Association of depression with adherence to breast cancer screening among women aged 50 to 74 years in the United States

Role of life satisfaction, emotional support, and feeling of social isolation on adherence to breast cancer screening recommendations among US women

BACKGROUND

Psychosocial factors can play important roles in promoting preventive health behaviors. This study aimed to assess how life satisfaction, receipt of emotional support, and feeling of social isolation were associated with adherence to the USPSTF recommendation of breast cancer screening in a nationally representative US population.

METHODS

Using data on 71,583 women aged 50 to 74 years, from the 2022 Behavioral Risk Factor Surveillance System (BRFSS) survey, we estimated multivariable logistic regressions to assess the odds of adherence across different categories of the respective psychosocial constructs. We accounted for various demographic and socioeconomic correlates and checked the robustness of the relationship within income and educational sub-groups.

RESULTS

We found that women who were dissatisfied with their life were 52.0% less likely to adhere compared to women who reported to be very satisfied. Similarly, women who rarely/never got emotional support and who always/usually felt socially isolated were 51.6% and 39.9% less likely to adhere, compared to women who always got support and never felt isolated, respectively. These results were robust across different levels of income and educational attainment.

CONCLUSION

Our findings demonstrated a strong association between social environment, psychological wellbeing, and adherence to breast cancer screening, and thus suggested scope of potential psychosocial interventions to improve adherence.

POLICY SUMMARY

Efforts to improve women's psychosocial wellbeing could facilitate compliance with breast cancer screening recommendations.

Psychological distress and bowel cancer screening participation

OBJECTIVE

To better understand barriers to participation in mail-out bowel cancer screening programs, two survey studies tested the relationship between psychological distress and self-reported bowel cancer screening.

METHODS

First, a nationally representative sample of Australians N = 5421 completed measures of bowel cancer screening and psychological distress (using the Kessler Psychological Distress Scale; K10). Second, N = 479 completed a survey measuring participation in the National Bowel Cancer Screening Program (NBCSP) and psychological distress using the Depression, Anxiety and Stress Scale. In both studies, logistic regressions were conducted to test relationships between psychological distress and self-reported screening participation.

RESULTS

Study one found that psychological distress had a significant quadratic effect on having ever screened for bowel cancer, where screening rates were similar for those with low, moderate, or high levels of distress, but were lower for those with very high levels of distress. In study two, depression scores had a negative linear relationship with NBCSP participation (higher depression levels were associated with lower screening participation), and anxiety had a quadratic effect whereby NBCSP participation rates were higher with increasing levels of anxiety except in the severe category, where participation was significantly lower.

CONCLUSIONS

Findings indicate that psychological distress has a complex relationship with screening, and those with extreme levels of distress consistently show lower participation rates. Special efforts to encourage screening may be required for those experiencing extreme psychological distress and mental health disorders.

The effect of emotional disorders on adherence to mammography screening guidelines

BACKGROUND

Depression, anxiety, and other emotional disorders are highly prevalent; however, the impact of these on adherence to mammography screening guidelines remains unclear. We sought to determine the effect of feeling limited by emotional disorders on adherence to mammographic screening guidelines.

METHODS

Data from the 2018 National Health Interview Survey were used to evaluate whether women aged 50-74 who felt limited in some way by an emotional issue (EI; defined as depression, anxiety, or another emotional problem) were less likely to report having had a mammogram within the past two years than those who reported no such limitation.

RESULTS

Of the 5815 women surveyed, 3.25% stated that they were limited in some way by EI. These women were significantly less likely to report having had a mammogram within the past two years compared to those without EI (68.28% vs. 79.36%, p = 0.002). Controlling for sociodemographic factors, EI no longer predicted worse mammography screening adherence (OR = 0.78; 95% CI: 0.54-1.12, p = 0.182). Rather, family income relative to poverty level, health insurance coverage, and having a usual place of healthcare were independent predictors of adherence to screening mammography guidelines.

CONCLUSION

Women who feel limited by an EI tend to have lower mammography screening rates than those without such limitations; however, this is driven primarily by socioeconomic factors such as income, insurance status, and access to healthcare.