Moderate psychological distress as a barrier to breast cancer screening among women

Abstract

Objective: To examine the relationship between Breast Cancer Screening (BCS) and Moderate Psychological Distress (MPD). Also, to assess the effect of aggregating women with No Psychological Distress (NPD) and MPD into one group, as done in prior studies when evaluating the relationship between BCS and Psychological Distress (PD).Methods: The study population comprised of 34,565 women aged 50-74 years who participated in the National Health Interview Survey from 2013 to 2017. The Kessler-6 PD index score (0-24) was dichotomized (0-12: NPD; > 13: Severe Psychological Distress SPD) and trichotomized (0-5: NPD; 5-12: MPD; > 13 SPD). Two multivariate logistic regressions were conducted for the dichotomous and trichotomous PD categories. Andersen’s Behavioral Model of Health Services Use guided the choice of covariates. Data analysis was conducted using SAS version 9.4.Results: Our study showed 4.6% had SPD, and 17.9% had MPD. The latter group (MPD) was included in the NPD group in the dichotomous analysis. In the dichotomous analysis, women with SPD (adjusted Odds Ratio (aOR) = 0.71, 95% CI = 0.63, 0.81, p < .00001) were less likely to have received a mammogram than those with NPD. In the trichotomous model, women with SPD (aOR = 0.76, 95% CI = 0.67, 0.87, p = .0001) and MPD (aOR = 0.84, 95% CI = 0.78, 0.91, p <.00001) were both less likely to have had a mammogram than those with NPD.Conclusions: Prior studies that included individuals with MPD among those with NPD overestimated the effect of SPD on mammography and minimized the importance of targeting women with MPD along with those that have SPD to enhance the uptake of mammography.

Offering on-site mammography in workplaces improved screening rates: Cluster randomized controlled trial

“…This was also consistent with another study that reported that on-site mammography was particularly effective for some subgroups with low screening rates. 28 Previous studies have reported that cancer screening rates are lower among populations such as smokers, [32][33][34] part-time workers, 35 people with depression, 33,36 obese people, 37 and those with low health literacy. 38 There has also been concern that educational health promotion is less likely to be effective among individuals with low health interest and increased health disparities.…”

The association between diabetes and gastric cancer: results from the Stomach Cancer Pooling Project Consortium

“…However, the similarity of ORs between studies that used hospital controls and those with controls from the general population, as well as across levels of other sociodemographic characteristics suggests this bias was unlikely to have occurred. Due to absent or limited data, we were not able to adjust for other established correlates of diabetes and gastric cancer in our models, including medications use, salt intake, glycemic control, family history of gastric cancer, and factors known to affect diabetes or cancer-related health-seeking behaviors, such as mental wellbeing (Peleteiro et al , 2011; Bajaj et al , 2012; Tseng and Tseng, 2014; Kabir et al , 2020). However, our inclusion of H. pylori infection serostatus, fruit/vegetable consumption, and history of gastric ulcer as covariates in study-specific logistic regression models is a significant improvement in many previous studies.…”