI: 4.0–11.9) and 15.0 (95% CI: 4.0–11.9) %‐points higher among gynecologic and other cancer survivors compared to that of 65.2% among those without any history of cancer. However, no differences were observed in breast cancer screening between gynecologic cancer survivors (78.5%) and respondents without any history of cancer (78.7%). Coverage of influenza vaccination among gynecologic cancer survivors were 4.0 (95% CI: 0.3–7.6) %‐points higher than that of the no cancer group, but 11.6 (95% CI: 7.6–15.6) %‐points lower than that of the other cancer group. Pneumonia vaccination rate among gynecologic cancer survivors, however, was not statistically different than that of other cancer survivors and respondents with no history of cancer. When examining modifiable risk behaviors, the prevalence of smoking among gynecologic cancer survivors was 12.8 (95% CI: 9.5–16.0) and 14.2 (95% CI: 10.8–17.7) %‐points higher than smoking prevalence among other cancer survivors and respondents without any history of cancer. The rate differentials were even higher in rural areas, 17.4 (95% CI: 7.2–27.6) and 18.4 (95% CI: 7.4–29.4) %‐points respectively. There were no differences in the prevalence of heavy drinking across the groups. Lastly, gynecologic and other cancer survivors were less likely to be physically active (Δ = −12.3, 95% CI: −15.8 to −8.8 and Δ = −6.9, 95% CI: −8.5 to −5.3, respectively) than those without any history of cancer.ConclusionSmoking prevalence among gynecologic cancer survivors is alarmingly high. Intervention studies are needed to identify effective ways to assist gynecologic cancer survivors to quit smoking and refrain from hazardous alcohol consumption. In addition, women with gynecologic malignancies should made aware of the importance of physical activity.

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“…2 Disparities in cancer screening rates between racial and ethnic groups have been reported by the Centers for Disease Control (Table 2)-even when screening rates are comparable, screening recommendations, patterns, and quality of screening techniques vary for different cancer types. 2,[8][9][10] Black patients are generally diagnosed later in the disease course and have a higher likelihood of having advanced disease at diagnosis for cancers where screening is recommended (e.g., lung, colorectal, female breast, and cervical cancers), compared with other racial and ethnic groups. 11 This may be due in part to the fact that screening guidelines do not take into account the increased prevalence of genetic mutations such as PALB2 and BRCA 1/2, and age-specific incidence for certain cancers in Black patients.…”

Section: Cancer Disparities In Older Adults Of Color: Backgroundmentioning

confidence: 99%

Disparities in care of older adults of color with cancer: A narrative review

Dotan,

Lynch,

Ryan

et al. 2024

Cancer Medicine

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This review describes the barriers and challenges faced by older adults of color with cancer and highlights methods to improve their overall care. In the next decade, cancer incidence rates are expected to increase in the United States for people aged ≥65 years. A large proportion will be older adults of color who often have worse outcomes than older White patients. Many issues contribute to racial disparities in older adults, including biological factors and social determinants of health (SDOH) related to healthcare access, socioeconomic concerns, systemic racism, mistrust, and the neighborhood where a person lives. These disparities are exacerbated by age‐related challenges often experienced by older adults, such as decreased functional status, impaired cognition, high rates of comorbidities and polypharmacy, poor nutrition, and limited social support. Additionally, underrepresentation of both patients of color and older adults in cancer clinical research results in a lack of adequate data to guide the management of these patients. Use of geriatric assessments (GA) can aid providers in uncovering age‐related concerns and personalizing interventions for older patients. Research demonstrates the ability of GA‐directed care to result in fewer treatment‐related toxicities and improved quality of life, thus supporting the routine incorporation of validated GA into these patients' care. GA can be enhanced by including evaluation of SDOH, which can help healthcare providers understand and address the needs of older adults of color with cancer who face disparities related to their age and race.

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Cancer Screening Test Use―U.S., 2019

Cited by 25 publications

References 17 publications

Recent trends in cervical cancer incidence, stage at diagnosis, and mortality according to county‐level income in the United States, 2000–2019

Recent trends in cervical cancer incidence, stage at diagnosis, and mortality according to county‐level income in the United States, 2000–2019

Preventive behaviors and behavioral risk factors among gynecologic cancer survivors: Results from the 2020 Behavioral Risk Factor Surveillance System Survey

Disparities in care of older adults of color with cancer: A narrative review

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