1
|
Altová A, Kulhánová I, Brůha L, Lustigová M. Breast and cervical cancer screening attendance among Czech women. Cent Eur J Public Health 2021; 29:90-95. [PMID: 34245547 DOI: 10.21101/cejph.a6623] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 05/05/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aim of the study was to investigate the variation in breast and cervical cancer screening attendance among Czech women by age and in regions in 2009-2017. METHODS The data from the health insurance company that covers around 50% of the Czech population were used to calculate age-specific attendance rates and standardized attendance rates by year and region. RESULTS In 2017, the attendance of all eligible women was 52% in breast cancer screening and 46% in cervical cancer screening. There were differences in attendance among groups of women. Women aged 45-49 had attendance rates in both screenings around 60%, while 39% of women aged 75-79 attended breast cancer screening, and 23% attended cervical cancer screening. In regions, attendance ranged from 38% to 70% in breast cancer screening and from 32% to 55% in cervical cancer screening. CONCLUSIONS We identified the age-specific differences and regional variation in both breast and cervical cancer screening attendance among Czech women. Those with lower attendance may have a higher risk of dying from breast and cervical cancers. Mitigating this risk should be a priority of public health policies.
Collapse
Affiliation(s)
- Anna Altová
- Department of Demography and Geodemography, Faculty of Science, Charles University, Prague, Czech Republic
| | - Ivana Kulhánová
- Department of Demography and Geodemography, Faculty of Science, Charles University, Prague, Czech Republic.,Department of Social Geography and Regional Development, Faculty of Science, Charles University, Prague, Czech Republic
| | - Lukáš Brůha
- Department of Applied Geoinformatics and Cartography, Faculty of Science, Charles University, Prague, Czech Republic
| | - Michala Lustigová
- Department of Social Geography and Regional Development, Faculty of Science, Charles University, Prague, Czech Republic.,National Institute of Public Health, Prague, Czech Republic
| |
Collapse
|
2
|
Cancer incidence trends in the Czech Republic. Cancer Epidemiol 2021; 74:101975. [PMID: 34247066 DOI: 10.1016/j.canep.2021.101975] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 06/22/2021] [Accepted: 06/25/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Evaluation of time trends is an integral part of a comprehensive analysis of cancer data. Our study aimed to assess trends in cancer incidence in the period 1977-2018 in the Czech Republic. METHODS Cancer data were obtained from the Czech National Cancer Registry. Incidence trends were evaluated using the joinpoint regression. The overall trend for the entire analysed period and the current trend for the last 10 years were determined using the average annual percentage change. RESULTS In the period 1977-2018, the age-standardised incidence (European standard) of malignant neoplasms excluding non-melanoma skin cancers increased from 518.2 to 681.9 cases per 100,000 population in men, and from 320.9 to 467.2 in women. The largest increase in trend in the analysed period was observed for melanoma, which showed an average annual increase of 4.0 % in men and 3.3 % in women. Over the last decade, a significant increase has been observed for head and neck cancer and oesophageal cancer, mainly in women. On the contrary, the largest decrease in trend in the analysed period was observed for stomach cancer, with an average decrease of 2.9 % in men and 2.8 % in women. Over the last 10 years, a highly significant decrease has also been observed for colorectal cancer: 3.2 % in men and 2.8 % in women. The largest difference in trend between the sexes was recorded in lung cancer: a steady decline of 1.3 % per year was observed for men, but an increase of 3.1 % per year was demonstrated for women. After the introduction of colorectal and cervical cancer screening programmes, a significant decrease of incidence rates for these diagnoses was observed. CONCLUSIONS Knowledge of the current cancer burden in the population and its time trends will help to prioritise targets and future resource allocation to cancer control.
Collapse
|
3
|
Pehalová L, Krejčí D, Svobodová I, Ngo O, Májek O, Mužík J, Dušek L. Epidemiology of breast neoplasms at the time of organized screening program in the Czech Republic. ACTA ACUST UNITED AC 2020. [DOI: 10.36290/xon.2020.056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
4
|
Večeřová L, Petráš M, Čelko AM, Rambousková J. Risk of Breast Cancer Revealed by Mammographic Screening in Czech Women Aged 40-45 Years, a Monocentric Cohort Study. Diagnostics (Basel) 2020; 10:E726. [PMID: 32967208 PMCID: PMC7554746 DOI: 10.3390/diagnostics10090726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/18/2020] [Accepted: 09/19/2020] [Indexed: 11/23/2022] Open
Abstract
The aim of the present study was to evaluate breast cancer risk in women aged 40-45 years not included in the routine mammographic screening programme in the Czech Republic and to assess the suitability of the screening interval. Our cohort study was conducted using registry data of one mammography centre (Bulovka Hospital in Prague) between 1 January 2008 and 31 December 2017. The risk of breast cancer was evaluated using a positive predictive finding (PPF) corresponding to the Breast Imaging-Reporting and Data System (BI-RADS) scores of 4 and 5. The annual PPF incidence rate achieved 2.25 per 1000 women aged 40-45 years and was not significantly different from that (3.31) of women of 45-50 years of age as demonstrated by an adjusted hazard ratio of 0.75 (95% confidence interval: 0.42-1.33). It was found that a screening interval longer than 3 years increased the chance of PPF occurrence 1.7 times independently of the women's age, signalling a risk of failure of early detection of breast cancer. The same PPF incidence rates both in women aged 40-45 years and in older ones indicates that even younger women should be eligible for enrolment in the routine mammographic screening programme in the Czech Republic.
Collapse
Affiliation(s)
- Lívia Večeřová
- Third Faculty of Medicine, Charles University, Ruská 87, 10000 Prague, Czech Republic; (L.V.); (A.M.Č.); (J.R.)
- Bulovka Hospital, Budínova 67/2, 18081 Prague 8, Czech Republic
| | - Marek Petráš
- Third Faculty of Medicine, Charles University, Ruská 87, 10000 Prague, Czech Republic; (L.V.); (A.M.Č.); (J.R.)
| | - Alexander M. Čelko
- Third Faculty of Medicine, Charles University, Ruská 87, 10000 Prague, Czech Republic; (L.V.); (A.M.Č.); (J.R.)
| | - Jolana Rambousková
- Third Faculty of Medicine, Charles University, Ruská 87, 10000 Prague, Czech Republic; (L.V.); (A.M.Č.); (J.R.)
| |
Collapse
|
5
|
Dimitrova N, Znaor A, Agius D, Eser S, Sekerija M, Ryzhov A, Primic-Žakelj M, Coebergh JW. Breast cancer in South-Eastern European countries since 2000: Rising incidence and decreasing mortality at young and middle ages. Eur J Cancer 2017; 83:43-55. [PMID: 28711578 DOI: 10.1016/j.ejca.2017.06.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 06/01/2017] [Accepted: 06/11/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Marked variations exist in the incidence and mortality trends of major cancers in South-Eastern European (SEE) countries which have now been detailed by age for breast cancer (BC) to seek clues for improvement. METHODS We brought together and analysed data from 14 cancer registries (CRs), situated in SEE countries or directly adjacent. Age-standardised rate at world standard (ASRw) and truncated incidence and mortality rates during 2000-2010 by year, and for four age groups, were calculated. Average annual percentage change of rates was estimated using Joinpoint regression. RESULTS Annual incidence rates increased significantly in countries and age groups, by 2-4% (15-39 years), 2-5% (40-49), 1-4% (50-69) and 1-6% (at 70+). Mortality rates decreased significantly in all age-groups in most countries, but increased up to 5% annually above age 55 in Ukraine, Serbia, Moldova and Cyprus. The BC data quality was evaluated by internationally agreed indicators which appeared suboptimal for Moldova, Bosnia and Herzegovina and Romania. CONCLUSION The observed variations of incidence trends reflect the influence of risk factors, as well as levels of early detection activities (screening). While mortality rates were mostly decreasing, probably due to improved cancer care and introduction of more effective systemic treatment regimens, the worrying increasing mortality trends in the 55-plus age groups in some countries have to be addressed by health professionals and policymakers. In order to assess and monitor the effects of cancer control activities in the region, the CRs need substantial investments.
Collapse
Affiliation(s)
| | - Ariana Znaor
- Cancer Surveillance Unit, International Agency for Research on Cancer, Lyon, France
| | | | - Sultan Eser
- Hacettepe University, Institute of Public Health, Ankara and Cancer Registry of Izmir, Izmir, Turkey
| | - Mario Sekerija
- Croatian Institute of Public Health, Croatian National Cancer Registry, Andrija Stampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Anton Ryzhov
- National Cancer Registry of Ukraine, National Institute of Cancer, Kyiv, Ukraine
| | | | | |
Collapse
|
6
|
Boncz I, Döbrőssy L, Péntek Z, Kovács A, Budai A, Imre L, Vajda R, Sebestyén A. [Attendance of the fourth (2008-2009) screening round of the Hungarian organized, nationwide breast cancer screening program]. Orv Hetil 2016; 154:1975-83. [PMID: 24317356 DOI: 10.1556/oh.2013.29744] [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] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Organised, nationwide screening for breast cancer with mammography in the age group between 45 and 65 years with 2 years screening interval started in Hungary in January 2002. AIM The aim of this study is to analyze the attendance rate of nationwide breast screening programme for the 2008-2009 years. METHOD The data derive from the database of the National Health Insurance Fund Administration. The ratio of women in the age group 45-65 years was calculated having either a screening mammography or a diagnostic mammography in the 4th screening round of the programme. RESULTS In the years 2000-2001, 7.6% of the women had an opportunistic screening mammography while in 2008-2009 31.2% of the target population had screening mammography within the organized programme. During the same periods 20.2% (2000-2001) and 20.4% (2008-2009) of women had a diagnostic mammography. Thus the total (screening and diagnostic) coverage of mammography increased from 26.6% (2000-2001) to 50.1% (2008-2009). The attendance rate failed to change between 2002 and 2009. CONCLUSIONS In order to decrease the mortality due to breast cancer, the attendance rate of mammography screening programme should be increased. Orv. Hetil., 154(50), 1975-1983.
Collapse
Affiliation(s)
- Imre Boncz
- Pécsi Tudományegyetem, Egészségtudományi Kar Egészségbiztosítási Intézet Pécs Mária u. 5-7. 7621
| | | | | | | | | | | | | | | |
Collapse
|
7
|
Altobelli E, Lattanzi A. Breast cancer in European Union: an update of screening programmes as of March 2014 (review). Int J Oncol 2014; 45:1785-92. [PMID: 25174328 PMCID: PMC4203333 DOI: 10.3892/ijo.2014.2632] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Accepted: 06/26/2014] [Indexed: 12/11/2022] Open
Abstract
Breast cancer, a major cause of female morbidity and mortality, is a global health problem; 2008 data show an incidence of ~450,000 new cases and 140,000 deaths (mean incidence rate 70.7 and mortality rate 16.7, world age-standardized rate per 100,000 women) in European Union Member States. Incidence rates in Western Europe are among the highest in the world. We review the situation of BC screening programmes in European Union. Up to date information on active BC screening programmes was obtained by reviewing the literature and searching national health ministries and cancer service websites. Although BC screening programmes are in place in nearly all European Union countries there are still considerable differences in target population coverage and age and in the techniques deployed. Screening is a mainstay of early BC detection whose main weakness is the rate of participation of the target population. National policies and healthcare planning should aim at maximizing participation in controlled organized screening programmes by identifying and lowering any barriers to adhesion, also with a view to reducing healthcare costs.
Collapse
Affiliation(s)
- E Altobelli
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - A Lattanzi
- Epidemiologic and Social Marketing Unit, AUSL 4 Teramo, Italy
| |
Collapse
|
8
|
Pavlík T, Májek O, Büchler T, Vyzula R, Petera J, Ryska M, Ryška A, Cibula D, Babjuk M, Abrahámová J, Vorlíček J, Mužík J, Dušek L. Trends in stage-specific population-based survival of cancer patients in the Czech Republic in the period 2000–2008. Cancer Epidemiol 2014; 38:28-34. [DOI: 10.1016/j.canep.2013.11.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Revised: 10/16/2013] [Accepted: 11/14/2013] [Indexed: 12/23/2022]
|
9
|
Cazzoli R, Buttitta F, Di Nicola M, Malatesta S, Marchetti A, Pass HI. microRNAs derived from circulating exosomes as noninvasive biomarkers for screening and diagnosing lung cancer. J Thorac Oncol 2013; 8:1156-62. [PMID: 23945385 PMCID: PMC4123222 DOI: 10.1097/jto.0b013e318299ac32] [Citation(s) in RCA: 337] [Impact Index Per Article: 30.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Lung cancer is the highest cause of mortality among tumor pathologies worldwide. There are no validated techniques for an early detection of pulmonary cancer lesions other than low-dose helical computed tomography scan. Unfortunately, this method has some negative effects. Recent studies have laid the basis for development of exosomes-based techniques to screen/diagnose lung cancers. As the isolation of circulating exosomes is a minimally invasive procedure, this technique opens new possibilities for diagnostic applications. METHODS We used a first set of 30 plasma samples from as many patients, including 10 patients affected by lung adenocarcinomas, 10 with lung granulomas, and 10 healthy smokers matched for age and sex as negative controls. Wide-range microRNAs analysis (742 microRNAs) was performed by quantitative real time polymerase chain reaction. Data were compared on the basis of lesion characteristics, using WEKA software for statistics and modeling. Subsequently, selected microRNAs were evaluated on an independent larger group of samples (105 specimens: 50 lung adenocarcinomas, 30 lung granulomas, and 25 healthy smokers). RESULTS This analysis led to the selection of four microRNAs to perform a screening test (miR-378a, miR-379, miR-139-5p, and miR-200b-5p), useful to divide population into two groups: nodule (lung adenocarcinomas + carcinomas) and non-nodule (healthy former smokers). Six microRNAs (miR-151a-5p, miR-30a-3p, miR-200b-5p, miR-629, miR-100, and miR-154-3p) were selected for a second test on the nodule population to discriminate between lung adenocarcinoma and granuloma. CONCLUSIONS The screening test showed 97.5% sensitivity, 72.0% specificity, and area under the curve receiver operating characteristic of 90.8%. The diagnostic test had 96.0% sensitivity, 60.0% specificity, and area under the curve receiver operating characteristic of 76.0%. Further evaluation is needed to confirm the predictive power of these models on larger cohorts of samples.
Collapse
Affiliation(s)
- Riccardo Cazzoli
- Center of Predictive Molecular Medicine, Center of Excellence on Aging, University-Foundation, Chieti, Italy
- Department of Cardiothoracic Surgery, NYU School of Medicine, New York, NY
| | - Fiamma Buttitta
- Center of Predictive Molecular Medicine, Center of Excellence on Aging, University-Foundation, Chieti, Italy
- Oncological and Cardiovascular Molecular Medicine Unit, University-Foundation, Chieti, Italy
| | - Marta Di Nicola
- Laboratory of Biostatistics, Department of Biomedical Sciences, University “G. d’Annunzio”, Chieti, Italy
| | - Sara Malatesta
- Center of Predictive Molecular Medicine, Center of Excellence on Aging, University-Foundation, Chieti, Italy
| | - Antonio Marchetti
- Center of Predictive Molecular Medicine, Center of Excellence on Aging, University-Foundation, Chieti, Italy
| | - Harvey I. Pass
- Department of Cardiothoracic Surgery, NYU School of Medicine, New York, NY
| |
Collapse
|
10
|
Andreeva VA, Pokhrel P. Breast cancer screening utilization among Eastern European immigrant women worldwide: a systematic literature review and a focus on psychosocial barriers. Psychooncology 2013; 22:2664-75. [PMID: 23824626 DOI: 10.1002/pon.3344] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Revised: 05/28/2013] [Accepted: 05/31/2013] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Many countries host growing Eastern European immigrant communities whose breast cancer preventive behaviors are largely unknown. Thus, we aimed to synthesize current evidence regarding secondary prevention via breast cancer screening utilized by that population. METHODS All observational, general population studies on breast cancer screening with Eastern European immigrant women and without any country, language, or age restrictions were identified. Screening modalities included breast self-examination, clinical breast examination, and mammography. RESULTS The selected 30 studies were published between 1996 and 2013 and came from Australia, Canada, Denmark, Germany, Israel, the Netherlands, Spain, Switzerland, the UK, and the USA. The reported prevalence of monthly breast self-examination was 0-48%; for yearly clinical breast examination 27-54%; and for biennial mammography 0-71%. The substantial methodologic heterogeneity prevented a meta-analysis. Nonetheless, irrespective of host country, healthcare access, or educational level, the findings consistently indicated that Eastern European immigrant women underutilize breast cancer screening largely because of insufficient knowledge about early detection and an external locus of control regarding decision making in health matters. CONCLUSIONS This is a vulnerable population for whom the implementation of culturally tailored breast cancer screening programs is needed. As with other underscreened immigrant/minority groups, Eastern European women's inadequate engagement in prevention is troublesome as it points to susceptibility not only to cancer but also to other serious conditions for which personal action and responsibility are critical.
Collapse
|
11
|
Patterns of breast cancer mortality trends in Europe. Breast 2013; 22:244-53. [PMID: 23478201 DOI: 10.1016/j.breast.2013.02.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Revised: 01/25/2013] [Accepted: 02/11/2013] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES To identify patterns of variation in breast cancer mortality in Europe (1980-2010), using a model-based approach. METHODS Mortality data were obtained from the World Health Organization database and mixed models were used to describe the time trends in the age-standardized mortality rates (ASMR). Model-based clustering was used to identify clusters of countries with homogeneous variation in ASMR. RESULTS Three patterns were identified. Patterns 1 and 2 are characterized by stable or slightly increasing trends in ASMR in the first half of the period analysed, and a clear decline is observed thereafter; in pattern 1 the median of the ASMR is higher, and the highest rates were achieved sooner. Pattern 3 is characterised by a rapid increase in mortality until 1999, declining slowly thereafter. CONCLUSION This study provides a general model for the description and interpretation of the variation in breast cancer mortality in Europe, based in three main patterns.
Collapse
|
12
|
Hofvind S, Ponti A, Patnick J, Ascunce N, Njor S, Broeders M, Giordano L, Frigerio A, Törnberg S. False-Positive Results in Mammographic Screening for Breast Cancer in Europe: A Literature Review and Survey of Service Screening Programmes. J Med Screen 2012; 19 Suppl 1:57-66. [PMID: 22972811 DOI: 10.1258/jms.2012.012083] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Solveig Hofvind
- Researcher, Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Antonio Ponti
- Epidemiologist, Epidemiology Unit, CPO Piemonte, AOU S. Giovanni Battista, Turin, Italy
| | | | - Nieves Ascunce
- Public Health Doctor, Navarra Breast Cancer Screening Programme. Spanish Cancer Screening Network, Public Health Institute, Pamplona, Spain
| | - Sisse Njor
- Post Doc, Centre for Epidemiology and Screening, University of Copenhagen, Copenhagen, Denmark
| | - Mireille Broeders
- Senior Epidemiologist, Department of Epidemiology, Biostatistics and HTA, Radboud University Nijmegen Medical Centre, and National Expert and Training Centre for Breast Cancer Screening, Nijmegen, The Netherlands
| | - Livia Giordano
- MD MPH, Epidemiologist, Epidemiology Unit, CPO Piemonte, AOU S. Giovanni Battista, Turin, Italy
| | - Alfonso Frigerio
- Radiologist, Regional Reference Centre for Breast Cancer Screening, AOU S. Giovanni Battista, Turin, Italy
| | - Sven Törnberg
- Oncologist and Director, Cancer Screening Unit, Oncologic Centre S3:00, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
13
|
Adherence to breast and cervical cancer screening in Spanish women with diabetes: associated factors and trend between 2006 and 2010. DIABETES & METABOLISM 2011; 38:142-8. [PMID: 22078638 DOI: 10.1016/j.diabet.2011.09.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2011] [Revised: 09/28/2011] [Accepted: 09/29/2011] [Indexed: 11/24/2022]
Abstract
AIM This study aimed to assess the adherence to breast and cervical cancer screening of women with diabetes mellitus (DM), and the associated factors and trend of use over time of these preventative services between 2006 and 2010 in Spain. METHODS The study used data from a population of women aged greater or equal to 18 years (n=11,957) who participated in the European Health Interview Survey in Spain (EHISS, 2009). Diabetes status was self-reported and included those with type 2 DM. Adherence to screening for cancer prevention was assessed by asking women aged greater or equel to 40 years whether they had undergone mammography and a Papanicolaou (Pap) cervical smear (in those aged 18-69 years) within the previous 2 and 3 years, respectively. Independent variables included sociodemographic and health-related characteristics. Also, the age-standardized prevalences of mammography and Pap smear uptake were compared in women with diabetes between 2006 and 2010. RESULTS Among the diabetic women, 37.9% underwent mammography and 49.1% had a Pap smear vs 53.8% and 64%, respectively, in women without diabetes, with corresponding adjusted odds ratios of 0.81 (95% CI: 0.68-0.97) and 0.74 (95% CI: 0.60-0.91). Among diabetic women, attending more "physician visits" was a positive predictor of having both screening tests. Also, a higher monthly income level was associated with mammography uptake, and a higher educational level with Pap smear uptake. There was also a significant decrease in mammography screening uptake between 2006 and 2010 compared with a stable rate of uptake of cervical cancer screening. CONCLUSION Spanish women with diabetes consistently underuse breast and cervical cancer screening tests compared with non-diabetic women. The decline in mammography uptake rates needs to be carefully monitored and may even call for intervention.
Collapse
|