Cervical Cancer Screening among Women in Metropolitan Areas of the United States by Individual-Level and Area-Based Measures of Socioeconomic Status, 2000 to 2002

Coughlin, Steven S.; King, Jessica; Richards, Thomas B.; Ekwueme, Donatus U.

doi:10.1158/1055-9965.epi-05-0914

Cited by 109 publications

(93 citation statements)

References 22 publications

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“…In accordance with the existing literature, education, income, having health insurance, and having a PHP were found to be significant predictors of adequate cervical cancer screening behavior 11,[15][16][17] ; age, education, income, having health insurance, and having a PHP were found to be significant predictors of adequate breast cancer screening behavior. 11,18,19 Overall, our findings from analyses of the 2004 national BRFSS sample provide strong evidence to support that having a PHP and health insurance are 2 important independent factors associated with adequate cervical and breast cancer screening.…”

Section: Discussionsupporting

confidence: 87%

Having a Personal Healthcare Provider and Receipt of Adequate Cervical and Breast Cancer Screening

Cardarelli

Kurian²,

Pandya³

2010

The Journal of the American Board of Family Medicine

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Introduction:The purpose of this study was to assess the relationship between having a personal health care provider and adequate cervical and breast cancer screening behavior.Methods: Cross-sectional data were obtained from the 2004 Behavior Risk Factor Surveillance System. For cervical cancer, female respondents 18 years of age and older who did not have hysterectomy were included (n ‫؍‬ 130,359); for breast cancer, female respondents 40 years of age or older were included (n ‫؍‬ 129,929). Multiple logistic regression analyses were performed to determine the association between having a personal health care provider, specific demographics, and health insurance status with adequate cervical and breast cancer screening behavior.Results: Approximately 9% and 14% of the study population for the breast cancer and cervical cancer analyses, respectively, did not have a personal health care provider. Having at least one personal health care provider was significantly associated with adequate cervical cancer screening behavior (odds ratio, 2.37; 95% CI, 2.08 -2.70) and breast cancer screening behavior (odds ratio, 2.86; 95% CI, 2.54 -3.24) in multivariate analyses. Both multivariate analyses were adjusted for age, race/ethnicity, education, income, and health insurance.Conclusion: Having at least one personal health care provider was associated with adequate cervical and breast cancer screening behavior. Efforts to increase primary care access are a necessary part of the plan to increase preventive health services utilization.

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Section: Discussionsupporting

confidence: 87%

Having a Personal Healthcare Provider and Receipt of Adequate Cervical and Breast Cancer Screening

Cardarelli

Kurian²,

Pandya³

2010

The Journal of the American Board of Family Medicine

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“…4 Barriers to screening for socioeconomically disadvantaged women include not being able to afford transportation or child care, lack of awareness of the need for screening, low health literacy and, again, lack of physician recommendation. 29,30,[43][44][45] Our results are consistent with other Canadian and international literature. A recent multi-country study showed that disability was consistently more prevalent in the poorest than richest quintiles.…”

Section: Cmaj Opensupporting

confidence: 91%

Screening for cervical cancer in women with disability and multimorbidity: a retrospective cohort study in Ontario, Canada

et al. 2014

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Background: People with disability, multiple chronic conditions or both may experience challenges in accessing primary care. We aimed to determine the association between appropriate cervical cancer screening and level of disability among women eligible for screening in Ontario and the influence of relevant sociodemographic and health-related variables, including level of morbidity (measured by number of chronic conditions), on screening. Methods:We used multiple linked databases, including 2 waves of the Canadian Community Health Survey (2005 and 2007/08). Of the 22 824 women included in the study, 7600 reported some level of disability. We used Ontario Health Insurance Plan fee codes to identify appropriate cervical cancer screening.Results: Compared with women without disability, women with disability were older, less educated, had lower income and had more chronic conditions (36.2% had at least 2 conditions v. 8.4% of women without disability). Women with no disability and no chronic conditions were more frequently screened appropriately than those with severe disability and 2 or more chronic conditions (64.5% v. 39.8%). In multivariable logistic regression analysis, age, rurality, education, marital status and household income were each independently associated with cervical cancer screening. There was a significant interaction between level of morbidity and level of disability. Women with a higher level of disability were less likely to be screened than women with lower level of disability as their level of morbidity increased. Conclusion:The rate of screening for cervical cancer is low among women with both disability and multimorbidity. Policymakers should note these results as they work toward improving cancer screening rates for an aging population with complex medical needs. AbstractCMAJ OPEN, 2(4) E241

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“…[7,28] Despite the fact that all study participants were eligible for IHS-funded health care, markers for socioeconomic status (education and income) predicted improved screening rates. Studies in many other populations have found educational status and/or income to be predictive of cancer screening [5,8,[29][30][31][32][33][34]. The finding has important implications for reaching American Indian and Alaska Native people to improve cancer screening.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and predictors of cancer screening among American Indian and Alaska native people: the EARTH study

Schumacher

Slattery

Lanier

et al. 2008

Cancer Causes Control

105

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Purpose-The purpose of this study was to examine the prevalence rates for cervical, breast, and colorectal cancer screening among American Indian and Alaska Native people living in Alaska and in the Southwest US, and to investigate predictive factors associated with receiving each of the cancer screening tests. Methods-We used the Education and Research Towards Health (EARTH)Study to measure selfreported cancer screening prevalence rates among 11,358 study participants enrolled in [2004][2005][2006][2007]. We used prevalence odds ratios to examine demographic, lifestyle and medical factors associated with receiving age-and sex-appropriate cancer screening tests.Results-The prevalence rates of all the screening tests were higher in Alaska than in the Southwest. Pap test in the past 3 years was reported by 75.1% of women in Alaska and 64.6% of women in the Southwest. Mammography in the past 2 years was reported by 64.6% of women aged 40 years and older in Alaska and 44.0% of those in the Southwest. Colonoscopy or sigmoidoscopy in the past 5 years was reported by 41.1% of study participants aged 50 years and older in Alaska and by 11.7% of those in the Southwest US. Multivariate analysis found that location (Alaska versus the Southwest), higher educational status, income and the presence of one or more chronic medical condition predicted each of the three screening tests. Additional predictors of Pap test were age (women aged 25-39 years more likely to be screened than older or younger women), marital status (ever married more likely to be screened), and language spoken at home (speakers of American Indian Alaska Native language only less likely to be screened). Additional predictors of mammography were age (women aged 50 years and older were more likely to be screened than those aged 40-49 years), positive family history of breast cancer, use of smokeless tobacco (never users more likely to be screened), and urban/rural residency (urban residents more likely to be screened). Additional predictors of colonoscopy/sigmoidoscopy were age (men and women aged 60 years and older slightly more likely to be screened than those aged 50-59 years), family history of any cancer, family history of colorectal cancer, former smoking, language spoken at home (speakers of American Indian Alaska Native language less likely to be screened), and urban/rural residence (urban residents more likely to be screened).

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Cervical Cancer Screening among Women in Metropolitan Areas of the United States by Individual-Level and Area-Based Measures of Socioeconomic Status, 2000 to 2002

Cited by 109 publications

References 22 publications

Having a Personal Healthcare Provider and Receipt of Adequate Cervical and Breast Cancer Screening

Having a Personal Healthcare Provider and Receipt of Adequate Cervical and Breast Cancer Screening

Screening for cervical cancer in women with disability and multimorbidity: a retrospective cohort study in Ontario, Canada

Prevalence and predictors of cancer screening among American Indian and Alaska native people: the EARTH study

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