Cervical cancer screening and predictors of screening by diabetes status

Abstract

Purpose Women with diabetes have lower survival rates after a cervical cancer diagnosis compared to women without diabetes. Pap smears and human papilloma virus (HPV) testing are highly effective screening tests for cervical cancer, therefore, it is important to know the prevalence of guideline-concordant screening among women with diabetes and understand if their predictors of screening differ. The purpose of this analysis was to assess guideline-concordant cervical cancer screening and predictors by diabetes status. Methods We used the 2019 National Health Interview Survey data, limited to women aged 21–65 years without a previous diagnosis of cancer, a hysterectomy, or diagnosed with diabetes in the year prior to the survey. We considered the Pap and HPV tests together and concordance as being tested within the past 3 years as part of a routine exam. We calculated weighted, adjusted prevalence, and prevalence ratios (PRs) of screening concordance comparing women with diabetes to those without. Results The unadjusted prevalence of concordant screening was 66.5% for women with diabetes compared to 73.3% for women without diabetes (PR = 0.91 95% CI 0.84–0.98). In the fully adjusted model adjusting for factors known to be associated with diabetes and access to healthcare, the association was attenuated and no longer statistically significant (PR = 0.96 95% CI 0.89–1.04). Conclusion Cervical cancer screening concordance was lower in women with diabetes compared to those without overall but the deficit appears to be due primarily to underlying differences in sociodemographic characteristics and access to healthcare and not diabetes independently.

Does the Intersectionality of Race/Ethnicity and Type 2 Diabetes Increase the Odds of a Cervical Cancer Diagnosis? A Nested Case–Control Study of a Florida Statewide Multisite EHR Database

“…Diabetes may play a role in elevating the prevalence of cervical cancer diagnosis among Black women. Additionally, T2D is an additional factor increasing the odds of cervical cancer risk in Black women because women with T2D have lower rates of cervical cancer screening compared with women without T2D [ 19 , 20 ]. Cervical cancer screening is associated with early detection of precancerous cervical changes, resulting in the prevention of cervical cancer [ 16 ].…”

“…However, medically underserved women, women living in poverty, and women living in rural areas are more likely to miss cervical cancer screening [ 8 , 17 ]. Several studies have shown that women with T2D have lower cervical cancer screening rates [ 18 , 19 , 20 ], and have higher mortality rates from cervical cancer compared with women without T2D [ 21 , 22 ]. Given the similar sociodemographic trends between cervical cancer and T2D, there is a need to examine the relationship between T2D and receiving a cervical cancer diagnosis while controlling for sociodemographic factors (race/ethnicity and SES).…”

Effects of diabetes, hypercholesterolemia and low-density lipoprotein levels on survival in patients with cervical cancer

“…van Dorst et al) have indicates that cancer causes the in ltration of in ammatory cells in the arterial wall, and elevated baseline serum levels of in ammatory markers, including C-reactive protein and interleukin-6, are associated with high blood pressure [(5)] . Additionally, the frequent cooccurrence of other metabolic disorders may in uence cancer progression through various mechanisms, including endothelial dysfunction and chronic in ammation [7] . Several epidemiological studies have consistently shown that individuals with diabetes, especially type 2 diabetes, have an increased risk of developing certain types of cancer.…”

“…Several epidemiological studies have consistently shown that individuals with diabetes, especially type 2 diabetes, have an increased risk of developing certain types of cancer. These include colorectal cancer, liver cancer, pancreatic cancer, and breast cancer [7] , but cervical cancer and diabetes are not well studied. Despite these insights, the speci c impact of cholesterol and other metabolic parameters on cervical cancer outcomes remains insu ciently explored.…”

“…This study aimed to bridge this gap by evaluating the associations between cholesterol levels, as well as other metabolic factors, such as diabetes and triglyceride and low-density lipoprotein levels, and the survival rates of cervical cancer patients [(6)] . Understanding these relationships is crucial for developing comprehensive management strategies that encompass not only the oncological aspects of patient health but also the metabolic health of patients with cervical cance r[ (7)] . This study used a large dataset of clinical and metabolic factors in cervical cancer patients, providing a unique opportunity to elucidate the in uence of metabolic health on cancer prognosis.…”