Impact of socio‐economic status on breast cancer screening in women with diabetes: a population‐based study

Chan, WC; Yun, Lingsong; Austin, Peter C.; Jaakkimainen, R. Liisa; Booth, Gillian L.; Hux, Janet E.; Rochon, Paula A.; Lipscombe, Lorraine L.

doi:10.1111/dme.12422

Cited by 25 publications

(31 citation statements)

References 26 publications

(52 reference statements)

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“…Previous studies have found that diabetes poses a significant barrier to adequate breast cancer screening . Our group has shown that women with diabetes are less likely to undergo screening mammography than those without diabetes, even within the Ontario Breast Cancer Screening Program . However, this study did not show a similar trend for diagnostic testing once women were screened.…”

Section: Discussioncontrasting

confidence: 77%

“…Evidence suggests that women with diabetes are more likely to be diagnosed with postmenopausal breast cancer, present at an advanced stage, and have increased all-cause mortality after being diagnosed with breast cancer, compared to women without diabetes [1][2][3][4][5][6]. Although effective screening has been shown to decrease breast cancer mortality in postmenopausal women, those with diabetes are less likely to undergo regular mammograms [7][8][9][10][11]. Even if a screening mammogram is performed, an abnormal test needs to be followed-up in a timely ORIGINAL RESEARCH Time to follow-up of an abnormal mammogram in women with diabetes: a population-based study manner in order for the screening to be considered effective.…”

Section: Introductionmentioning

confidence: 99%

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Time to follow‐up of an abnormal mammogram in women with diabetes: a population‐based study

et al. 2016

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Women with diabetes have a higher breast cancer incidence and mortality. They are also significantly less likely to undergo screening mammography and present with more advanced stage than women without diabetes. The purpose of this study was to examine if women with diabetes are more likely to have delays in follow‐up of abnormal mammograms, compared to women without diabetes. Using population‐based health databases, this retrospective cohort study examined women between the ages of 50 and 74, with and without diabetes, living in the province of Ontario, Canada, who underwent screening through a centralized program and who had an abnormal mammogram between 2003 and 2012. We compared rates of follow‐up of a diagnostic test within 180 days, as well as likelihood of mastectomy or excision procedure and a diagnosis of breast cancer. Following an abnormal screening mammogram, 97.5% of women with diabetes had a diagnostic procedure within 180 days compared to 97.9% of women without diabetes. After adjustment for other factors, women with diabetes were only 3% less likely to have follow‐up testing after an abnormal mammogram than women without diabetes (hazard ratio [HR] 0.97, 95% CI: 0.96–0.99, P < 0.001). The majority of Ontario women who underwent screening mammography through a centralized screening program had timely follow‐up of an abnormal mammogram, with no meaningful delays in those who had diabetes. The results of this study suggest that diagnostic delays after screening do not significantly contribute to higher breast cancer mortality in women with diabetes.

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Section: Discussioncontrasting

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Time to follow‐up of an abnormal mammogram in women with diabetes: a population‐based study

et al. 2016

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“…However, women with diabetes are less likely to be up-to-date compared to men with diabetes. Further, women with diabetes tend to participate less in clinical preventive services (i.e., mammography screening) compared to women without diabetes ( 35 ). We did not specifically evaluate interactions between patient characteristics, but important subgroups, such as overweight women with diabetes could be potential target populations for screening outreach.…”

Section: Discussionmentioning

confidence: 99%

Patterns of Colorectal Cancer Screening Uptake in Newly Eligible Men and Women

Wernli

Hubbard

Johnson

et al. 2014

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background We describe patterns of colorectal cancer screening uptake in a U.S. insured population as individuals become newly-eligible for screening at age 50 and assess temporal trends and patient characteristics with screening uptake. Methods We identified a cohort of 81,223 men and women who were members of Group Health and turned 50 years old from 1996 – 2010. We ascertained receipt of colorectal cancer screening within five years. Time to screening was estimated by year of cohort entry using cumulative incidence curves and Cox proportional hazards models estimated patient characteristics associated with screening uptake. Results Stool-based screening tests were the most common, 72% of first screening tests. The proportion of individuals initiating colorectal cancer screening via colonoscopy increased from 8% in 1996–98 to 33% in 2008–10. Patient factors associated with increased colorectal cancer screening were: turning 50 more recently (2008–10) (p-trend<0.0001) or Asian race (HR=1.14, 95% CI 1.10–1.19). Patient factors associated with decreased screening were: being a woman (HR=0.70, 95% CI 0.68–0.72), Native American (HR=0.68, 95% CI 0.60–0.78) or Pacific Islander race (HR=0.82, 95% CI 0.72–0.95), and having prevalent diabetes (HR=0.78, 95% CI 0.75–0.82) and higher body mass index (p-trend<0.0001). Conclusions Patient characteristics associated with initiation of colorectal cancer screening in a newly-eligible population are similar to characteristics associated with overall screening participation in all age-eligible adults. Our results identify patient populations to target in outreach programs. Impact Disparities in receipt of colorectal cancer screening are evident from onset of an age-eligible cohort, identifying key groups for future interventions for screening.

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“…[9–11]. Some studies demonstrate that individuals with existing co-morbidities, such as diabetes, have lower cancer screening rates than those without co-morbidities[12–14]; and in some cases, those with diabetes have lower screening rates despite having more visits to healthcare providers [9, 15–17]. A proposed reason for this under-screening includes competing priorities, i.e.…”

Section: Introductionmentioning

confidence: 99%

Non-communicable chronic diseases and timely breast cancer screening among women of the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study

Wang

Thompson

Galusha

et al. 2018

Cancer Causes Control

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Impact of socio‐economic status on breast cancer screening in women with diabetes: a population‐based study

Abstract: The presence of diabetes was an independent barrier to breast cancer screening, which was not explained by differences in socio-economic status. Interventions that target patient, provider, and health system factors are needed to improve cancer screening in this population.

Cited by 25 publications

References 26 publications

Time to follow‐up of an abnormal mammogram in women with diabetes: a population‐based study

Time to follow‐up of an abnormal mammogram in women with diabetes: a population‐based study

Patterns of Colorectal Cancer Screening Uptake in Newly Eligible Men and Women

Non-communicable chronic diseases and timely breast cancer screening among women of the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study

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