Title: Racial/Ethnic Differences Affecting Adherence to Cancer Screening Guidelines Among Women
Country: United States
Age: Adult Only
Population: Multiple Groups
Care Setting: Outpatient Ambulatory and Primary Care
Clinical Setting: Breast Cancer Screening
Data Level: National
Data Type: Government Survey
Data Source: Health Information National Trends Survey
Conclusion: Disparities In Some Minority Groups
Health OutComes Reported: No
Free Text Conclusion: Black patients were more likely to have completed a mammogram in the past two years in comparison with Non-Hispanic White patients when adjusted by age, race, education, income, marital status, BMI, health insurance, and history of cancer.
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.