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Abstract
BACKGROUND It is unclear which psychological factors (stressors, emotional correlates, and psychophysiological markers) induce cancer risk. This currently limits the potential for prevention strategies. PURPOSE The aim of this review is to bring forth evidence of stress as a determinant of cancer risk from a public health perspective, written for a broad public of practitioners and scientists. METHODS Based on a semisystematic literature search, the impact of different aspects/types of stress and the potential physiological and behavioral pathways are summarized, while highlighting further research, public health and clinical implications. RESULTS Between 2007 and 2020, 65 case-control or cohort studies have been identified. Apart from overall cancer ( N = 24), 12 cancer types have been associated with psychological stress with most for breast ( N = 21), colorectal ( N = 11) and lung/prostate/pancreas cancer ( N = 8 each). Although the evidence regarding the mechanisms is still scarce, cancer development in relation to stress might be due to interacting and combined effects of different stress(or) types, but such interaction has not really been tested yet. The path from stress towards cancer incidence consists of a biological pathway with endocrinology and immunology as well as stress-induced behavioral pathways, including smoking, alcoholism, sleep disruption, an unhealthy diet, and low physical activity together with the related phenomenon of obesity. CONCLUSION Not only the stress but also the stress-induced lifestyle should be targeted for cancer prevention and treatment. Future research should include a more diverse spectrum of cancer types (not only hormonal related like breast cancer) and of stress measures while also considering behavioral covariates.
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Affiliation(s)
- Ananyaa Mohan
- Friedman School of Nutrition Science and Policy, Boston, Massachusetts, USA
| | - Inge Huybrechts
- International Agency for Research on Cancer, Nutrition and Metabolism Section, Lyon, France and Departments of
| | - Nathalie Michels
- Public Health and Primary Care
- Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
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Liu D, Schuchard H, Burston B, Yamashita T, Albert S. Interventions to Reduce Healthcare Disparities in Cancer Screening Among Minority Adults: a Systematic Review. J Racial Ethn Health Disparities 2021; 8:107-126. [PMID: 32415578 DOI: 10.1007/s40615-020-00763-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 12/16/2019] [Accepted: 04/14/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Racial minority populations face an increased burden relative to cancer interventions. Compared with Caucasians, the cancer screening rate is substantially lower among African American, Asian American, Latinx American, and American Indian/Alaska Native populations. Barriers such as low health literacy, lack of health insurance, and miscommunication between patients and providers have been identified as important factors that result in low screening rates among minority adults. This study was designed to identify interventions targeting racial minority adults 40 years of age or older that were effective in increasing cancer screening uptake rates. METHODS A systematic review of articles published in and after January 2009 was conducted using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Twenty-six published studies of cancer screening intervention tested with minority adults were identified through the searches of CINAHL, Global Health, PsycINFO, PubMed, and Scopus databases. RESULTS Thirteen (50%) of the studies utilized lay community health workers to increase cancer awareness and knowledge and to encourage screening. These methods took place over the telephone, at community education sessions, or within the context of personalized patient navigation support. The intervention programs utilized culturally relevant materials as well as spoken and written information in the targeted population's native language. Various intervention designs resulted in statistically significant increases in cancer screening adherence. However, we found no intervention that consistently elevated cancer screening rates across all racial/ethnic minority adults. CONCLUSIONS The finding suggests that highly segmented interventions are needed in order to improve cancer screening among various racial/ethnic minority adults.
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Affiliation(s)
- Darren Liu
- Department of Public Health, Des Moines University, 3200 Grand Avenue, Des Moines, IA, 50312, USA.
| | - Hayley Schuchard
- College of Osteopathic Medicine, Des Moines University, Des Moines, IA, USA
| | - Betty Burston
- Department of Health Care Administration and Policy, University of Nevada Las Vegas, Las Vegas, NV, USA
| | - Takashi Yamashita
- Department of Sociology, Anthropology, and Health Administration and Policy, University of Maryland, Baltimore County, Baltimore, MD, USA
| | - Steven Albert
- Department of Behavioral & Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
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Cadet T, Burke SL, Bakk L, Nedjat-Haiem FR, Schroepfer T. Attending to the Psychosocial Needs of Older Hispanic, Black and Non-Hispanic White Women and Their Breast Cancer Screening Behaviors. J Natl Med Assoc 2020; 113:342-350. [PMID: 34278988 DOI: 10.1016/j.jnma.2020.09.145] [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: 06/06/2020] [Revised: 09/03/2020] [Accepted: 09/29/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cancer risk increases with age. Despite breast cancer screening guidelines, older minorities are less likely to obtain screenings. Many factors influence cancer screening participation, though the literature rarely examines factors influencing cancer screening in older adult minority populations. METHODS Using 2008 and 2012 waves of data from the Health and Retirement study, we examined and compared the relationships between psychosocial factors and breast screening participation among older African American, Hispanic and non-Hispanic White women. We utilized logistic regression to determine the influence of psychosocial factors (satisfaction with aging, religiosity, perceived control, emotions, purpose in life) in 2008 predicting breast cancer screening participation in 2012, given the increasing importance of understanding health behaviors as predicted by prior circumstances. While controlling for other variables, the major findings demonstrated that the odds of having a mammogram among Hispanics decreased as feelings that 'things were getting worse' with age intensified; and screening was more likely among Hispanic religious women. The odds of obtaining a mammogram increased with increasing purpose in life for Hispanics. CONCLUSIONS AND IMPLICATIONS These findings suggest the need for comprehensive geriatric assessments to understand the perspectives of older minority women, and provides formative data to inform shared decision-making interventions.
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Affiliation(s)
- Tamara Cadet
- Simmons University School of Social Work, Boston, MA, USA; Lecturer on Oral Health Policy and Epidemiology Harvard School of Dental Medicine, Oral Health Policy and Epidemiology.
| | - Shanna L Burke
- Florida International University, Robert Stempel College of Public Health and Social Work, School of Social Work, Miami, FL, USA
| | - Louanne Bakk
- School of Social Work, The University at Buffalo, Buffalo, NY, USA
| | | | - Tracy Schroepfer
- Hartford Geriatric Social Work Faculty Scholar, School of Social Work, University of Wisconsin-Madison, Madison, WI, USA
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Krok-Schoen JL, Adams IK, Baltic RD, Fisher JL. Ethnic disparities in cancer incidence and survival among the oldest old in the United States. ETHNICITY & HEALTH 2020; 25:79-92. [PMID: 29076352 DOI: 10.1080/13557858.2017.1395818] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 09/19/2017] [Indexed: 06/07/2023]
Abstract
Objective: To examine potential ethnic disparities in cancer incidence and survival rates among the oldest old using data from the SEER Program.Design: Cases diagnosed with one of the leading four cancer sites (lung and bronchus, colon and rectum, female breast, prostate) and four cancer sites (stomach, liver and intrahepatic bile duct, gallbladder, and cervical) that disproportionally affect Hispanics were reported to one of 18 SEER registries. Differences in cancer incidence were examined for cases aged ≥85 years diagnosed during the most recent 5-year time period (2009-2013) and, to examine changes over time, from 1992 to 2013. Five-year relative cancer survival probability was examined for Hispanics and non-Hispanics aged ≥85 years diagnosed 2006-2012.Results: From 2009 to 2013, non-Hispanics aged ≥85 years had higher incidence rates compared to Hispanics for colon and rectum, lung and bronchus, female breast, and prostate cancers. Five-year survival probability for cancers of all stages combined was higher for non-Hispanics than Hispanics in this age group. However, Hispanics had higher survival probability of colon and rectum and lung and bronchus cancers diagnosed at regional (colon and rectum: 67.2% vs. 60.5%; lung and bronchus: 15.9% vs. 12.7%) and distant (colon and rectum: 5.4% vs. 3.8%; lung and bronchus: 2.8% vs. 2.2%) stages than non-Hispanics, respectively.Conclusion: Ethnic differences in cancer incidence and survival probability exist for the ≥85 population. Continued efforts are needed to understand and reduce ethnic disparities in cancer prevention and treatment for this population.
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Affiliation(s)
- Jessica L Krok-Schoen
- Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio University, Columbus, OH, USA
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| | - Ingrid K Adams
- Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio University, Columbus, OH, USA
- The Ohio State University Extension, College of Food, Agricultural, and Environmental Sciences, The Ohio University, Columbus, OH, USA
| | - Ryan D Baltic
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| | - James L Fisher
- Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, OH, USA
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5
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Adunlin G, Cyrus JW, Asare M, Sabik LM. Barriers and Facilitators to Breast and Cervical Cancer Screening Among Immigrants in the United States. J Immigr Minor Health 2019; 21:606-658. [PMID: 30117005 DOI: 10.1007/s10903-018-0794-6] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
To summarize the literature on barriers and facilitators to breast and cervical cancer screening among immigrants to the US. A literature review was conducted for studies on breast and cervical cancer screening among immigrant populations. A thematic analysis of 180 studies identified a variety of barriers and facilitators to screening at the personal and system levels. Personal barriers included lack of knowledge and insurance coverage, high cost of care, and immigration status. System barriers included poor access to services, lack of interpreter services, and insensitivity to patient needs. Facilitators to screening included knowledge of disease, access to information sources, physician recommendation, and social networks. Cultural norms and resource availability at the individual and system levels influence screening among immigrants. Health insurance coverage was found to be an important predictor of preventative screening use. Future research should seek to identify the best way to address this and other barriers to cancer screening among immigrants groups.
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Affiliation(s)
- Georges Adunlin
- McWhorter School of Pharmacy, Samford University, 2100 Lakeshore Dr, Homewood, AL, 35229, USA.
| | - John W Cyrus
- Tompkins-McCaw Library, Virginia Commonwealth University, 509 N 12th St, Richmond, VA, 23298-0430, USA
| | - Matthew Asare
- Department of Public Health, Baylor University, One Bear Place #97313, Waco, TX, 76798-7313, USA
| | - Lindsay M Sabik
- Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health, 130 De Soto St., Pittsburgh, PA, 15261, USA
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Rodriguez-Torres SA, McCarthy AM, He W, Ashburner JM, Percac-Lima S. Long-Term Impact of a Culturally Tailored Patient Navigation Program on Disparities in Breast Cancer Screening in Refugee Women After the Program's End. Health Equity 2019; 3:205-210. [PMID: 31106287 PMCID: PMC6524343 DOI: 10.1089/heq.2018.0104] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Purpose: To examine the long-term effects of a patient navigation (PN) program for mammography screening tailored to refugee women and to assess screening utilization among these women after PN ended. Methods: We assessed the proportion of patients completing mammography screening during the prior 2 years during 2012–2016 for refugee women who had previously received PN compared with that of English-speaking women cared for at the same health center during the same period, both overall and stratifying by age. We used logistic regression to compare screening completion between refugees and English speakers, adjusting for age, race, insurance status, number of clinic visits, and clustering by primary care physician and to test trends in screening over time. Results: In 2012, the year when the funding for PN ceased, among 126 refugee women eligible for breast cancer screening, mammography screening rates were significantly higher among refugees (90.5%, 95% confidence interval [CI]: 83.5–94.7%) than among English speakers (81.9%, 95% CI: 76.2–86.5%, p=0.006). By 2016, screening rates decreased among refugee women (76.5%, 95% CI: 61.6–86.9%, p=0.023) but were not statistically significantly different from those among English-speaking women (80.5%, 95% CI: 74.4–85.3%, p=0.460). Screening prevalence for refugee women remained above the pre-PN program screening levels, and considerably so in women <50 years. Conclusion: The culturally and language-tailored PN program for refugee women appeared to have persistent effects, with refugee women maintaining similar levels of mammography screening to English-speaking patients 5 years after the PN program's end.
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Affiliation(s)
| | - Anne Marie McCarthy
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts.,Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Wei He
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Jeffrey M Ashburner
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts.,Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Sanja Percac-Lima
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts.,Department of Medicine, Harvard Medical School, Boston, Massachusetts
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7
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Demb J, Akinyemiju T, Allen I, Onega T, Hiatt RA, Braithwaite D. Screening mammography use in older women according to health status: a systematic review and meta-analysis. Clin Interv Aging 2018; 13:1987-1997. [PMID: 30349218 PMCID: PMC6188129 DOI: 10.2147/cia.s171739] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The extent to which screening mammography (SM) recommendations in older women incorporate life expectancy factors is not well established. Objective The objective of this review was to evaluate evidence on SM utilization in older women by life expectancy factors. Data sources We searched Medline, Embase and Web of Science from January 1991 to March 2016. Study selection We included studies examining SM utilization in women ages ≥65 years that measured life expectancy using comorbidity, functional limitations or health or prognostic status. Data extraction and synthesis ORs and 95% CIs were extracted and grouped by life expectancy category. Findings were aggregated into pooled ORs and 95% CIs and meta-analyzed by life expectancy category. Main outcomes and measures The primary outcome was SM utilization within the last 5 years. Life expectancy factors included number of comorbidities, Charlson Comorbidity Index (CCI), activities of daily living, instrumental activities of daily living, self-reported health status and 5-year prognostic indices. Results Of 2,606 potential titles, we identified 25 meeting the inclusion criteria (comorbidity: eight studies, functional status: 11 studies and health/prognostic status: 13 studies). Women with higher CCI scores had decreased SM utilization (pooled OR: 0.75, 95% CI: 0.67–0.85), but increased absolute number of comorbidities were weakly associated with increased SM utilization (pooled OR: 1.17, 95% CI: 1.00–1.36). Women with more functional limitations had lower SM use odds than women with no limitations (pooled OR: 0.72, 95% CI: 0.62–0.83). Screening utilization odds were lower among women with poor vs excellent health (pooled OR: 0.85, 95% CI: 0.74–0.96). Conclusion Greater CCI score, functional limitations and lower perceived health were associated with decreased SM use, whereas higher absolute number of comorbidities was associated with increased SM use. SM guidelines should consider these factors to improve assessments of potential benefits and harms in older women.
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Affiliation(s)
- Joshua Demb
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.,Department of Oncology, Georgetown University School of Medicine, Washington, DC, USA,
| | - Tomi Akinyemiju
- Department of Epidemiology, University of Kentucky, Lexington, KY, USA
| | - Isabel Allen
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Tracy Onega
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Robert A Hiatt
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Dejana Braithwaite
- Department of Oncology, Georgetown University School of Medicine, Washington, DC, USA,
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8
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Crist JD, Montgomery ML, Pasvogel A, Phillips LR, Ortiz-Dowling EM. The association among knowledge of and confidence in home health care services, acculturation, and family caregivers' relationships to older adults of Mexican descent. Geriatr Nurs 2018; 39:689-695. [PMID: 29880443 DOI: 10.1016/j.gerinurse.2018.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 05/18/2018] [Indexed: 12/15/2022]
Abstract
The purposes of this study were to examine the relationships among knowledge of and confidence in health care services (HHCS), acculturation, characteristics of family caregivers of Mexican descent, and differences by caregivers' relationship (spouse or adult child). A sample of Mexican-descent older adults and their caregivers was recruited (n = 74 dyads) in Arizona. Each participant completed questionnaires on knowledge, confidence, and acculturation. There were moderate but significant associations among higher Anglo Orientation with Knowledge and with Confidence. Fear of HHCS was positively associated with higher Anglo Orientation and English Language Preference; and negatively associated with Mexican Orientation and Spanish Language Preference. For Spouse caregivers, Fear of HHCS was positively correlated with higher Anglo Orientation and English Language Preference; for Offspring caregivers, Fear of HHCS was negatively correlated with Mexican Orientation and Spanish Language Preference. Results support assessing caregiver cohort and socio-cultural context to decrease HHCS use disparities by Mexican-descent caregiving families.
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Affiliation(s)
- Janice D Crist
- College of Nursing, The University of Arizona, PO Box 210203, Tucson, AZ 85721-0203.
| | | | - Alice Pasvogel
- College of Nursing, The University of Arizona, PO Box 210203, Tucson, AZ 85721-0203
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9
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Cadet TJ, Burke SL, Stewart K, Howard T, Schonberg M. Cultural and emotional determinants of cervical cancer screening among older Hispanic women. Health Care Women Int 2017; 38:1289-1312. [PMID: 28825525 DOI: 10.1080/07399332.2017.1364740] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Older adults are at highest risk of cancer and yet have the lowest rates of cancer screening participation. Older minority adults bear the burden of cancer screening disparities leading to late stage cancer diagnoses. This investigation, utilization data from the 2008 wave of the Health and Retirement study examined the cultural and emotional factors thought to influence cervical cancer screening among older Hispanic women. We utilized logistic regression models to conduct the analyses. Findings indicate that the emotional factors were not significant but the cultural factor, time orientation was a significant predictor for older Hispanics' cervical cancer screening behaviors.
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Affiliation(s)
- Tamara J Cadet
- a Simmons College School of Social Work , Boston , Massachusetts , USA.,b Harvard School of Dental Medicine Department of Oral Health Policy and Epidemiology , Boston , Massachusetts , USA
| | - Shanna L Burke
- c Florida International University , Robert Stempel College of Public Health and Social Work , Miami , Florida, USA
| | | | - Tenial Howard
- a Simmons College School of Social Work , Boston , Massachusetts , USA
| | - Mara Schonberg
- e Harvard Medical School , Beth Israel Deaconess Medical Center , Boston , Massachusetts , USA
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10
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Cadet TJ, Stewart K, Howard T. Psychosocial correlates of cervical cancer screening among older Hispanic women. SOCIAL WORK IN HEALTH CARE 2017; 56:124-139. [PMID: 27960632 PMCID: PMC5890332 DOI: 10.1080/00981389.2016.1263268] [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] [Indexed: 06/06/2023]
Abstract
Early detection through screening can reduce mortality rates of cervical cancer, and yet Hispanic women who have incidence rates higher than their non-Hispanic White counterparts are least likely to participate in cancer screening initiatives. This study utilized data from the 2008 wave of the Health and Retirement Study to investigate the psychosocial correlates associated with older Hispanic women's participation in cervical cancer screening services. Logistic regression models were used. Findings indicated that greater life satisfaction and religiosity were associated with a greater likelihood of participating in cervical cancer screening. Despite ongoing national conversations, evidence indicates there is agreement that underserved women need to be screened, particularly the older Hispanic population.
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Affiliation(s)
- Tamara J Cadet
- a School of Social Work, Simmons College , Boston , Massachusetts , USA
| | - Kathleen Stewart
- a School of Social Work, Simmons College , Boston , Massachusetts , USA
| | - Tenial Howard
- a School of Social Work, Simmons College , Boston , Massachusetts , USA
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11
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Braithwaite D, Demb J, Henderson LM. Optimal breast cancer screening strategies for older women: current perspectives. Clin Interv Aging 2016; 11:111-25. [PMID: 26893548 PMCID: PMC4745843 DOI: 10.2147/cia.s65304] [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] [Indexed: 01/17/2023] Open
Abstract
Breast cancer is a major cause of cancer-related deaths among older women, aged 65 years or older. Screening mammography has been shown to be effective in reducing breast cancer mortality in women aged 50–74 years but not among those aged 75 years or older. Given the large heterogeneity in comorbidity status and life expectancy among older women, controversy remains over screening mammography in this population. Diminished life expectancy with aging may decrease the potential screening benefit and increase the risk of harms. In this review, we summarize the evidence on screening mammography utilization, performance, and outcomes and highlight evidence gaps. Optimizing the screening strategy will involve separating older women who will benefit from screening from those who will not benefit by using information on comorbidity status and life expectancy. This review has identified areas related to screening mammography in older women that warrant additional research, including the need to evaluate emerging screening technologies, such as tomosynthesis among older women and precision cancer screening. In the absence of randomized controlled trials, the benefits and harms of continued screening mammography in older women need to be estimated using both population-based cohort data and simulation models.
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Affiliation(s)
- Dejana Braithwaite
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Joshua Demb
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Louise M Henderson
- Department of Radiology, University of North Carolina, Chapel Hill, NC, USA
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12
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Richter NL, Gorey KM, Haji-Jama S, Luginaah IN. Care and survival of Mexican American women with node negative breast cancer: historical cohort evidence of health insurance and barrio advantages. J Immigr Minor Health 2015; 17:652-9. [PMID: 24155037 PMCID: PMC3911961 DOI: 10.1007/s10903-013-9941-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
We hypothesized 3-way ethnicity by barrio by health insurance interactions such that the advantages of having adequate health insurance were greatest among Mexican American (MA) women who lived in barrios. Barrios were neighborhoods with relatively high concentrations of MAs (60% or more). Data were analyzed for 194 MA and 2,846 non-Hispanic white women diagnosed with, very treatable, node negative breast cancer in California between 1996 and 2000 and followed until 2011. Significant interactions were observed such that the protective effects of Medicare or private health insurance on radiation therapy access and long term survival were largest for MA women who resided in MA barrios, neighborhoods that also tended to be extremely poor. These paradoxical findings are consistent with the theory that more facilitative social and economic capital available to MA women in barrios enables them to better absorb the indirect and direct, but uncovered, costs of breast cancer care.
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Affiliation(s)
- Nancy L Richter
- School of Social Work, University of Windsor, 401 Sunset Avenue, Windsor, ON, N9B 3P4, Canada,
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13
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Cadet TJ. The relationship between psychosocial factors and breast cancer screening behaviors of older Hispanic women. SOCIAL WORK IN PUBLIC HEALTH 2015; 30:207-223. [PMID: 25611310 DOI: 10.1080/19371918.2014.969857] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Guided by the theory of planned behavior, this study utilized data from the 2008 wave of the Health and Retirement Study to investigate psychosocial factors associated with older Hispanic women's participation in breast cancer screening services. Hierarchical logistic regression models were used to assess the odds of breast cancer screening participation. Findings indicate that satisfaction with aging and constraints were associated with a reduced likelihood of participating in breast cancer screening. These findings suggest the continued importance to assess older women's attitudes when discussing preventive services.
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Affiliation(s)
- Tamara J Cadet
- a School of Social Work, Simmons College , Boston , Massachusetts , USA
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14
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Jandorf L, Hecht MF, Winkel G, Thélémaque LD, Saad-Harfouche FG, Bursac Z, Greene P, Erwin DO, Jandorf L. Increasing Cancer Screening for Latinas: Examining the Impact of Health Messages and Navigation in a Cluster-Randomized Study. J Racial Ethn Health Disparities 2014. [DOI: 10.1007/s40615-014-0014-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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15
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Uyeturk U, Tatli AM, Gucuk S, Oksuzoglu B, Ulas A, Avci N, Ozbay MF, Gunduz S, Akinci MB, Salim DK, Sonmez OU, Akdag F, Ergenc H. Risk Factors for Stage IV Breast Cancer at the Time of Presentation in Turkey. Asian Pac J Cancer Prev 2013; 14:7445-9. [DOI: 10.7314/apjcp.2013.14.12.7445] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Bassal R, Schejter E, Bachar R, Shapira H, Sandbank J, Supino Rosin L, Schvimer M, Cohen D, Keinan-Boker L. Cervical Pap screening among Israeli women, 2005-2010. Arch Gynecol Obstet 2013; 289:615-22. [PMID: 24085583 DOI: 10.1007/s00404-013-3045-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Accepted: 09/19/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE This study describes the distribution and the trends of cervical abnormalities in Israel, based on Pap smear results. METHODS A retrospective analysis of cervical smears received by the Central Pathology Laboratory of Maccabi Healthcare Services between January 2005 and December 2010. RESULTS In total, 711,541 Pap smears were screened in the study period. Cytological abnormalities were observed in 4.78% of the total smears screened. An increase was observed in the rate of positive results from 2.63% in 2005 to 6.78% in 2010 (p = 0.0026). The cervical abnormalities in the study period distributed as follows: atypical squamous cell (ASC)-2.72%, low-grade squamous intraepithelial lesion (LSIL)-1.54%, high-grade squamous intraepithelial lesion (HSIL)-0.34%, squamous cell carcinoma-0.01%, atypical glandular cells (AGC)-0.10%, adenocarcinoma in situ (AIS)-0.06% and invasive adenocarcinoma-0.01%. The increase was statistically significant for ASC (p = 0.0028), LSIL (p = 0.0069) and for HSIL (p = 0.0260). The mean ages at diagnosis of women with ASCUS, LSIL, HSIL, squamous cell carcinoma, AGC, AIS and adenocarcinoma were 37.8, 33.2, 38.6, 55.4, 41.1, 49.9 and 57.1 years, respectively. CONCLUSIONS The increase in the rate of squamous cell abnormalities demonstrated in this study emphasizes the need of implementing an education and a screening program among Israeli women. HPV vaccine, sexual behavior, cytology performance and HPV test are primary and secondary prevention tools which may reduce morbidity and mortality in the future. In addition, based on the age at diagnosis of the different pathologies, the age group in which Pap test is performed in Israel should be expanded from 35-54 to 25-65 years.
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Affiliation(s)
- Ravit Bassal
- Department of Epidemiology and Preventive Medicine, Sackler Faculty of Medicine, School of Public Health, Tel Aviv University, Tel Aviv, Israel,
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Abstract
The study objective was to examine the association, among older persons with cutaneous melanoma, between areal socioeconomic status (SES) and receiving chemotherapy. SEER-Medicare-linked database (1,239 white men and women aged ≥ 66, with invasive melanoma [regional and distant stages]; 1991-1999) was used. SES was measured by census tract poverty level (average of 1990 and 2000 Census data). Covariates were sociodemographics, tumor characteristics, and comorbidity index. Residing in poorer SES areas was associated with a lower likelihood for receiving chemotherapy among patients in the overall sample (adjusted odds ratios = OR 0.97, 95% confidence interval = CI 0.95-0.99), and those with regional stage at diagnosis (OR 0.97, 95% CI 0.94-0.98). These findings reflect socioeconomic disparities in chemotherapy use for melanoma among older white patients in the United States.
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