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Higashi RT, Tiro JA, Winer RL, Ornelas IJ, Bravo P, Quirk L, Kessler LG. Understanding the effect of new U.S. cervical cancer screening guidelines and modalities on patients' comprehension and reporting of their cervical cancer screening behavior. Prev Med Rep 2023; 32:102169. [PMID: 36922960 PMCID: PMC10009194 DOI: 10.1016/j.pmedr.2023.102169] [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: 11/06/2022] [Revised: 02/27/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
With recent shifts in guideline-recommended cervical cancer screening in the U.S., it is important to accurately measure screening behavior. Previous studies have indicated the U.S. National Health Interview Survey (NHIS), a resource for measuring self-reported screening adherence, has lower validity among non-White racial/ethnic groups and non-English speakers. Further, measuring diverse population groups' comprehension of items and attitudes toward HPV self-sampling merits investigation as it is a modality likely to be recommended in the U.S. soon. This study cognitively tested NHIS items assessing recency of and reasons for receiving cervical cancer screening and attitudes toward HPV self-sampling. We conducted cognitive interviews between April 2021 - April 2022 in English and Spanish with individuals screened in the past two years by either a medical center in metropolitan Seattle, Washington or a safety-net healthcare system in Dallas, Texas. Interviews probed understanding of reasons for screening, experiences with abnormal results, and interest in HPV self-sampling. We completed 32 interviews in Seattle and 42 interviews in Dallas. A majority of participants were unaware that two different tests for cervical cancer screening exist (Pap and HPV). Many did not know which type(s) of test they received. Dallas participants had more limited and inaccurate knowledge of HPV compared to Seattle participants, and fewer responded favorably toward HPV self-sampling (32% vs. 55%). To improve comprehension and accurate reporting of cervical cancer screening, we suggest specific refinements to currently used survey questions. Attitudes toward self-sampling should be explored further as differences may exist by region and/or sociodemographic factors.
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Affiliation(s)
- Robin T Higashi
- University of Texas Southwestern Medical Center, Peter O'Donnell Jr. School of Public Health, 5323 Harry Hines Blvd, Dallas, TX, 75390-9066, USA.,Harold C. Simmons Comprehensive Cancer Center, 2201 Inwood Road, Dallas, TX, 75235, USA
| | - Jasmin A Tiro
- University of Texas Southwestern Medical Center, Peter O'Donnell Jr. School of Public Health, 5323 Harry Hines Blvd, Dallas, TX, 75390-9066, USA.,Harold C. Simmons Comprehensive Cancer Center, 2201 Inwood Road, Dallas, TX, 75235, USA
| | - Rachel L Winer
- University of Washington, Department of Epidemiology, Box 351619, 3980 15th Ave NE, Seattle, WA 98195, USA.,Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA 98101, USA
| | - India J Ornelas
- University of Washington, Department of Health Systems and Population Health, School of Public Health, 3980 15th Ave NE, UW Box 351621, Seattle, WA 98195, USA
| | - Perla Bravo
- University of Washington, Department of Health Systems and Population Health, School of Public Health, 3980 15th Ave NE, UW Box 351621, Seattle, WA 98195, USA
| | - Lisa Quirk
- University of Texas Southwestern Medical Center, Peter O'Donnell Jr. School of Public Health, 5323 Harry Hines Blvd, Dallas, TX, 75390-9066, USA
| | - Larry G Kessler
- University of Washington, Department of Health Systems and Population Health, School of Public Health, 3980 15th Ave NE, UW Box 351621, Seattle, WA 98195, USA
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Patton T, Abramovitz D, Johnson D, Leas E, Nobles A, Caputi T, Ayers J, Strathdee S, Bórquez A. Characterizing Help-Seeking Searches for Substance Use Treatment From Google Trends and Assessing Their Use for Infoveillance: Longitudinal Descriptive and Validation Statistical Analysis. J Med Internet Res 2022; 24:e41527. [PMID: 36454620 PMCID: PMC9756118 DOI: 10.2196/41527] [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: 07/29/2022] [Revised: 11/01/2022] [Accepted: 11/04/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND There is no recognized gold standard method for estimating the number of individuals with substance use disorders (SUDs) seeking help within a given geographical area. This presents a challenge to policy makers in the effective deployment of resources for the treatment of SUDs. Internet search queries related to help seeking for SUDs using Google Trends may represent a low-cost, real-time, and data-driven infoveillance tool to address this shortfall in information. OBJECTIVE This paper assesses the feasibility of using search query data related to help seeking for SUDs as an indicator of unmet treatment needs, demand for treatment, and predictor of the health harms related to unmet treatment needs. We explore a continuum of hypotheses to account for different outcomes that might be expected to occur depending on the demand for treatment relative to the system capacity and the timing of help seeking in relation to trajectories of substance use and behavior change. METHODS We used negative binomial regression models to examine temporal trends in the annual SUD help-seeking internet search queries from Google Trends by US state for cocaine, methamphetamine, opioids, cannabis, and alcohol from 2010 to 2020. To validate the value of these data for surveillance purposes, we then used negative binomial regression models to investigate the relationship between SUD help-seeking searches and state-level outcomes across the continuum of care (including lack of care). We started by looking at associations with self-reported treatment need using data from the National Survey on Drug Use and Health, a national survey of the US general population. Next, we explored associations with treatment admission rates from the Treatment Episode Data Set, a national data system on SUD treatment facilities. Finally, we studied associations with state-level rates of people experiencing and dying from an opioid overdose, using data from the Agency for Healthcare Research and Quality and the CDC WONDER database. RESULTS Statistically significant differences in help-seeking searches were observed over time between 2010 and 2020 (based on P<.05 for the corresponding Wald tests). We were able to identify outlier states for each drug over time (eg, West Virginia for both opioids and methamphetamine), indicating significantly higher help-seeking behaviors compared to national trends. Results from our validation analyses across different outcomes showed positive, statistically significant associations for the models relating to treatment need for alcohol use, treatment admissions for opioid and methamphetamine use, emergency department visits related to opioid use, and opioid overdose mortality data (based on regression coefficients having P≤.05). CONCLUSIONS This study demonstrates the clear potential for using internet search queries from Google Trends as an infoveillance tool to predict the demand for substance use treatment spatially and temporally, especially for opioid use disorders.
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Affiliation(s)
- Thomas Patton
- Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA, United States
| | - Daniela Abramovitz
- Department of Medicine, University of California San Diego, La Jolla, CA, United States
| | | | - Eric Leas
- Herbert Wertheim School of Public Health & Human Longevity Science, University of California San Diego, La Jolla, CA, United States
| | - Alicia Nobles
- Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA, United States
| | - Theodore Caputi
- Department of Economics, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - John Ayers
- Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA, United States
| | - Steffanie Strathdee
- Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA, United States
| | - Annick Bórquez
- Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA, United States
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Aljuhani SH, Bamaroof SA, Alghamdi TH, Almogbel AA, Alkhammash AS, Alkhammash BS, Bahusayn AA, Bangash MH, Baeesa SS, Chaudhary AG, Abuzenadah AM, Mirza AA, Saka MY, Hussein DM. Public awareness of central nervous system tumors in the Kingdom of Saudi Arabia. NEUROSCIENCES (RIYADH, SAUDI ARABIA) 2018; 23:227-237. [PMID: 30007999 PMCID: PMC8015579 DOI: 10.17712/nsj.2018.3.20180055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 03/14/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate individuals` knowledge about central nervous system tumors (CNST) signs and symptoms and risk factors, as well as their readiness to seek medical advice. The signs and symptoms associated with CNSTs are often vague, and failure to recognize them could lead to delays in seeking help and possibly fatal results. METHODS This was a cross-sectional survey that utilized 2 delivery methods. A total of 1,500 personally delivered and 1,500 online self-administered questionnaires were completed in parallel between June 2015 and June 2016 for the occupants of the Kingdom of Saudi Arabia. RESULTS Significant differences were observed for the sociodemographic characteristics of participants recruited via the 2 methods. The most recognized symptom was "Headaches" (45.2%), and the most recognized risk factor was "Radioactive location/occupation" (84.1%). Overall knowledge scores were low, significantly predicted by employment and cancer contact (p<0.05), while the scores significantly higher for participants who were willing to see their doctors within a week (p<0.005). The most recognized barrier to seeking help was "Worry about what the doctor might find" (74.0%). CONCLUSION The level of awareness of CNSTs was low. Using a questionnaire delivered in 2 different ways enabled the recruitment of sample pools with different sociodemographic characteristics.
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Affiliation(s)
- Shahad H. Aljuhani
- From the Faculty of Applied Medical Sciences (Aljuhani, Bamaroof, Alghamdi, Almogbel, Alkhammash A, Alkhammash B, Bahusayn, Chaudhary, Abuzenadah, Mirza), Division of Neurosurgery (Bangash, Baeesa), Center of Excellence in Genomic Medicine Research (Chaudhary), and from King Fahd Medical Research Center (Abuzenadah, Saka, Hussein), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Saja A. Bamaroof
- From the Faculty of Applied Medical Sciences (Aljuhani, Bamaroof, Alghamdi, Almogbel, Alkhammash A, Alkhammash B, Bahusayn, Chaudhary, Abuzenadah, Mirza), Division of Neurosurgery (Bangash, Baeesa), Center of Excellence in Genomic Medicine Research (Chaudhary), and from King Fahd Medical Research Center (Abuzenadah, Saka, Hussein), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Thoraya H. Alghamdi
- From the Faculty of Applied Medical Sciences (Aljuhani, Bamaroof, Alghamdi, Almogbel, Alkhammash A, Alkhammash B, Bahusayn, Chaudhary, Abuzenadah, Mirza), Division of Neurosurgery (Bangash, Baeesa), Center of Excellence in Genomic Medicine Research (Chaudhary), and from King Fahd Medical Research Center (Abuzenadah, Saka, Hussein), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Alhanoof A. Almogbel
- From the Faculty of Applied Medical Sciences (Aljuhani, Bamaroof, Alghamdi, Almogbel, Alkhammash A, Alkhammash B, Bahusayn, Chaudhary, Abuzenadah, Mirza), Division of Neurosurgery (Bangash, Baeesa), Center of Excellence in Genomic Medicine Research (Chaudhary), and from King Fahd Medical Research Center (Abuzenadah, Saka, Hussein), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Alhanof S. Alkhammash
- From the Faculty of Applied Medical Sciences (Aljuhani, Bamaroof, Alghamdi, Almogbel, Alkhammash A, Alkhammash B, Bahusayn, Chaudhary, Abuzenadah, Mirza), Division of Neurosurgery (Bangash, Baeesa), Center of Excellence in Genomic Medicine Research (Chaudhary), and from King Fahd Medical Research Center (Abuzenadah, Saka, Hussein), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Batool S. Alkhammash
- From the Faculty of Applied Medical Sciences (Aljuhani, Bamaroof, Alghamdi, Almogbel, Alkhammash A, Alkhammash B, Bahusayn, Chaudhary, Abuzenadah, Mirza), Division of Neurosurgery (Bangash, Baeesa), Center of Excellence in Genomic Medicine Research (Chaudhary), and from King Fahd Medical Research Center (Abuzenadah, Saka, Hussein), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Amjad A. Bahusayn
- From the Faculty of Applied Medical Sciences (Aljuhani, Bamaroof, Alghamdi, Almogbel, Alkhammash A, Alkhammash B, Bahusayn, Chaudhary, Abuzenadah, Mirza), Division of Neurosurgery (Bangash, Baeesa), Center of Excellence in Genomic Medicine Research (Chaudhary), and from King Fahd Medical Research Center (Abuzenadah, Saka, Hussein), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Mohamad H. Bangash
- From the Faculty of Applied Medical Sciences (Aljuhani, Bamaroof, Alghamdi, Almogbel, Alkhammash A, Alkhammash B, Bahusayn, Chaudhary, Abuzenadah, Mirza), Division of Neurosurgery (Bangash, Baeesa), Center of Excellence in Genomic Medicine Research (Chaudhary), and from King Fahd Medical Research Center (Abuzenadah, Saka, Hussein), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Saleh S. Baeesa
- From the Faculty of Applied Medical Sciences (Aljuhani, Bamaroof, Alghamdi, Almogbel, Alkhammash A, Alkhammash B, Bahusayn, Chaudhary, Abuzenadah, Mirza), Division of Neurosurgery (Bangash, Baeesa), Center of Excellence in Genomic Medicine Research (Chaudhary), and from King Fahd Medical Research Center (Abuzenadah, Saka, Hussein), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Adeel G. Chaudhary
- From the Faculty of Applied Medical Sciences (Aljuhani, Bamaroof, Alghamdi, Almogbel, Alkhammash A, Alkhammash B, Bahusayn, Chaudhary, Abuzenadah, Mirza), Division of Neurosurgery (Bangash, Baeesa), Center of Excellence in Genomic Medicine Research (Chaudhary), and from King Fahd Medical Research Center (Abuzenadah, Saka, Hussein), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Adel M. Abuzenadah
- From the Faculty of Applied Medical Sciences (Aljuhani, Bamaroof, Alghamdi, Almogbel, Alkhammash A, Alkhammash B, Bahusayn, Chaudhary, Abuzenadah, Mirza), Division of Neurosurgery (Bangash, Baeesa), Center of Excellence in Genomic Medicine Research (Chaudhary), and from King Fahd Medical Research Center (Abuzenadah, Saka, Hussein), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Ahmed A. Mirza
- From the Faculty of Applied Medical Sciences (Aljuhani, Bamaroof, Alghamdi, Almogbel, Alkhammash A, Alkhammash B, Bahusayn, Chaudhary, Abuzenadah, Mirza), Division of Neurosurgery (Bangash, Baeesa), Center of Excellence in Genomic Medicine Research (Chaudhary), and from King Fahd Medical Research Center (Abuzenadah, Saka, Hussein), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Mohamad Y. Saka
- From the Faculty of Applied Medical Sciences (Aljuhani, Bamaroof, Alghamdi, Almogbel, Alkhammash A, Alkhammash B, Bahusayn, Chaudhary, Abuzenadah, Mirza), Division of Neurosurgery (Bangash, Baeesa), Center of Excellence in Genomic Medicine Research (Chaudhary), and from King Fahd Medical Research Center (Abuzenadah, Saka, Hussein), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Deema M. Hussein
- From the Faculty of Applied Medical Sciences (Aljuhani, Bamaroof, Alghamdi, Almogbel, Alkhammash A, Alkhammash B, Bahusayn, Chaudhary, Abuzenadah, Mirza), Division of Neurosurgery (Bangash, Baeesa), Center of Excellence in Genomic Medicine Research (Chaudhary), and from King Fahd Medical Research Center (Abuzenadah, Saka, Hussein), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
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Fedewa SA, Sauer AG, Siegel RL, Jemal A. Prevalence of major risk factors and use of screening tests for cancer in the United States. Cancer Epidemiol Biomarkers Prev 2016; 24:637-52. [PMID: 25834147 DOI: 10.1158/1055-9965.epi-15-0134] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Much of the suffering and death from cancer could be prevented by more systematic efforts to reduce tobacco use, improve diet, increase physical activity, reduce obesity, and expand the use of established screening tests. Monitoring the prevalence of cancer risk factors and screening is important to measure progress and strengthen cancer prevention and early detection efforts. In this review article, we provide recent prevalence estimates for several cancer risk factors, including tobacco, obesity, physical activity, nutrition, ultraviolet radiation exposure as well as human papillomavirus and hepatitis B vaccination coverage and cancer screening prevalence in the United States. In 2013, cigarette smoking prevalence was 17.8% among adults nationally, but ranged from 10.3% in Utah to 27.3% in West Virginia. In addition, 15.7% of U.S. high school students were current smokers. In 2011-2012, obesity prevalence was high among both adults (34.9%) and adolescents (20.5%), but has leveled off since 2002. About 20.2% of high school girls were users of indoor tanning devices, compared with 5.3% of boys. In 2013, cancer screening prevalence ranged from 58.6% for colorectal cancer to 80.8% for cervical cancer and remains low among the uninsured, particularly for colorectal cancer screening where only 21.9% of eligible adults received recommended colorectal cancer screening.
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Affiliation(s)
- Stacey A Fedewa
- Department of Intramural Research, American Cancer Society, Atlanta, Georgia. Department of Epidemiology, Emory University, Atlanta, Georgia.
| | - Ann Goding Sauer
- Department of Intramural Research, American Cancer Society, Atlanta, Georgia
| | - Rebecca L Siegel
- Department of Intramural Research, American Cancer Society, Atlanta, Georgia
| | - Ahmedin Jemal
- Department of Intramural Research, American Cancer Society, Atlanta, Georgia
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