Chronic Medical Illness as a Risk Factor for Poor Mammography Screening Adherence

Miles, Randy C.; Narayan, Anand K.; López, Diego B.; Lehman, Constance D.; Harvey, H. Benjamin; Mishra, Vishala; Glover, McKinley; Flores, Efrén J.

doi:10.1089/jwh.2018.7315

Cited by 6 publications

(2 citation statements)

References 40 publications

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“…Having any chronic illness paradoxically increased the likelihood of colorectal cancer screening compared with breast and cervical cancer screening, after accounting for gender and SOGI. Consistent with our results, others demonstrated that chronic conditions decreased mammography [20] and cervical cancer screening [21] rates among women. In 2010, the Centers for Disease Control initiated the Colorectal Cancer Control Program to promote colorectal cancer screening at the population level using evidence-based interventions, especially among medically underserved groups.…”

Section: Discussionsupporting

confidence: 93%

Modifiers of Cancer Screening Prevention Among Sexual and Gender Minorities in the Behavioral Risk Factor Surveillance System

Charkhchi

Schabath

Carlos

2019

Journal of the American College of Radiology

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Purpose: Increasing social acceptance of sexual and gender minorities may not translate to parity in health care access and health outcomes. Sexual orientation and gender identity (SOGI) may continue to contribute to differences in preventive health behavior including cancer screening. Our purpose was to estimate the independent effect of SOGI on breast, cervical, and colorectal cancer screening adherence.Methods: We used sampling weighted data from 2016 Behavioral Risk Factor Surveillance System. We defined breast, cervical, and colorectal cancer screening using the US Preventive Services Task Force guidelines. All survey data were self-reported including demographic and medical information. We calculated the prevalence of screening by sexual orientation (straight, lesbian or gay, bisexual) and gender identity (cisgender, transgender). The term "sexual and gender minorities" in our study refers to lesbian or gay, bisexual, and transgender individuals. Logistic regression models assessed independent effect of SOGI on screening adherence.Results: Prevalence of breast, cervical, and colorectal cancer screening varied significantly by SOGI. After adjusting for other variables, bisexual persons had significantly lower odds (odds ratio [OR] ¼ 0.60, 95% confidence interval [CI] ¼ 0.38-0.93) of breast cancer screening adherence. Lesbian or gay persons had significantly decreased likelihood (OR ¼ 0.53, 95% CI ¼ 0.29-0.95) of cervical cancer screening adherence. Although rate of colorectal cancer screening adherence varied significantly by SOGI, we did not find an independent effect of SOGI and colorectal cancer screening adherence after adjusting for other variables. No independent effect of gender identity categories on breast, cervical, and colorectal cancer screening adherence was detected. Social determinants of health, such as health care access and insurance, that disproportionately disadvantaged bisexual individuals independently influenced screening adherence.Conclusions: SOGI can affect cancer screening adherence. Bisexual individuals had worse health care access and socioeconomic hardships among sexual and gender minorities. Given the independent effects of social determinants of health on cancer screening adherence, more attention needs to be paid to sexual and gender minorities, especially bisexual population.

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Section: Discussionsupporting

confidence: 93%

Modifiers of Cancer Screening Prevention Among Sexual and Gender Minorities in the Behavioral Risk Factor Surveillance System

Charkhchi

Schabath

Carlos

2019

Journal of the American College of Radiology

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“…Lack of a regular health care provider is associated with a reduced coverage rate of screening both inside [17] and outside a BCSP [7]. Other individual level characteristics include residential instability [18], being an immigrant [19], physical disability [20], and having one or more chronic diseases [21]. Only a relatively small amount of studies are dedicated to exploration of the determinants of screening outside a BCSP.…”

Section: Introductionmentioning

confidence: 99%

Coverage determinants of breast cancer screening in Flanders: an evaluation of the past decade

Ding

Jidkova

Greuter

et al. 2020

Int J Equity Health

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Background Breast cancer (BC) is the most common cancer in women in the developed world. In order to find developing cancers in an early stage, BC screening is commonly used. In Flanders, screening is performed in and outside an organized breast cancer screening program (BCSP). However, the determinants of BC screening coverage for both screening strategies are yet unknown. Objective To assess the determinants of BC screening coverage in Flanders. Methods Reimbursement data were used to attribute a screening status to each woman in the target population for the years 2008–2016. Yearly coverage data were categorized as screening inside or outside BCSP or no screening. Data were clustered by municipality level. A generalized linear equation model was used to assess the determinants of screening type. Results Over all years and municipalities, the median screening coverage rate inside and outside BCSP was 48.40% (IQR: 41.50–54.40%) and 14.10% (IQR: 9.80–19.80%) respectively. A higher coverage rate outside BSCP was statistically significantly (P < 0.001) associated with more crowded households (OR: 3.797, 95% CI: 3.199–4.508), younger age, higher population densities (OR: 2.528, 95% CI: 2.455–2.606), a lower proportion of unemployed job seekers (OR: 0.641, 95% CI: 0.624–0.658) and lower use of dental care (OR: 0.969, 95% CI: 0.967–0.972). Conclusion Coverage rate of BC screening is not optimal in Flanders. Women with low SES that are characterized by younger age, living in a high population density area, living in crowded households, or having low dental care are less likely to be screened for BC in Flanders. If screened, they are more likely to be screened outside the BCSP.

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Patients characteristics related to screening mammography cancellation and rescheduling rates during the COVID-19 pandemic

et al. 2021

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Purpose To identify patient characteristics associated with screening mammography cancellations and rescheduling during the COVID-19 pandemic. Methods Scheduled screening mammograms during three time periods were retrospectively reviewed: state-mandated shutdown (3/17/2020-6/16/2020) during which screening mammography was cancelled, a period of 2 months immediately after screening mammography resumed (6/17/2020-8/16/2020), and a representative period prior to COVID-19 (6/17/2019-8/16/2019). Relative risk of cancellation before COVID-19 and after reopening was compared for age, race/ethnicity, insurance, history of chronic disease, and exam location, controlling for other collected variables. Risk of failure to reschedule was similarly compared between all 3 time periods. Results Overall cancellation rate after reopening was higher than before shutdown (7663/16595, 46% vs 5807/15792, 37%; p < 0.001). Relative risk of cancellation after reopening increased with age (1.20 vs 1.27 vs 1.36 for ages at 25th, 50th, and 75th quartile or 53, 61, and 70 years, respectively, p < 0.001). Relative risk of cancellation was also higher among Medicare patients (1.41) compared to Medicaid and those with other providers (1.26 and 1.21, respectively, p < 0.001) and non-whites compared to whites (1.34 vs 1.25, p = 0.03). Rescheduling rate during shutdown was higher than before COVID-19 and after reopening for all patients (10,658/13593, 78%, 3569/5807, 61%, and 4243/7663, respectively, 55%, p < 0.001). Relative risk of failure to reschedule missed mammogram was higher in hospitals compared to outpatient settings both during shutdown and after reopening (0.62 vs 0.54, p = 0.005 and 1.29 vs 1.03, p < 0.001, respectively). Conclusion Minority race/ethnicity, Medicare insurance, and advanced age were associated with increased risk of screening mammogram cancellation during COVID-19.

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Chronic Medical Illness as a Risk Factor for Poor Mammography Screening Adherence

Cited by 6 publications

References 40 publications

Modifiers of Cancer Screening Prevention Among Sexual and Gender Minorities in the Behavioral Risk Factor Surveillance System

Modifiers of Cancer Screening Prevention Among Sexual and Gender Minorities in the Behavioral Risk Factor Surveillance System

Coverage determinants of breast cancer screening in Flanders: an evaluation of the past decade

Patients characteristics related to screening mammography cancellation and rescheduling rates during the COVID-19 pandemic

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