» Articles » PMID: 9669564

Chronic Disease As a Barrier to Breast and Cervical Cancer Screening

Overview
Publisher Springer
Specialty General Medicine
Date 1998 Jul 21
PMID 9669564
Citations 83
Authors
Affiliations
Soon will be listed here.
Abstract

Objective: To assess whether chronic disease is a barrier to screening for breast and cervical cancer.

Design: Structured medical record review of a retrospectively defined cohort.

Setting: Two primary care clinics of one academic medical center.

Patients: All eligible women at least 43 years of age seen during a 6-month period in each of the two study clinics (n = 1,764).

Measurements And Main Results: Study outcomes were whether women had been screened: for mammogram, every 2 years for ages 50-74; for clinical breast examinations (CBEs), every year for all ages; and for Pap smears, every 3 years for ages under 65. An index of comorbidity, adapted from Charlson (0 for no disease, maximum index of 8 among our patients), and specific chronic diseases were the main independent variables. Demographics, clinic use, insurance, and clinical data were covariates. In the appropriate age groups for each test, 58% of women had a mammogram, 43% had a CBE, and 66% had a Pap smear. As comorbidity increased, screening rates decreased (p < .05 for linear trend). After adjustment, each unit increase in the comorbidity index corresponded to a 17% decrease in the likelihood of mammography (p = .005), 13% decrease in CBE (p = .006), and 20% decrease in Pap smears (p = .002). The rate of mammography in women with stable angina was only two fifths of that in women without.

Conclusions: Among women who sought outpatient care, screening rates decreased as comorbidity increased. Whether clinicians and patients are making appropriate decisions about screening is not known.

Citing Articles

Comorbidities And Reducing InEquitieS (CARES): Feasibility of self-monitoring and community health worker support in management of comorbidities among Black breast and prostate cancer patients.

Schubel L, Barac A, Magee M, Mete M, Peeples M, Shomali M Contemp Clin Trials Commun. 2025; 43():101387.

PMID: 39810843 PMC: 11732108. DOI: 10.1016/j.conctc.2024.101387.


Disability and Participation in Colorectal Cancer Screening: A Systematic Review and Meta-Analysis.

Ricciardi G, Cuciniello R, De Ponti E, Lunetti C, Pennisi F, Signorelli C Curr Oncol. 2024; 31(11):7023-7039.

PMID: 39590148 PMC: 11593103. DOI: 10.3390/curroncol31110517.


Burden of cancers attributable to high fasting plasma glucose in the Middle East and North Africa region, 1990-2019.

Tondro Anamag F, Noori M, Nejadghaderi S, Sullman M, Grieger J, Kolahi A Cancer Med. 2023; 12(8):10031-10044.

PMID: 36951550 PMC: 10166946. DOI: 10.1002/cam4.5743.


Effect of Patient Characteristics on Uptake of Screening Using a Mailed Human Papillomavirus Self-sampling Kit: A Secondary Analysis of a Randomized Clinical Trial.

Winer R, Lin J, Tiro J, Miglioretti D, Beatty T, Gao H JAMA Netw Open. 2022; 5(11):e2244343.

PMID: 36449291 PMC: 9713609. DOI: 10.1001/jamanetworkopen.2022.44343.


Robots do not judge: service robots can alleviate embarrassment in service encounters.

Holthower J, van Doorn J J Acad Mark Sci. 2022; :1-18.

PMID: 35463183 PMC: 9019535. DOI: 10.1007/s11747-022-00862-x.


References
1.
Bastani R, Marcus A . Screening mammography rates and barriers to use: a Los Angeles County survey. Prev Med. 1991; 20(3):350-63. DOI: 10.1016/0091-7435(91)90034-2. View

2.
Etzi S, Lane D, Grimson R . The use of mammography vans by low-income women: the accuracy of self-reports. Am J Public Health. 1994; 84(1):107-9. PMC: 1614905. DOI: 10.2105/ajph.84.1.107. View

3.
LINN B, Linn M, GUREL L . Cumulative illness rating scale. J Am Geriatr Soc. 1968; 16(5):622-6. DOI: 10.1111/j.1532-5415.1968.tb02103.x. View

4.
Mor V, Pacala J, Rakowski W . Mammography for older women: who uses, who benefits?. J Gerontol. 1992; 47 Spec No:43-9. View

5.
Schoen R, Marcus M, Braham R . Factors associated with the use of screening mammography in a primary care setting. J Community Health. 1994; 19(4):239-52. DOI: 10.1007/BF02260384. View