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Türkoğlu S, Özen M, Eke RN, Acar AB. A study on obese patients' participation in cancer screening programs: an example from Turkey. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2024; 70:e20240261. [PMID: 39166675 PMCID: PMC11329256 DOI: 10.1590/1806-9282.20240261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 05/31/2024] [Indexed: 08/23/2024]
Abstract
OBJECTIVE Obesity is associated with many types of cancers. Despite this, the participation of obese individuals in cancer screenings is limited. The aim of this study was to evaluate the cancer screening-related attitudes of obese patients. METHODS The study included 185 obese patients who presented to the obesity center (OC) and 191 obese patients who presented to the family medicine outpatient clinic from October to December 2019. The participants in both groups were first asked whether or not they had ever undergone any cancer screening tests and then provided with relevant training. After 3 months, the participants were contacted again and their attitudes toward cancer screening tests were re-evaluated. RESULTS Patients who followed in the OC were found to have higher awareness of and compliance with cancer screening tests than the obese patients admitted to the outpatient clinic. The factors of being female, being followed in the OC, and residing in an urban area were positively associated with participation in cancer screening tests. CONCLUSION Monitoring obese patients in target-oriented facilities such as an OC increases the chance of success in the fight against obesity and related health problems.
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Affiliation(s)
| | - Mehmet Özen
- University of Health Sciences, Antalya Training and Research Hospital, The Clinic of Family Medicine - Antalya, Turkey
| | - Remziye Nur Eke
- University of Health Sciences, Antalya Training and Research Hospital, The Clinic of Family Medicine - Antalya, Turkey
| | - Aysima Bulca Acar
- University of Health Sciences, Antalya Training and Research Hospital, The Clinic of Family Medicine - Antalya, Turkey
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Tsige AW, Beyene DA. Cervical cancer: Challenges and prevention strategies: A narrative review. Health Sci Rep 2024; 7:e2149. [PMID: 38826620 PMCID: PMC11139676 DOI: 10.1002/hsr2.2149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 03/25/2024] [Accepted: 05/09/2024] [Indexed: 06/04/2024] Open
Abstract
Background and Aims Human papillomavirus (HPV) infections that continue to exist are the main cause of cervical cancer (CC), two-thirds of CC occurrences worldwide are caused by HPV 16 and HPV 18, and 99.7% of CC tumors are linked to oncogenic HPV infection. To identify challenges of CC and its prevention and treatment modalities. Methods This review examined the epidemiology, predisposing factors, genetic factors, clinical assessment methods, current treatment options, and prevention approaches for CC. We had perform a narrative data synthesis rather than a pooled analysis. A thorough literature search in pertinent databases related to CC was done with the inclusion of data that were published in the English language. Results Early detection of CC is of utmost importance to detect precancerous lesions at an early stage. Therefore, all responsible agencies concerned with health should make all women aware of the benefits of CC screening and educate the general public. HPV vaccination coverage is very low in resource-limited settings. Conclusion To achieve the goal of eliminating CC as a public health problem in 2030, the World Health Organization will pay special attention to increasing HPV vaccination coverage throughout the world. To further improve HPV vaccine acceptability among parents and their children, safety-related aspects of the HPV vaccine should be further investigated through post-marketing surveillance and multicentre randomized clinical trials.
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Affiliation(s)
- Abate Wondesen Tsige
- Department of Pharmacy, Asrat Woldeyes Health Science CampusDebre Berhan UniversityDebre BerhanEthiopia
| | - Dessale Abate Beyene
- Department of Pharmacy, Asrat Woldeyes Health Science CampusDebre Berhan UniversityDebre BerhanEthiopia
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3
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Ahadinezhad B, Maleki A, Amerzadeh M, Mohtashamzadeh B, Khosravizadeh O. What rate of Iranian women perform Pap smear test? Results from a meta-analysis. Prev Med 2024; 180:107871. [PMID: 38262561 DOI: 10.1016/j.ypmed.2024.107871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 12/30/2023] [Accepted: 01/18/2024] [Indexed: 01/25/2024]
Abstract
In this study, an attempt was made to estimate the aggregated proportion of Pap smear test uptake among women in Iran from 2012 to 2022 using meta-analysis. The data collection process involved reviewing records registered in databases between January 1, 2012, and September 11, 2022. The final data was analyzed using random effects models, and potential heterogeneity was assessed using the I2 index. To examine publication bias, Egger's test and Funnel Plot were employed. Sensitivity analysis, specifically single study exclusion Meta-analysis, was conducted to assess the influence of each individual study on the aggregated percentage of Pap smear test uptake. A total of 28,754 women were included across the 33 articles analyzed. The pooled percentage of Pap smear test uptake for both one-time and regular screenings was found to be 46.52% (95% CI: 40.91 to 52.14) and 17.80% (95% CI: 12.42 to 23.18), respectively. No significant evidence of publication bias was detected, although the influence of smaller studies was confirmed. Sensitivity analysis indicated that the overall rate of Pap smear test uptake was not highly sensitive to the results of individual studies. The findings emphasize the low rate of regular Pap smear testing among Iranian women and suggest that tailored interventions considering cultural and geographical factors specific to different provinces in Iran could help increase the utilization of this screening service.
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Affiliation(s)
- Bahman Ahadinezhad
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Aisa Maleki
- Student Research Committee, Qazvin University of Medical Sciences, Iran
| | - Mohammad Amerzadeh
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | | | - Omid Khosravizadeh
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
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Castañeda KM, Sidorenkov G, Mourits MJE, van der Vegt B, Siebers AG, Vermeulen KM, Schuuring E, Wisman GBA, de Bock GH. Impact of health-related behavioral factors on participation in a cervical cancer screening program: the lifelines population-based cohort. BMC Public Health 2023; 23:2376. [PMID: 38037016 PMCID: PMC10688458 DOI: 10.1186/s12889-023-17293-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 11/22/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Regular participation in cervical cancer screening is critical to reducing mortality. Although certain sociodemographic factors are known to be associated with one-time participation in screening, little is known about other factors that could be related to regular participation. Therefore, this study evaluated the association between health-related behavioral factors and regular participation in cervical cancer screening. METHODS The Lifelines population-based cohort was linked to data for cervical cancer screening from the Dutch Nationwide Pathology Databank. We included women eligible for all four screening rounds between 2000 and 2019, classifying them as regular (4 attendances), irregular (1-3 attendances), and never participants. Multinomial logistic regression was performed to evaluate the association between behavioral factors and participation regularity, with adjustment made for sociodemographic factors. RESULTS Of the 48,325 included women, 55.9%, 35.1%, and 9% were regular, irregular, and never screening participants. After adjustment for sociodemographic factors, the likelihood of irregular or never screening participation was increased by smoking, obesity, marginal or inadequate sleep duration, alcohol consumption and low physical activity, while it was decreased by hormonal contraception use. CONCLUSION An association exists between unhealthy behavioral factors and never or irregular participation in cervical cancer screening.
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Affiliation(s)
- Kelly M Castañeda
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, 9700 RB, Groningen, the Netherlands.
| | - Grigory Sidorenkov
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, 9700 RB, Groningen, the Netherlands
| | - Marian J E Mourits
- Department of Gynaecologic Oncology, Cancer Research Center Groningen, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands
| | - Bert van der Vegt
- Department of Pathology & Medical Biology, University of Groningen, University Medical Center Groningen, 9700 RB, Groningen, the Netherlands
| | - Albert G Siebers
- Dutch Nationwide Pathology Databank, PALGA, 3991 SZ, Houten, the Netherlands
| | - Karin M Vermeulen
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, 9700 RB, Groningen, the Netherlands
| | - Ed Schuuring
- Department of Pathology & Medical Biology, University of Groningen, University Medical Center Groningen, 9700 RB, Groningen, the Netherlands
| | - G Bea A Wisman
- Department of Gynaecologic Oncology, Cancer Research Center Groningen, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands
| | - Geertruida H de Bock
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, 9700 RB, Groningen, the Netherlands
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Zhu B, Yu H, Ni P, Chen X, Zhang J, Wang D. A population-based cross-sectional study on the situation of cervical cancer screening in Liaoning, China. BMC Womens Health 2023; 23:144. [PMID: 36991455 PMCID: PMC10061794 DOI: 10.1186/s12905-023-02249-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 02/28/2023] [Indexed: 03/30/2023] Open
Abstract
Abstract
Background
Cervical cancer (CC) screening is currently recognized as an effective intervention for CC. Previous studies found that the proportion of screening was low in China, especially in Liaoning. Therefore, we performed a population-based cross-sectional survey to investigate the situation of cervical cancer screening and analyze their related factors for providing a decision-making basis for sustainable and effective development of cervical cancer screening.
Methods
This population-based cross-sectional study involved aged 30 to 69 years in nine counties/districts in Liaoning from 2018 to 2019. Data were collected using the quantitative data collection methods, and analyzed in SPSS version 22.0.
Results
Overall, only 22.37% of 5334 respondents reported having ever been screened for cervical cancer in past 3 years, and 38.41% of respondents reported having the willingness for cervical cancer screening in next 3 years. In the rate of CC screening, multilevel analysis indicated that age, marital status, education level, type of occupation, medical insurance, family income, place of residence and regional economic level had a significant impact on proportion of screening. In the rate of CC screening willingness, multilevel analysis indicated that age, family income, health status, place of residence, regional economic level and CC screening still had a significant impact, but marital status, education level and medical insurance type had no significant impact. There was no significant difference in marital status, education level and medical insurance type after the factors of CC screening were added in the model.
Conclusion
Our study found both proportion of screening and willingness were at a low level, and age, economic and regional factors were the main factors for implementation of CC screening in China. In the future, targeted policies should be formulated according to the characteristics of different groups of people, and reduce the gap in the current health service capacity between different regions.
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Suurna M, Orumaa M, Ringmets I, Pärna K. Inequalities in reported use of cervical screening in Estonia: results from cross-sectional studies in 2004-2020. BMC Womens Health 2022; 22:545. [PMID: 36566176 PMCID: PMC9789641 DOI: 10.1186/s12905-022-02123-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 12/12/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Despite the national cervical cancer (CC) screening program established in 2006, the CC incidence in Estonia in 2020 was still one of the highest in Europe. To better understand the possible barriers among women, the aim of this study was to describe the inequalities in the Pap smear uptake trend in 2004-2020 and to analyse the associations between different factors in Estonia. METHODS Weighted data of 25-64-year-old women (N = 6685) from population-based cross-sectional studies of Health Behaviour among Estonian Adult Population in 2004-2020 was used. Linear trends in uptake of Pap smear over time were tested using the Cochrane-Armitage test. Binary logistic regression with interactions was performed to analyse associations between the uptake of Pap smear and sociodemographic, socioeconomic, health-related and lifestyle factors. Crude and adjusted odds ratios with 95% confidence intervals were calculated. RESULTS Prevalence of lifetime uptake of Pap smear increased in 2004-2020 from 50.6 to 86.7% (P < 0.001). From 2004 to 2020, uptake of Pap smear increased significantly among women aged 25-34, 35-44, 45-54 and 55-64, in both ethnicity groups and among women with basic, secondary and higher education (P < 0.001). The gap in Pap smear uptake increased between Estonians and non-Estonians but decreased between education levels over time. Lower lifetime uptake of Pap smear was associated from sociodemographic factors with younger age, being non-Estonian and single, from socioeconomic factors with lower educational level and unemployment, from health indicators with higher body mass index indicating overweight and obesity, presence of chronic disease and depressiveness, and from lifestyle factors with non-smoking. CONCLUSIONS Although Pap smear uptake among 25-64 year old women increased significantly in Estonia in 2004-2020, inequalities were found indicating an opportunity for development of targeted CC prevention strategies.
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Affiliation(s)
- Maria Suurna
- grid.416712.70000 0001 0806 1156Department of Epidemiology and Biostatistics, National Institute for Health Development, Hiiu 42, 11619 Tallinn, Estonia
| | - Madleen Orumaa
- grid.416712.70000 0001 0806 1156Department of Epidemiology and Biostatistics, National Institute for Health Development, Hiiu 42, 11619 Tallinn, Estonia ,grid.418941.10000 0001 0727 140XDepartment of Research, Cancer Registry of Norway, Oslo, Norway
| | - Inge Ringmets
- grid.10939.320000 0001 0943 7661Institute of Family Medicine and Public Health, University of Tartu, Ravila 19, 50411 Tartu, Estonia
| | - Kersti Pärna
- grid.10939.320000 0001 0943 7661Institute of Family Medicine and Public Health, University of Tartu, Ravila 19, 50411 Tartu, Estonia
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Oh J, Oda K, Dang K, Ibrayev Y, Fraser GE, Knutsen SF. Lower Compliance with Cervical Cancer Screening Guidelines Among Vegetarians in North America. JOURNAL OF PREVENTION (2022) 2022; 43:783-800. [PMID: 35759069 DOI: 10.1007/s10935-022-00691-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/30/2022] [Indexed: 06/15/2023]
Abstract
Cervical cancer is preventable and treatable through regular screening and follow-up. However, the utilization of cervical cancer screening may vary widely based on individual lifestyles. The purpose of this study was to examine the differences in the adherence to cervical cancer screening guidelines in various dietary groups. Our study included 21,376 women from the United States and Canada, aged 30-69 from the Adventist Health Study-2, a large population-based prospective cohort study. Modified Poisson regression with robust variance estimation was used to determine the prevalence ratios of cervical cancer screening behavior in participants following five different dietary patterns (non-vegetarians, semi-vegetarians, pesco-vegetarians, lacto-ovo-vegetarians, and vegans). All analyses were adjusted for age, race/ethnicity, marital status, education, personal income, body mass index, smoking, alcohol use, exercise, and family history of all female cancer. Vegetarians, in general, had similar screening prevalence as non-vegetarians. However, vegans were 16% less likely to have had a Pap test compared to non-vegetarians (prevalence ratio (PR) = 0.84, 95% confidence interval 0.81-0.86). Women who were younger, Black, married, more educated, had a family history of all female cancer, had a higher income, and exercise reported higher compliance to a Pap test. It remains to be seen whether vegan women in Adventist Health-2 experience a higher incidence of cervical cancer or are diagnosed at a later stage compared to non-vegetarians.
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Affiliation(s)
- Jisoo Oh
- Epidemiology, School of Public Health, Loma Linda University, 24951 North Circle Drive, Nichol Hall #2008, Loma Linda, CA, 92350, USA.
| | - Keiji Oda
- Epidemiology, School of Public Health, Loma Linda University, 24951 North Circle Drive, Nichol Hall #2008, Loma Linda, CA, 92350, USA
- Center for Nutrition, Healthy Lifestyle and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA, 92350, USA
| | - Kaitlyn Dang
- Epidemiology, School of Public Health, Loma Linda University, 24951 North Circle Drive, Nichol Hall #2008, Loma Linda, CA, 92350, USA
| | - Yermek Ibrayev
- Epidemiology, School of Public Health, Loma Linda University, 24951 North Circle Drive, Nichol Hall #2008, Loma Linda, CA, 92350, USA
| | - Gary E Fraser
- Epidemiology, School of Public Health, Loma Linda University, 24951 North Circle Drive, Nichol Hall #2008, Loma Linda, CA, 92350, USA
- Epidemiology, School of Public Health and Preventive Medicine, School of Medicine, Loma Linda University, Loma Linda, CA, 92350, USA
| | - Synnove F Knutsen
- Epidemiology, School of Public Health, Loma Linda University, 24951 North Circle Drive, Nichol Hall #2008, Loma Linda, CA, 92350, USA
- Epidemiology, School of Public Health, Loma Linda University, Loma Linda, CA, 92350, USA
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Suresh RR, Kulandaisamy AJ, Nesakumar N, Nagarajan S, Lee JH, Rayappan JBB. Graphene Quantum Dots – Hydrothermal Green Synthesis, Material Characterization and Prospects for Cervical Cancer Diagnosis Applications: A Review. ChemistrySelect 2022. [DOI: 10.1002/slct.202200655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Raghavv Raghavender Suresh
- Department of Bioengineering School of Chemical & Biotechnology SASTRA Deemed University Thanjavur 613 401 Tamil Nadu India
- Centre for Nanotechnology & Advanced Biomaterials (CeNTAB) SASTRA Deemed University Thanjavur 613 401 Tamil Nadu India
| | - Arockia Jayalatha Kulandaisamy
- Centre for Nanotechnology & Advanced Biomaterials (CeNTAB) SASTRA Deemed University Thanjavur 613 401 Tamil Nadu India
- School of Electrical & Electronics Engineering SASTRA Deemed University Thanjavur 613 401 Tamil Nadu India
| | - Noel Nesakumar
- Department of Bioengineering School of Chemical & Biotechnology SASTRA Deemed University Thanjavur 613 401 Tamil Nadu India
- Centre for Nanotechnology & Advanced Biomaterials (CeNTAB) SASTRA Deemed University Thanjavur 613 401 Tamil Nadu India
| | - Saisubramanian Nagarajan
- Center for Research in Infectious Diseases (CRID) School of Chemical and Biotechnology SASTRA Deemed University Thanjavur 613 401 Tamil Nadu India
| | - Jung Heon Lee
- Research Center for Advanced Materials Technology School of Advanced Materials Science & Engineering Biomedical Institute for Convergence at SKKU (BICS) Sungkyunkwan University (SKKU) Suwon 16419 South Korea
| | - John Bosco Balaguru Rayappan
- Centre for Nanotechnology & Advanced Biomaterials (CeNTAB) SASTRA Deemed University Thanjavur 613 401 Tamil Nadu India
- School of Electrical & Electronics Engineering SASTRA Deemed University Thanjavur 613 401 Tamil Nadu India
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Women with obesity participate less in cervical cancer screening and are more likely to have unsatisfactory smears: Results from a nationwide Danish cohort study. Prev Med 2022; 159:107072. [PMID: 35460722 DOI: 10.1016/j.ypmed.2022.107072] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/22/2022] [Accepted: 04/18/2022] [Indexed: 11/21/2022]
Abstract
Some studies found an association between obesity and increased cervical cancer risk, but potential mechanisms are unknown. In this nationwide register-based cohort study, we investigated the association between overweight/obesity and cervical cancer screening participation and risk of unsatisfactory smears. The study population was identified in the Danish Medical Birth Registry. We included 342,526 women aged 23-49 years with pre-pregnancy body mass index (BMI) registered during 2004-2013. Screening participation and unsatisfactory smears during up to four years after child birth were identified in a nationwide pathology register. We used absolute risk regression to estimate the relative absolute risk (RAR) with 95% confidence intervals (CIs) of screening participation according to BMI, adjusted for age, calendar year, sociodemographic characteristics, parity and previous high-grade cervical intraepithelial neoplasia. Among those who were screened (n = 295,482), we used log-binomial regression to investigate the relative risk (RR) of an unsatisfactory smear according to BMI, adjusted for age, year, parity, oral contraceptive use and pathology department. A lower proportion of obese women (79.3%) than women of normal weight (85.8%) were screened, and obese women had lower adjusted probability of being screened than women of normal weight (RARadjusted = 0.94, 95% CI, 0.93-0.95). A higher proportion of obese women (2.4%) than women of normal weight (1.7%) had an unsatisfactory smear, and this association remained after adjustments (RRadjusted = 1.28, 95% CI, 1.19-1.38). In conclusion, women with obesity were less likely to participate in cervical cancer screening and more likely to have an unsatisfactory smear than women of normal weight.
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Comorbidity Profiles and Lung Cancer Screening among Older Adults: U.S. Behavioral Risk Factor Surveillance System 2017 to 2019. Ann Am Thorac Soc 2021; 18:1886-1893. [PMID: 33939595 DOI: 10.1513/annalsats.202010-1276oc] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
RATIONALE Although lung cancer screening (LCS) with low-dose computed tomography (LDCT) is now recommended for those meeting standard risk factor-based eligibility criteria, the role of comorbidity in the uptake of LCS with LDCT in an older real-world U.S. population is not well established. OBJECTIVE To examine the relationships between comorbidity, functional status and LCS utilization in the United States. METHODS Using population-based data from the 2017-2019 Behavioral Risk Factor Surveillance System (BRFSS), we examined the association of comorbid conditions and functional limitations regarding activities of daily living with LCS utilization among participants that met the LCS criteria based on the US Preventive Service Taskforce guidelines. We employed multivariable weighted logistic regression models to evaluate these associations, both overall and within subgroups defined by age (<65 vs. ≥65 years), gender, and smoking history. RESULTS Of 11,214 participants that met the eligibility criteria for LCS, 1731 (16%) underwent LCS with LDCT. The majority were white (90%), male (55%), former smokers (52%) and living with at least one chronic comorbid condition (77%). Over 28% had 3 or more comorbid conditions and approximately 40% of participants reported having some form of functional limitations. In the multivariable models, the likelihood of undergoing LCS with LDCT within the past year was positively associated with higher levels of comorbidity (≥5 vs. 0: aOR=2.34, 95% CI=1.22,4.48) but not with functional limitations (≥3 vs. 0: aOR=1.00, 95% CI=0.66, 1.50). CONCLUSION The presence of comorbid conditions is associated with a higher likelihood of undergoing LCS with LDCT. Because poor health status may diminish the benefits of screening, future research is needed to precisely characterize the health status of LCS-eligible individuals.
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Chou JF, Ford JS, Kleinerman RA, Abramson DH, Francis JH, Sklar CA, Oeffinger KC, Robison LL, Dunkel IJ, Friedman DN. General cancer screening practices among adult survivors of retinoblastoma: Results from the Retinoblastoma Survivor Study. Pediatr Blood Cancer 2021; 68:e28873. [PMID: 33501778 PMCID: PMC7904654 DOI: 10.1002/pbc.28873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 12/02/2020] [Accepted: 12/12/2020] [Indexed: 11/07/2022]
Abstract
We assessed breast, cervical, and colorectal cancer screening practices in adult retinoblastoma (Rb) survivors and non-Rb controls. We found that most Rb survivors adhered to general population cancer screening recommendations. Rates did not differ among Rb survivors and non-Rb controls, or among survivors by laterality, even though bilateral survivors reported higher levels of concern about future health and cancer risk. Older age, being overweight/obese, and lack of recent contact with medical personnel were independently associated with decreased utilization of Pap smear among female Rb survivors. Future studies are warranted to determine whether these associations might provide an opportunity for intervention.
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Affiliation(s)
- Joanne F. Chou
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Jennifer S. Ford
- Hunter College, Department of Psychology and The Graduate Center, New York, NY United States
| | | | - David H. Abramson
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
- Weill Cornell Medical College, New York, NY, United States
| | - Jasmine H. Francis
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
- Weill Cornell Medical College, New York, NY, United States
| | - Charles A. Sklar
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
- Weill Cornell Medical College, New York, NY, United States
| | | | | | - Ira J. Dunkel
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
- Weill Cornell Medical College, New York, NY, United States
| | - Danielle Novetsky Friedman
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
- Weill Cornell Medical College, New York, NY, United States
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Nunes MF, Leite AH, Dias SF. Inequalities in adherence to cervical cancer screening in Portugal. Eur J Cancer Prev 2021; 30:171-177. [PMID: 32732693 DOI: 10.1097/cej.0000000000000612] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Cervical cancer is the second cancer with the highest incidence and mortality in women aged 15-44 living in Europe. Screening is an effective strategy to reduce these rates, although in Portugal, as in other European countries, adherence to screening still presents significant disparities. Thus, this study aimed to assess the prevalence and factors associated with cervical cancer screening (CCS) nonadherence in Portugal. Cross-sectional data from 5929 women aged 25-64 included in the 2014 Portuguese National Health Survey (2014 NHS) were analyzed. The prevalence of CCS nonadherence was estimated. The association between multiple factors and CCS nonadherence was analyzed, using logistic regression, adjusting for age and educational level. The weighted prevalence of nonadherence was 13.2% [95% confidence interval (CI): 12.0-14.0]. Additionally, 10.5% of women had performed the last cervical cytology 3 years ago or more. Higher odds of nonadherence to screening were found for younger women, with low levels of education and income, unemployed, single, born outside Portugal, who never had a medical appointment or had over 12 months ago, who were never pregnant and who had never had a mammography. No association was found with other variables studied, including having public/private health insurance, BMI or smoking status. This study showed that inequalities in CCS adherence in Portugal persist. These findings reinforce the need for developing strategies to reduce inequalities in CCS adherence.
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Affiliation(s)
- Mariana F Nunes
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon
| | - Andreia H Leite
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon
- Unidade de Saúde Pública, Agrupamento de Centros de Saúde Amadora, Portugal
| | - Sónia F Dias
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon
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Jolidon V, De Prez V, Willems B, Bracke P, Cullati S, Burton-Jeangros C. Never and under cervical cancer screening in Switzerland and Belgium: trends and inequalities. BMC Public Health 2020; 20:1517. [PMID: 33028278 PMCID: PMC7542418 DOI: 10.1186/s12889-020-09619-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 09/27/2020] [Indexed: 12/18/2022] Open
Abstract
Background Research on inequalities in cervical cancer screening (CCS) participation has overlooked the distinction between ‘never-’ and ‘under-screeners’ while different socioeconomic and demographic determinants may underlie ‘non-’ and ‘under-’ screening participation. This study examines socioeconomic and demographic inequalities in never and under CCS participation. We compare cross-national prevalence and trends among these two groups in Switzerland and Belgium, two countries with similar opportunistic CCS strategy but different healthcare systems. Methods Data on 38,806 women aged 20–70 from the Swiss Health Interview Survey (1992–2012) and 19,019 women aged 25–64 from the Belgian Health Interview Survey (1997–2013), both population-based cross-sectional nationally representative surveys, was analysed. Weighted adjusted prevalence ratios were estimated with multivariate Poisson regressions. Results Over the studied period, never screening prevalence was about 15% in both Switzerland and Belgium and under screening prevalence about 14.0%. Socioeconomic gradients were found among both never- and under-screeners. Higher income women had lower never and under screening prevalence in Switzerland and a similar gradient in education was observed in Belgium. Importantly, distinct socioeconomic and demographic determinants were found to underlie never and under screening participation. Never screening was significantly higher among foreign nationals in both countries and this association was not observed in under screening. Never screening prevalence was lower among older age groups, while under screening increased with older age. Over time, age inequalities diminished among never- and under- screeners in Switzerland while educational inequalities increased among never-screeners in Belgium. Conclusion Findings revealed that determinants of screening inequalities differed among never- and under-screeners and hence these should be addressed with different public health strategies. Crucially, socioeconomic and demographic inequalities were more pronounced among never-screeners who appeared to face more structural and persistent inequalities. Differences between the two countries should also be noted. The more liberal-type Swiss healthcare systems appeared to shape income-related screening inequalities, while education appeared to be a stronger determinant of never- and under-screening in Belgium.
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Affiliation(s)
- Vladimir Jolidon
- Institute of Sociological Research, University of Geneva, 40 Bd du Pont-d'Arve, 1211, Genève 4, Switzerland.
| | - Vincent De Prez
- Department of Sociology, Ghent University, Korte Meer 5, 9000, Ghent, Belgium
| | - Barbara Willems
- Department of Sociology, Ghent University, Korte Meer 5, 9000, Ghent, Belgium
| | - Piet Bracke
- Department of Sociology, Ghent University, Korte Meer 5, 9000, Ghent, Belgium
| | - Stéphane Cullati
- Institute of Sociological Research, University of Geneva, 40 Bd du Pont-d'Arve, 1211, Genève 4, Switzerland.,Population Health Laboratory, University of Fribourg, Rte des Arsenaux 41, 1700, Fribourg, Switzerland
| | - Claudine Burton-Jeangros
- Institute of Sociological Research, University of Geneva, 40 Bd du Pont-d'Arve, 1211, Genève 4, Switzerland
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Harder E, Hertzum-Larsen R, Frederiksen K, Kjær SK, Thomsen LT. Non-participation in cervical cancer screening according to health, lifestyle and sexual behavior: A population-based study of nearly 15,000 Danish women aged 23-45 years. Prev Med 2020; 137:106119. [PMID: 32387298 DOI: 10.1016/j.ypmed.2020.106119] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 03/18/2020] [Accepted: 04/26/2020] [Indexed: 01/03/2023]
Abstract
High participation in cervical cancer screening is essential for an effective screening program. In this population-based study, we investigated associations between general health, lifestyle and sexual behavior, and non-participation in cervical cancer screening in Denmark. During 2011-2012, a random sample of women aged 18-45 years from the general female population were invited to participate in a survey regarding health, lifestyle and sexual habits. Altogether 18,631 women responded (response rate: 75.1%), of whom 14,271 women aged 23-45 years were included in this analysis. Information on screening participation within four years after response, and data on sociodemographic characteristics, was obtained from nationwide registers. Logistic regression was used to calculate odds ratios (ORs) for non-participation, crude and adjusted for sociodemographic characteristics. Overall, 13.9% of the women were not screened during follow-up. The odds of non-participation was increased in women who were overweight (ORadj. = 1.20; 95% CI, 1.06-1.35), obese (ORadj. = 1.46; 95% CI, 1.27-1.67), perceived themselves as much too fat (ORadj. = 1.50; 95% CI, 1.29-1.74), had poor self-perceived health (ORadj. = 1.22; 95% CI, 1.03-1.45) or smoked daily (ORadj. = 1.81; 95% CI, 1.61-2.03). Conversely, women with previous genital warts or other sexually transmitted infections, and young women with ≥10 lifetime sexual partners or ≥2 new recent partners, had decreased odds of non-participation. In conclusion, obesity, poor self-perceived health and daily smoking were associated with lower participation in cervical cancer screening. Interventions targeting these groups are needed.
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Affiliation(s)
- Elise Harder
- Unit of Virus, Lifestyle, and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Rasmus Hertzum-Larsen
- Unit of Virus, Lifestyle, and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Kirsten Frederiksen
- Unit of Statistics and Pharmacoepidemiology, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Susanne K Kjær
- Unit of Virus, Lifestyle, and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Louise T Thomsen
- Unit of Virus, Lifestyle, and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.
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15
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Rebolj M, Parmar D, Maroni R, Blyuss O, Duffy SW. Concurrent participation in screening for cervical, breast, and bowel cancer in England. J Med Screen 2020; 27:9-17. [PMID: 31525303 DOI: 10.1177/0969141319871977] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2024]
Abstract
Objectives To determine how many women participate in all three recommended cancer screening programmes (breast, cervical, and bowel). During their early 60s, English women receive an invitation from all the three programmes. Methods For 3060 women aged 60–65 included in an England-wide breast screening case–control study, we investigated the number of screening programmes they participated in during the last invitation round. Additionally, using the Fingertips database curated by Public Health England, we explored area-level correlations between participation in the three cancer screening programmes and various population characteristics for all 7014 English general practices with complete data. Results Of the 3060 women, 1086 (35%) participated in all three programmes, 1142 (37%) in two, 526 (17%) in one, and 306 (10%) in none. Participation in all three did not appear to be a random event (p < 0.001). General practices from areas with less deprivation, with more patients who are carers or have chronic illnesses themselves, and with more patients satisfied with the provided service were significantly more likely to attain high coverage rates in all programmes. Conclusions Only a minority of English women is concurrently protected through all recommended cancer screening programmes. Future studies should consider why most women participate in some but not all recommended screening.
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Affiliation(s)
- Matejka Rebolj
- Cancer Prevention Group, School of Cancer & Pharmaceutical Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Dharmishta Parmar
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Roberta Maroni
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Oleg Blyuss
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Department of Paediatrics, Sechenov University, Moscow, Russia
| | - Stephen W Duffy
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Zhang D, Advani S, Huchko M, Braithwaite D. Impact of healthcare access and HIV testing on utilisation of cervical cancer screening among US women at high risk of HIV infection: cross-sectional analysis of 2016 BRFSS data. BMJ Open 2020; 10:e031823. [PMID: 31911515 PMCID: PMC6955489 DOI: 10.1136/bmjopen-2019-031823] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 12/12/2019] [Accepted: 12/13/2019] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE Previous studies identified several factors associated with cervical cancer screening. However, many of them used samples from the general population and limited studies focused on women with high-risk health behaviours. We aimed to disentangle the association of cervical cancer screening with healthcare access and HIV testing among women at a high risk of HIV infection. DESIGN Nationwide cross-sectional survey in the USA. SETTING 2016 Behavioral Risk Factor Surveillance System. PARTICIPANTS 3448 women with a history of high-risk behaviours associated with HIV infection EXPOSURE AND OUTCOME: Clinical check-up, having personal healthcare provider, health coverage and HIV testing history were treated as exposures. Appropriate cervical cancer screening, which was defined according to 2016 US Preventive Services Task Force guideline, was treated as the outcome of interest. DATA ANALYSIS Multivariable logistic regression model was performed to evaluate associations of healthcare access and HIV testing with the uptake of cervical cancer screening; adjusted odds ratio (aOR) and 95% CI were reported. We further investigated if educational attainment modified associations identified in the primary multivariable model. RESULTS A total of 2911 (84.4%) high-risk women in our sample underwent cervical cancer screening. In the multivariable model, delayed clinical check-up (≥5 years ago vs within the past year: aOR: 0.19, 95% CI: 0.14 to 0.26), having no health insurance (aOR: 0.60, 95% CI: 0.46 to 0.79) and no history of HIV testing (no testing vs testing within the past year: aOR: 0.46, 95% CI: 0.35 to 0.61) were inversely associated with cervical cancer screening utilisation. CONCLUSION Factors reflecting healthcare access, specifically clinical check-up and health coverage, as well as history of HIV testing were associated with cervical cancer screening in this population-based study of high-risk women. Targeted interventions are warranted to further increase cervical cancer screening among women at high risk of HIV infection.
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Affiliation(s)
- Dongyu Zhang
- Department of Oncology, Georgetown University School of Medicine, Washington, District of Columbia, USA
| | - Shailesh Advani
- Department of Oncology, Georgetown University School of Medicine, Washington, District of Columbia, USA
- Social Behavioral Research Branch, National Institutes of Health, Bethesda, Maryland, USA
| | - Megan Huchko
- Department of Obstetrics and Gynecology, Duke Global Health Institute, Durham, North Carolina, USA
| | - Dejana Braithwaite
- Department of Oncology, Georgetown University School of Medicine, Washington, District of Columbia, USA
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Bhatia D, Lega IC, Wu W, Lipscombe LL. Breast, cervical and colorectal cancer screening in adults with diabetes: a systematic review and meta-analysis. Diabetologia 2020; 63:34-48. [PMID: 31650239 DOI: 10.1007/s00125-019-04995-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 08/09/2019] [Indexed: 12/24/2022]
Abstract
AIMS/HYPOTHESIS Individuals with diabetes are at increased risk of developing and dying from cancer. Evidence-based guidelines recommend universal screening for breast, cervical and colorectal cancer; however, evidence on the uptake of these tests in individuals with diabetes is mixed. We conducted a meta-analysis to quantify the association between diabetes and participation in breast, cervical and colorectal cancer screening. METHODS MEDLINE, EMBASE and CINAHL were searched systematically for publications between 1 January 1997 and 18 July 2018. The search was supplemented by handsearching of reference lists of the included studies and known literature reviews. Abstracts and full texts were assessed in duplicate according to the following eligibility criteria: study conducted in the general population; diabetes included as a predictor vs a comparison group without diabetes; and breast (mammography), cervical (Papanicolaou smear) or colorectal (faecal and endoscopic tests) cancer screening uptake included as an outcome. Random-effects meta-analyses were performed using the most-adjusted estimates for each cancer site. RESULTS Thirty-seven studies (25 cross-sectional, 12 cohorts) were included, with 27 studies on breast, 19 on cervical and 18 on colorectal cancer screening. Having diabetes was associated with significantly lower likelihood of breast (adjusted OR 0.83 [95% CI 0.77, 0.90]) and cervical (OR 0.76 [95% CI 0.71, 0.81]) cancer screening, relative to not having diabetes. Colorectal cancer screening was comparable across groups with and without diabetes (OR 0.95 [95% CI 0.86, 1.06]); however, women with diabetes were less likely to receive a colorectal cancer screening test than women without diabetes (OR 0.86 [95% CI 0.77, 0.97]). CONCLUSIONS/INTERPRETATION Our findings suggest that women with diabetes have suboptimal breast, cervical and colorectal cancer screening rates, compared with women without diabetes, although the absolute differences might be modest. Given the increased risk of cancer in this population, higher quality prospective evidence is necessary to evaluate the contribution of diabetes to cancer screening disparities in relation to other patient-, provider- and system-level factors. REGISTRATION PROSPERO registration ID CRD42017073107.
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Affiliation(s)
- Dominika Bhatia
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Iliana C Lega
- Women's College Research Institute, Women's College Hospital, 76 Grenville Street, Toronto, ON, M5S 1B2, Canada
| | - Wei Wu
- Women's College Research Institute, Women's College Hospital, 76 Grenville Street, Toronto, ON, M5S 1B2, Canada
| | - Lorraine L Lipscombe
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
- Women's College Research Institute, Women's College Hospital, 76 Grenville Street, Toronto, ON, M5S 1B2, Canada.
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The determinants of cervical cancer screening uptake in women with obesity: application of the Andersen's behavioral model to the CONSTANCES survey. Cancer Causes Control 2019; 31:51-62. [PMID: 31797124 DOI: 10.1007/s10552-019-01251-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 11/18/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Despite their higher risk for and mortality from cervical cancer, evidence indicates low rates of cervical cancer screening (CCS) among women with obesity. The literature on the specific factors related to CCS nonadherence in this population is limited. METHODS We examined the data on 2,934 women with obesity included in the CONSTANCES survey from 2012 to 2015. Using the Andersen's behavioral model, we studied the relationships between the socioeconomic, sociodemographic, health, health personal behaviors, and healthcare use-related factors with CCS nonadherence. The analysis was performed using structural equation models. RESULTS Regular follow-up by a gynecologist, good quality of primary care follow-up, and comorbidities were negatively associated with CCS nonadherence. Limited literacy, older age, being single, living without children, and financial strain were positively associated with CCS nonadherence. Our results do not point to competitive care, since women with comorbidities had better CCS behaviors, which were explained by a good quality of primary care follow-up. CONCLUSION Our study identified the factors that explain CCS nonadherence among women with obesity and clarified the effects of health status and healthcare use on screening. Further efforts should be undertaken to reduce the obstacles to CCS by improving care among women with obesity.
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Bremer D, Lüdecke D, von dem Knesebeck O. Social Relationships, Age and the Use of Preventive Health Services: Findings from the German Ageing Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16214272. [PMID: 31689892 PMCID: PMC6862648 DOI: 10.3390/ijerph16214272] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 10/28/2019] [Accepted: 10/30/2019] [Indexed: 01/01/2023]
Abstract
This paper investigates the associations between social relationships, age and the use of preventive health services among German adults. Data stem from the German Ageing Survey (10,324 respondents). The use of preventive health services was assessed by asking for regular use of flu vaccination and cancer screening in the past years. Predictors of interest were structural (having a partner, size of the social network) and functional aspects of social relationships (perceived informational support) and age. Logistic regression models were used to measure the associations between preventive health services use and these predictors. Self-perceived health, gender and education were considered as covariates. Having a partner (OR = 1.20, 95% CI: 1.07-1.34) and perceived informational support (OR = 1.38, 95% CI: 1.13-1.69) were associated with a higher probability of getting flu vaccination regularly over the past years. Informational support (OR = 1.42, 95% CI: 1.17-1.72) and having a partner (OR = 1.57, 95% CI: 1.41-1.75) were positively associated with regular cancer screening over the past years. Associations between the size of the social network and use of preventive health services were not statistically significant. Associations between the use of preventive health services and social relationships varied by age. Structural and functional aspects of social relationships may support preventive health behavior. To increase preventive health behavior and the use of preventive health services, it is necessary to integrate information on social relationships into routine care and to strengthen sources of social support.
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Affiliation(s)
- Daniel Bremer
- Department of Medical Psychology & Center for Health Care Research, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
| | - Daniel Lüdecke
- Department of Medical Sociology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
| | - Olaf von dem Knesebeck
- Department of Medical Sociology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
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20
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Guidelines for Cervical Cancer Screening in Immunosuppressed Women Without HIV Infection. J Low Genit Tract Dis 2019; 23:87-101. [DOI: 10.1097/lgt.0000000000000468] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Zhang D, Zhang C, Sun X, Zhao Y, Tan Q, Zhou J, Huang H. BMI, Physical Inactivity, and Pap Test Use in Asian Women in the U.S. Am J Prev Med 2019; 56:e85-e94. [PMID: 30655085 DOI: 10.1016/j.amepre.2018.10.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 10/09/2018] [Accepted: 10/10/2018] [Indexed: 01/03/2023]
Abstract
INTRODUCTION In the U.S., limited epidemiologic studies have investigated associations between BMI and physical inactivity and Pap test use among Asian women. The aim was to disentangle associations using data from the Behavioral Risk Factor Surveillance System between 2014 and 2016. METHODS In the Behavioral Risk Factor Surveillance System, BMI was categorized into four levels (<18.5, 18.5 to <25, 25 to <30, and ≥30) and inactivity was defined as having no physical activity in addition to the individual's regular job during the past month. Analyses were conducted in June 2018. Weighted percentages of covariates were used to descriptively summarize the data. Multivariable logistic regression corrected for sampling weight was used to estimate associations between BMI and inactivity and Pap test use. Subgroup analysis was conducted by income and education. RESULTS The analysis included 9,424 women and 59.6% of them had their last Pap test within 3 years. OR in the mutually adjusted model suggested underweight (BMI <18.5 compared with normal weight) was inversely associated with Pap test use within the last 3 years (OR=0.56, 95% CI=0.36, 0.88). Inactivity (compared with activity) was not associated with Pap test use within the last 3 years (OR=0.80, 95% CI=0.60, 1.06). Different association patterns of BMI and inactivity were observed by education. CONCLUSIONS This study suggests that being underweight, rather than overweight or obesity, is associated with a lower rate of Pap test use in U.S. Asian women. Health interventions to facilitate Pap test use in Asian women should explore other potential targets, not aiming to just prevent obesity or change physical inactivity.
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Affiliation(s)
- Dongyu Zhang
- Department of Oncology, Georgetown University School of Medicine, Washington, District of Columbia.
| | - Chengchen Zhang
- Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, Maryland
| | - Xuezheng Sun
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Yuan Zhao
- Department of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Qi Tan
- Department of Biostatistics, Yale University School of Public Health, New Haven, Connecticut
| | - Junmin Zhou
- West China School of Public Health, Sichuan University, Chengdu, China
| | - Hongtai Huang
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco School of Medicine, San Francisco, California
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Vassilakos P, Poncet A, Catarino R, Viviano M, Petignat P, Combescure C. Cost-effectiveness evaluation of HPV self-testing offered to non-attendees in cervical cancer screening in Switzerland. Gynecol Oncol 2019; 153:92-99. [PMID: 30718124 DOI: 10.1016/j.ygyno.2019.01.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 01/17/2019] [Accepted: 01/22/2019] [Indexed: 01/10/2023]
Abstract
OBJECTIVE About 30% of women who are eligible for cervical cancer (CC) screening remain un-screened or under-screened in Switzerland. HPV testing on self-collected vaginal samples (Self-HPV) has shown to be more sensitive than cytology while also reaching non-attendees. The objective of this study was to explore the cost-effectiveness of offering Self-HPV to non-attendees in Switzerland. METHODS A recursive decision-tree with one-year cycles was used to model the life-long natural HPV history. Markov cohort simulations were used to assess the expected outcomes from the model. The outcomes of three strategies were compared with the absence of screening: Self-HPV and triage with colposcopy (Self-HPV/colpo), Self-HPV and triage with Pap cytology (Self-HPV/PAP), cytological screening and triage with HPV (PAP/HPV). Sensitivity analyses for the key parameters of the model were conducted to check the robustness of findings. RESULTS Offering a Self-HPV screening to non-attendees could prevent 90% of CC and 94% of CC-related deaths in the study population. The current cytology-based program could reduce by 83% the number of CC cases and by 88% the number of CC-related deaths over the population's lifetime. Compared to the absence of screening, incremental cost-effectiveness ratios (ICER) were estimated to be, per saved Quality Adjusted Life Year (QALY), 12413US$ for the strategy Self-HPV/colpo, 11138US$ for the strategy Self-HPV/Pap and 22488US$ for the strategy PAP/HPV. CONCLUSIONS Offering Self-HPV as a CC screening strategy to non-attendees in Switzerland is a cost-effective solution that is associated with a reduction of CC cases and related deaths. Self-HPV is more cost-effective than the currently used cytology-based screening.
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Affiliation(s)
- Pierre Vassilakos
- Geneva Foundation for Medical Education and Research, route de Ferney 150, 1211 Geneva, Switzerland; Department of Gynaecology and Obstetrics, Geneva University Hospitals, Boulevard de la Cluse 30, 1205 Geneva, Switzerland
| | - Antoine Poncet
- Division of Clinical Epidemiology, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland
| | - Rosa Catarino
- Department of Gynaecology and Obstetrics, Geneva University Hospitals, Boulevard de la Cluse 30, 1205 Geneva, Switzerland.
| | - Manuela Viviano
- Department of Gynaecology and Obstetrics, Geneva University Hospitals, Boulevard de la Cluse 30, 1205 Geneva, Switzerland
| | - Patrick Petignat
- Department of Gynaecology and Obstetrics, Geneva University Hospitals, Boulevard de la Cluse 30, 1205 Geneva, Switzerland
| | - Christophe Combescure
- Division of Clinical Epidemiology, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland
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Stepwise strategy to improve cervical cancer screening adherence (SCAN-Cervical Cancer) - Automated text messages, phone calls and reminders: Population based randomized controlled trial. Prev Med 2018; 114:123-133. [PMID: 29894717 DOI: 10.1016/j.ypmed.2018.06.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 04/24/2018] [Accepted: 06/08/2018] [Indexed: 11/20/2022]
Abstract
UNLABELLED The aim of this study was to test the effectiveness of invitation to cervical cancer screening through a very low-cost strategy based on automated and customized text messages, phone calls and reminders. A randomized (1:1) controlled trial was conducted among 13 Portuguese primary care units, recruiting women aged 25 to 49 years, eligible for cervical cancer screening, with an available mobile phone number. In the intervention group, participants were invited for cervical cancer screening through automated/customized text messages and phone calls, followed by text message reminders. Participants in the control group were invited through a written letter (standard of care). The primary outcome was the proportion of women adherent to screening up to 45 days after invitation and the secondary outcome was defined as the adherence proportion after invitation based only on text messages and reminders. A total of 1220 women were randomized, 605 to intervention and 615 to control group. The adherence to cervical cancer was significantly higher among women assigned to intervention (39.0% vs. 25.7%, p < 0.001); this corresponds to a difference of 13.3% (95% CI 8.1 to 18.5). The difference in adherence between an invitation strategy based only on text messages and reminders and the standard of care was -0.4%, 95% CI -5.3 to 4.5. In conclusion, an invitation to cervical cancer screening using automated text messages/phone calls and reminders increases the adherence to cervical cancer screening. Such a low-cost and operator-independent strategy of invitation may contribute to the sustainability of organized screening programs. TRIAL REGISTRATION NUMBER NCT03122275.
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Harder E, Thomsen LT, Hertzum-Larsen R, Albieri V, Hessner MV, Juul KE, Bonde J, Frederiksen K, Kjaer SK. Determinants for Participation in Human Papillomavirus Self-Sampling among Nonattenders to Cervical Cancer Screening in Denmark. Cancer Epidemiol Biomarkers Prev 2018; 27:1342-1351. [DOI: 10.1158/1055-9965.epi-18-0480] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 06/25/2018] [Accepted: 08/03/2018] [Indexed: 11/16/2022] Open
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Harder E, Juul KE, Jensen SM, Thomsen LT, Frederiksen K, Kjaer SK. Factors associated with non-participation in cervical cancer screening - A nationwide study of nearly half a million women in Denmark. Prev Med 2018; 111:94-100. [PMID: 29501474 DOI: 10.1016/j.ypmed.2018.02.035] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 02/19/2018] [Accepted: 02/26/2018] [Indexed: 11/26/2022]
Abstract
Cervical cancer occurs most often in under-screened women. In this nationwide register study, we described differences in sociodemographic characteristics between passive and active non-participants and examined socio-demographic characteristics, reproductive history, and mental and physical health as potential determinants for passive non-participation compared with participation in the Danish cervical cancer screening program. Screening history in women aged 23-49 years invited for cervical cancer screening in 2008-2009 was retrieved from the Danish Pathology Databank with information about dates of invitation and unsubscription. We identified participants (n = 402,984), active non-participants (n = 10,251) and passive non-participants (n = 63,435) within four years following baseline invitation and retrieved data about the study population from high-quality registries. We examined differences in socio-demographic characteristics of passive and active non-participants, and used multiple logistic regression analyses to identify potential determinants of passive non-participation. We found that active and passive non-participants differed in relation to socio-demography. When compared with screening participants, the odds of passive non-participation was increased in women who originated from less developed countries; were unmarried; had basic education or low income; had four or more children; smoked during pregnancy; had multiple induced abortions; or had a history of obesity, intoxicant abuse or schizophrenia or other psychoses. In conclusion, in this nationwide, prospective, population-based study, differences in socio-demographic characteristics between passive and active non-participants were found. Furthermore, sociodemography, reproductive history, and mental and physical health were determinants for passive non-participation. Addressing inequalities in screening attendance may help to further decrease the incidence of and mortality from cervical cancer.
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Affiliation(s)
- Elise Harder
- Unit of Virus, Lifestyle, and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark
| | - Kirsten E Juul
- Unit of Virus, Lifestyle, and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark
| | - Signe M Jensen
- Unit of Statistics and Pharmacoepidemiology, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark
| | - Louise T Thomsen
- Unit of Virus, Lifestyle, and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark
| | - Kirsten Frederiksen
- Unit of Statistics and Pharmacoepidemiology, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark
| | - Susanne K Kjaer
- Unit of Virus, Lifestyle, and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark; Department of Gynecology, Rigshospitalet, University of Copenhagen, Juliane Maries Vej 8, 2100 Copenhagen, Denmark.
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Bao H, Zhang L, Wang L, Zhang M, Zhao Z, Fang L, Cong S, Zhou M, Wang L. Significant variations in the cervical cancer screening rate in China by individual-level and geographical measures of socioeconomic status: a multilevel model analysis of a nationally representative survey dataset. Cancer Med 2018; 7:2089-2100. [PMID: 29573569 PMCID: PMC5943548 DOI: 10.1002/cam4.1321] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 12/07/2017] [Accepted: 12/08/2017] [Indexed: 02/06/2023] Open
Abstract
Variations in cervical cancer screening rates in China have rarely been studied in depth. This study aimed to investigate cervical cancer screening rates in relation to both individual‐level and geographical measures of socioeconomic status (SES). Data were obtained from women aged 21 years or older by face‐to‐face interviews between August 2013 and July 2014 as part of the Chinese Chronic Diseases and Risk Factors Surveillance. The geographical variables were obtained from the 2010 Chinese population census. The cervical cancer screening rates and 95% confidence interval (CI) were estimated and mapped. Multilevel logistic regression models were fitted. Overall, only 21.4% (95% CI: 19.6–23.1%) of 91,816 women aged ≥21 years reported having ever been screened for cervical cancer and significant geographical variations at both province and county levels were identified (P < 0.01). The cervical cancer screening rates were the lowest among the poor [13.9% (95% CI: 12.1–15.7%)], uninsured [14.4% (95% CI: 10.3–18.4%)], less‐educated [16.0% (95% CI: 14.3–17.6%)], and agricultural employment [18.1% (95% CI: 15.8–20.4%)] women along with those residing in areas of low economic status [15.0% (95% CI: 11.8–18.2%)], of low urbanization [15.6% (95% CI: 13.4–17.7%)], and of low education status [16.0% (95% CI: 14.0–18.1%)]. The multilevel analysis also indicated that women with lower individual‐level measures of SES residing in areas with low geographical measures of SES were significantly less likely to receive cervical cancer screening (P < 0.0001). Despite the launch of an organized cancer screening program in China, cervical cancer screening rates remain alarmingly low and significant variations based on geographical regions and measures of SES still exist. It is therefore essential to adopt strategies to better direct limited available public resources to priority groups.
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Affiliation(s)
- Heling Bao
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lei Zhang
- Research Centre for Public Health, Tsinghua University, Beijing, China.,Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia.,Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.,School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Limin Wang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Mei Zhang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhenping Zhao
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Liwen Fang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shu Cong
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Maigeng Zhou
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Linhong Wang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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Petkeviciene J, Ivanauskiene R, Klumbiene J. Sociodemographic and lifestyle determinants of non-attendance for cervical cancer screening in Lithuania, 2006–2014. Public Health 2018; 156:79-86. [DOI: 10.1016/j.puhe.2017.12.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 11/29/2017] [Accepted: 12/16/2017] [Indexed: 01/21/2023]
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Fujiwara M, Inagaki M, Nakaya N, Fujimori M, Higuchi Y, Kakeda K, Uchitomi Y, Yamada N. Association between serious psychological distress and nonparticipation in cancer screening and the modifying effect of socioeconomic status: Analysis of anonymized data from a national cross-sectional survey in Japan. Cancer 2017; 124:555-562. [PMID: 29076156 DOI: 10.1002/cncr.31086] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 09/19/2017] [Accepted: 09/28/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND It is unclear whether individuals who have serious psychological distress (SPD) are less likely to participate in screening tests for gastric cancer, lung cancer, and other types of cancer. Of the few studies that have examined the association between SPD and participation in cancer screening, none have reported modifying effects of educational, marital, or employment status. METHODS The authors analyzed a national representative data set from the 2010 Comprehensive Survey of Living Conditions of Japan., including individuals aged <69 years who met the national program criteria for each type of cancer screening (colorectal, gastric, and lung cancers, n = 29,926; breast cancer, n = 15,423; and cervical cancer, n = 24,735). SPD was defined as a score of 13 or greater on the Kessler 6 scale. Logistic regression analyses were conducted to examine the association between SPD and participation in cancer screening, and multivariate analyses stratified by socioeconomic status also were conducted. RESULTS SPD was significantly associated with a lower odds ratio (OR) for participation in screening for colorectal cancer (OR, 0.743; 95% confidence interval [CI], 0.638-0.866), gastric cancer (OR, 0.823; 95% CI, 0.717-0.946), and lung cancer (OR, 0.691; 95% CI, 0.592-0.807). Only educational status significantly modified the effect of SPD on participation in these 3 types of cancer screening (P < .05). CONCLUSIONS Individuals with SPD, especially those with lower education levels, were less likely to participate in screening for colorectal, gastric, and lung cancers. Individuals with SPD should be encouraged and supported to participate in cancer screening tests. Cancer 2018;124:555-62. © 2017 American Cancer Society.
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Affiliation(s)
- Masaki Fujiwara
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama, Japan
| | - Masatoshi Inagaki
- Department of Neuropsychiatry, Okayama University Hospital, Okayama, Japan
| | - Naoki Nakaya
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Maiko Fujimori
- Division of Cohort Consortium Research, Epidemiology and Prevention Group/Division of Health Care Research, QOL Research Group,Center for Public Health Sciences,National Cancer Center, Tokyo, Japan
| | - Yuji Higuchi
- Department of Psychiatry, Taiyo Hills Hospital, Okayama, Japan
| | - Kyoko Kakeda
- Department of Neuropsychiatry, Kochi Medical School, Kochi University, Kochi, Japan
| | - Yosuke Uchitomi
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan
| | - Norihito Yamada
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama, Japan
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Effect of vitamin E supplementation on uterine cervical neoplasm: A meta-analysis of case-control studies. PLoS One 2017; 12:e0183395. [PMID: 28829815 PMCID: PMC5567498 DOI: 10.1371/journal.pone.0183395] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 08/03/2017] [Indexed: 12/28/2022] Open
Abstract
Several epidemiological studies have suggested that vitamin E could reduce the risk of uterine cervical neoplasm. However, controversial data were presented by different reports. Hence, we conducted a meta-analysis to assess the relationship between vitamin E and the risk of cervical neoplasia. We performed a comprehensive search of the PubMed, Embase and Cochrane databases through December 31, 2016. Based on a fixed-effects or random-effects model, the odds ratio (OR) and 95% confidence intervals (CIs) were calculated to assess the combined risk. Subgroup analyses and meta-regression were done to assess the source of heterogeneity. Subgroup analyses were performed according to survey ways, types of cervical neoplasia, study populations. A protocol was registered with PROSPERO (No. CRD42016036672). In total, 15 case-control studies were included, involving 3741 cases and 6328 controls. Our study suggested that higher category of vitamin E could reduce the cervical neoplasia risk (OR = 0.58, 95% CIs = 0.47–0.72, I2 = 83%). In subgroup-analysis, both vitamin E intake and blood levels of vitamin E had a significant inverse association with the risk of cervical neoplasm. Additionally, we found the same relationship between vitamin E and cervical neoplasia among different populations and types of cervical neoplasia. Meta-regression showed that none of the including covariates were significantly related to the outcomes. No evidence of publication bias was observed. In conclusion, vitamin E intake and blood vitamin E levels were inversely associated with the risk of cervical neoplasia.
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Diaz A, Kang J, Moore SP, Baade P, Langbecker D, Condon JR, Valery PC. Association between comorbidity and participation in breast and cervical cancer screening: A systematic review and meta-analysis. Cancer Epidemiol 2017; 47:7-19. [DOI: 10.1016/j.canep.2016.12.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 12/11/2016] [Accepted: 12/22/2016] [Indexed: 01/08/2023]
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Impact of Physical Inactivity on Risk of Developing Cancer of the Uterine Cervix: A Case-Control Study. J Low Genit Tract Dis 2017; 20:230-3. [PMID: 27105330 DOI: 10.1097/lgt.0000000000000210] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE In this study, we investigated whether physical inactivity was associated with risk of cervical cancer in women treated at an American cancer hospital. METHODS This case-control study included 128 patients with cervical cancer and 512 controls matched on age. Controls were women suspected of having but not ultimately diagnosed with a neoplasm. Physical inactivity was defined in accordance with the 2008 Physical Activity Guidelines for Americans. Thus, participants reporting, on average, no moderate or vigorous recreational physical activity were classified as inactive. Unconditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS Compared with noncancer controls, those with cervical cancer had significantly increased odds of reporting abstinence from recreational physical activity (OR, 2.43; 95% CI, 1.56-3.80). No association was noted between occupational-related physical inactivity and cervical cancer (OR, 0.88; 95% CI, 0.58-1.36). CONCLUSIONS Our findings suggest that abstinence from regular recreational physical activity is associated with increased odds of cervical cancer. To our knowledge, this is the first US-based study examining these associations. Given the 2008 Physical Activity Guidelines for Americans, this study has identified yet another potential public health benefit to regular physical activity. Further investigation is needed using a larger sample and prospectively collected data to characterize dose of activity to mitigate risk and the optimal window of susceptibility.
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Theme Filha MM, Leal MDC, Oliveira EFVD, Esteves-Pereira AP, Gama SGND. Regional and social inequalities in the performance of Pap test and screening mammography and their correlation with lifestyle: Brazilian national health survey, 2013. Int J Equity Health 2016; 15:136. [PMID: 27852313 PMCID: PMC5112710 DOI: 10.1186/s12939-016-0430-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 09/01/2016] [Indexed: 11/13/2022] Open
Abstract
Background Mass population screening for the early detection of cervical and breast cancer has been shown to be a safe and effective strategy worldwide and has reduced the incidence and mortality rates of these diseases. The aim of this study is to analyse the reach of screening tests for cervical and breast cancer according to sociodemographic variables and to analyse their correlation with a healthy lifestyle. Methods We have analysed data collected from 31.845 women aged 18 and over, who were interviewed for the Brazilian National Health Survey, a nationwide household inquiry, which took place between August 2013 and February 2014. The Pap tests performed in the last 3 years in women aged between 25 and 64 and screening mammogram performed in the last 2 years in women aged between 50 and 69 were considered adequate. We identified habits that constitute a healthy lifestyle, such as the consumption of five or more daily servings of fruits and vegetables, 30 min or more of leisurely physical activity and not smoking. Results We observed that the Pap test (78.8 %) was more widespread than the screening mammogram (54.5 %), with significant geographical and social differences concerning access to health care. Access for such screening was higher for women living in more developed regions (Southeast and South), who were white-skinned, better educated, living with a partner and, especially, who were covered by private health insurance. Those who underwent the tests according to established protocols also had a healthy lifestyle, which corroborates the healthy behaviour pattern of damage prevention. Conclusion Despite the progress made, social disparity still defines access to screening tests for cervical and breast cancer, with women covered by private health insurance tending to benefit the most. It is necessary to reduce social and regional inequalities and ensure a more uniform provision and access to the tests, especially for socially disadvantaged women, in order to reduce the incidence and mortality rate resulting from the aforementioned diseases.
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Affiliation(s)
- Mariza Miranda Theme Filha
- Department of Epidemiology and Quantitative Methods in Health, Sérgio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil. .,Escola Nacional de Saúde Pública Sérgio Arouca-ENSP/FIOCRUZ, Rua Leopoldo Bulhões 1480 sala 813, Manguinhos, 20041-210, RJ, Brazil.
| | - Maria do Carmo Leal
- Department of Epidemiology and Quantitative Methods in Health, Sérgio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Elaine Fernandes Viellas de Oliveira
- Department of Epidemiology and Quantitative Methods in Health, Sérgio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Ana Paula Esteves-Pereira
- Department of Epidemiology and Quantitative Methods in Health, Sérgio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Silvana Granado Nogueira da Gama
- Department of Epidemiology and Quantitative Methods in Health, Sérgio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
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Sözmen K, Unal B, Sakarya S, Dinc G, Yardim N, Keskinkilic B, Ergör G. Determinants of Breast and Cervical Cancer Screening Uptake Among Women in Turkey. Asia Pac J Public Health 2016; 28:528-38. [DOI: 10.1177/1010539516654541] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The aim of the study was to assess the influence of sociodemographic characteristics on breast and cervical cancer screening among women 30 years and older in Turkey. We used data from the National Chronic Diseases and Risk Factors Survey conducted by the Ministry of Health in 2011. Multivariate logistic regression analysis was used to assess the association of sociodemographic factors, lifestyle variables, and cancer screening. Overall, 22.0% of women ever had a Pap smear test for cervical cancer screening and 19.0% ever had a mammography for breast cancer screening(n = 6846). Individuals with a university degree, social security, doing moderate physical activity, and consuming 5 portions of fruit or vegetable/day were more likely to receive Pap smear test and mammography. Residing in the eastern region and living in rural area was associated with lower likelihood of receiving both types of screening.
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Affiliation(s)
| | | | | | | | - Nazan Yardim
- Turkish Institute of Public Health, Ministry of Health, Ankara, Turkey
| | - Bekir Keskinkilic
- Turkish Institute of Public Health, Ministry of Health, Ankara, Turkey
| | - Gül Ergör
- Dokuz Eylul University, Izmir, Turkey
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