Objective This study compares adherence to breast and ovarian cancer screening recommendations among a population cohort of women at familial risk to breast and/or ovarian cancer. Methods This cross-sectional study included 1039 first-degree female relatives without breast cancer identified from the Ontario site of the Breast Cancer Family Registry. We compared breast and ovarian cancer screening behaviours, using a telephone-administered questionnaire, among three groups of women defined by their familial risk (high; moderate; low) to breast and/or ovarian cancer. Associations between screening behaviours and familial risk were assessed using multinomial regression models adjusted by familial clustering. Results Women 40 to 49 years of age at moderate or high familial risk were significantly more likely to have had a screening mammogram within the past 12 months (OR: 2.80; 95% CI: 1.40-5.58), and women less than 50 years of age were more likely to have a clinical breast examination (OR: 1.84; 95% CI: 1.02-3.31) compared to women at low familial risk. Compared to women at low or moderate familial risk, women at high familial risk were significantly more likely to have ever had a genetic test for the BRCA 1/2 genes (OR: 2.67; 95% CI: 1.76-4.05). Conclusions Although the overall level of adherence among higher risk women is sub-optimal in the community, women at a higher familial risk are adhering more often to cancer screening recommendations than women at a lower familial risk.

Background: Previous research suggests that predisposing factors such as previous screening experience, participation in preventive health behaviors, and knowledge/beliefs about breast cancer and screening influence a woman's decision to make a timely return for a second screen. Methods: A stratified random sample of compliers and noncompliers to biennial screening were selected from a cohort of 51,242 women ages 50 to 65 years who had their initial screen at the Ontario Breast Screening Program. In total, 1,901 women were telephone-interviewed. The associations between predisposing factors and compliance were estimated separately for centers with and without nurses using logistic regression analyses adjusted for demographics and smoking status. Results: Women screened at nurse centers were less likely to comply if they thought women should stop

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Introduction Combat deployment is associated with mental and physical health disorders and functional impairment. Mental health (MH) diagnoses such as adjustment and anxiety disorders have received little research attention but may reflect important postdeployment sequelae. The purpose of this study was to investigate the association of combat exposure with the acquisition of a wide range of mental health diagnoses over 2 years. Materials and Methods This retrospective longitudinal study utilized multiple administrative Military Health System datasets compiled for all individuals who entered active duty in the U.S. Army from FY2005 to FY2011. A total eligible cohort of 289,922 Service members was stratified into three mutually exclusive groups according to their deployment status after 2 years in service: Deployed, Combat-Exposed; Deployed, Not-Combat-Exposed; and Not Deployed. Outcomes of interest were new mental health diagnoses grouped into six categories—posttraumatic stress disorder, anxiety, adjustment, mood, substance use disorders, and any MH diagnosis. Survival analyses over 2 years were conducted and adjusted hazard ratios were calculated. Results Combat exposure in the first 2 years of military service was associated with significantly higher rates of a wide range of mental health diagnoses over a two-year follow-up period, compared with deployment with no combat exposure and no deployment. Adjusted cumulative failure proportions demonstrated that approximately a third of the Combat-Exposed group, a quarter of the Not-Combat-Exposed, and a fifth of the Not Deployed groups received a MH diagnosis over 2 years. For all groups, cumulative failure proportions and incidence rates were highest for adjustment disorder and lowest for posttraumatic stress disorder diagnoses. Conclusions Researchers and providers should be alerted to the impact of combat exposure and the wide range of MH conditions and diagnoses that may represent important postdeployment sequelae.

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