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Racial/Ethnic Differences Affecting Adherence to Cancer Screening Guidelines Among Women.
J Womens Health (Larchmt). 2016 Apr; 25(4):371-80.JW

Abstract

BACKGROUND

Race/ethnicity has been shown to modify the effects between obesity and cancer screening among women. The purpose of this article is to update the literature with recent data to examine how the association between different characteristics, including body mass index (BMI), and cancer screening compliance varies by race/ethnicity in a national sample of women.

MATERIALS AND METHODS

Three cycles of the Health Information National Trends Survey (HINTS) were combined for this cross-sectional study. Weighted descriptive statistics were evaluated using chi-square tests. Multivariable logistic regression evaluated associations between women with underweight or normal (<25), overweight (25-29.9), and obese (>30) BMIs and cancer screening concordant with guidelines (Papanicolaou [Pap] testing ≤3 years, ages 21+ years; mammography ≤2 years, ages 40+ years) in analyses stratified by race/ethnicity. We also assessed variance between racial/ethnic groups in how age, income, and insurance status were associated with cancer screening compliance.

RESULTS

This study included 4992 women who were evaluated for Pap testing and 3773 for mammography. In analyses stratified by race/ethnicity, whites with a higher household income were more likely to report having a Pap test (adjusted prevalence ratio [aPR] 2.16, 95% confidence interval [95% CI] 1.38-3.40) and a mammogram (aPR 1.63, 95% CI 1.04-2.55) compared to lower income white women. Black women with BMIs between 25 and 30 were less likely to receive a Pap test (aPR 0.38, 95% CI 0.19-0.76) than black women with BMIs <25, while no association was observed among the other groups. Insurance was associated with increased likelihood of Pap testing among white and black women. Insurance coverage was positively associated with mammography only among white and Hispanic women.

CONCLUSIONS

We found variations in adherence to cancer screening guidelines by age, insurance coverage, and income between racial/ethnic groups. Little evidence was observed for variations in screening by BMI.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch , Galveston, Texas.Department of Obstetrics and Gynecology, Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch , Galveston, Texas.Department of Obstetrics and Gynecology, Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch , Galveston, Texas.Department of Obstetrics and Gynecology, Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch , Galveston, Texas.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

26579735

Citation

Hirth, Jacqueline M., et al. "Racial/Ethnic Differences Affecting Adherence to Cancer Screening Guidelines Among Women." Journal of Women's Health (2002), vol. 25, no. 4, 2016, pp. 371-80.
Hirth JM, Laz TH, Rahman M, et al. Racial/Ethnic Differences Affecting Adherence to Cancer Screening Guidelines Among Women. J Womens Health (Larchmt). 2016;25(4):371-80.
Hirth, J. M., Laz, T. H., Rahman, M., & Berenson, A. B. (2016). Racial/Ethnic Differences Affecting Adherence to Cancer Screening Guidelines Among Women. Journal of Women's Health (2002), 25(4), 371-80. https://doi.org/10.1089/jwh.2015.5270
Hirth JM, et al. Racial/Ethnic Differences Affecting Adherence to Cancer Screening Guidelines Among Women. J Womens Health (Larchmt). 2016;25(4):371-80. PubMed PMID: 26579735.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Racial/Ethnic Differences Affecting Adherence to Cancer Screening Guidelines Among Women. AU - Hirth,Jacqueline M, AU - Laz,Tabassum Haque, AU - Rahman,Mahbubur, AU - Berenson,Abbey B, Y1 - 2015/11/18/ PY - 2015/11/19/entrez PY - 2015/11/19/pubmed PY - 2016/12/15/medline SP - 371 EP - 80 JF - Journal of women's health (2002) JO - J Womens Health (Larchmt) VL - 25 IS - 4 N2 - BACKGROUND: Race/ethnicity has been shown to modify the effects between obesity and cancer screening among women. The purpose of this article is to update the literature with recent data to examine how the association between different characteristics, including body mass index (BMI), and cancer screening compliance varies by race/ethnicity in a national sample of women. MATERIALS AND METHODS: Three cycles of the Health Information National Trends Survey (HINTS) were combined for this cross-sectional study. Weighted descriptive statistics were evaluated using chi-square tests. Multivariable logistic regression evaluated associations between women with underweight or normal (<25), overweight (25-29.9), and obese (>30) BMIs and cancer screening concordant with guidelines (Papanicolaou [Pap] testing ≤3 years, ages 21+ years; mammography ≤2 years, ages 40+ years) in analyses stratified by race/ethnicity. We also assessed variance between racial/ethnic groups in how age, income, and insurance status were associated with cancer screening compliance. RESULTS: This study included 4992 women who were evaluated for Pap testing and 3773 for mammography. In analyses stratified by race/ethnicity, whites with a higher household income were more likely to report having a Pap test (adjusted prevalence ratio [aPR] 2.16, 95% confidence interval [95% CI] 1.38-3.40) and a mammogram (aPR 1.63, 95% CI 1.04-2.55) compared to lower income white women. Black women with BMIs between 25 and 30 were less likely to receive a Pap test (aPR 0.38, 95% CI 0.19-0.76) than black women with BMIs <25, while no association was observed among the other groups. Insurance was associated with increased likelihood of Pap testing among white and black women. Insurance coverage was positively associated with mammography only among white and Hispanic women. CONCLUSIONS: We found variations in adherence to cancer screening guidelines by age, insurance coverage, and income between racial/ethnic groups. Little evidence was observed for variations in screening by BMI. SN - 1931-843X UR - https://www.unboundmedicine.com/medline/citation/26579735/Racial/Ethnic_Differences_Affecting_Adherence_to_Cancer_Screening_Guidelines_Among_Women_ L2 - https://www.liebertpub.com/doi/10.1089/jwh.2015.5270?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -