Patterns and correlates of cervical cancer screening initiation in a large integrated health care system

Becerra-Culqui, Tracy A.; Lonky, Neal M.; Chen, Qiaoling; Chao, Chun

doi:10.1016/j.ajog.2017.12.209

Cited by 13 publications

(8 citation statements)

References 30 publications

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“…For all logistic regression models, we used manual backward selection to individually remove variables exceeding a p-value of .10 from each model, but determined a priori that clinician type, practice type, and region would be retained in all models regardless of the corresponding p-values based on the importance of these factors in determining screening and colposcopy practices during the pandemic. [21][22][23][24] Quantitative analyses were conducted in SPSS Version 26.…”

Section: Analytic Planmentioning

confidence: 99%

A cross-sectional survey examining the association of clinician characteristics with perceived changes in cervical cancer screening and colposcopy practice during the COVID-19 pandemic

Fuzzell

Brownstein

Fontenot

et al. 2023

Preprint

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Background: The COVID-19 pandemic led to reductions in cervical cancer screening and colposcopy. Therefore, in this mixed method study we explored perceived pandemic-related practice changes to cervical cancer screenings and colposcopies.Methods: In 2021, a national sample of 1,251 clinicians completed surveys, including 675 clinicians who performed colposcopy; a subset (n=55) of clinicians completed qualitative interviews.Results: Nearly half of all clinicians reported they were currently performing fewer cervical cancer screenings (47%) and colposcopies (44% of those who perform the procedure) than before the pandemic. About one-fifth (18.6%) of colposcopists reported performing fewer LEEPs than prior to the pandemic. Binomial regression analyses indicated that older, non-White, internal medicine and family medicine clinicians (compared to OB-GYNs), and those practicing in community health centers (compared to private practice) had higher odds of reporting reduced screening. Among colposcopists, males, internal medicine physicians, those practicing in community health centers, and in the South had higher odds of reporting reduced colposcopies. Qualitative interviews highlighted pandemic-related care disruptions and lack of tracking systems to identify overdue screenings.Conclusions: Reductions in cervical cancer screening and colposcopy among nearly half of clinicians more than one year into the pandemic raise concerns that inadequate screening and follow-up will lead to future increases in preventable cancers.Funding: This study was funded by the American Cancer Society, who had no role in the study’s design, conduct, or reporting.

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Section: Analytic Planmentioning

confidence: 99%

A cross-sectional survey examining the association of clinician characteristics with perceived changes in cervical cancer screening and colposcopy practice during the COVID-19 pandemic

Fuzzell

Brownstein

Fontenot

et al. 2023

Preprint

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“…Cervical cancer (CCa) is one of the most common female cancers globally 92 . The World Health Organization states that approximately 530,000 patients with CCa are diagnosed every year around the world; this number progressively increases annually at a rate of 5% of the total female population and skews young 93 .…”

Section: Mir‐32 In Cancersmentioning

confidence: 99%

“…Cervical cancer (CCa) is one of the most common female cancers globally. 92 The World Health Organization states that approximately 530,000 patients with CCa are diagnosed every year around the world; this number progressively increases annually at a rate of 5% of the total female population and skews young. 93 Liu et al 94 posted data showing that in CCa tissue and cell lines, miR‐32‐5p is expressed at significantly reduced levels and can inhibit cellular malignant behaviour by regulating the expression of HOXB8.…”

Section: Mir‐32 In Cancersmentioning

confidence: 99%

Magic and mystery of microRNA‐32

Zeng

Zhu

Zhao

et al. 2021

J Cellular Molecular Medi

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MicroRNAs (miRNAs) are a group of endogenous, small (∼22 nts in length) noncoding RNA molecules that function specifically by base pairing with the mRNA of genes and regulate gene expression at the post‐transcriptional level. Alterations in miR‐32 expression have been found in numerous diseases and shown to play a vital role in cell proliferation, apoptosis, oncogenesis, invasion, metastasis and drug resistance. MiR‐32 has been documented as an oncomiR in the majority of related studies but has been also verified as a tumour suppressor miRNA in conflicting reports. Moreover, it has a crucial role in metabolic and cardiovascular disorders. This review provides an in‐depth look into the most recent finding regarding miR‐32, which is involved in the expression, regulation and functions in different diseases, especially tumours. Additionally, this review outlines novel findings suggesting that miR‐32 may be useful as a noninvasive biomarker and as a targeted therapeutic in several diseases.

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“…Understanding factors that in uence cervical cancer screening utilization is crucial for the success of cancer screening programs [2]. While many studies explored patient-level sociodemographic factors in uencing screening [11,12], few have examined the screening patterns of physicians [13]. Evidence from a retrospective cohort study from Ontario suggests that international medical graduates (IMGs) are about 4% to 39% less likely to screen their patients for cancer than US-or Canadian-trained physicians [14].…”

Section: Introductionmentioning

confidence: 99%

Adherence to cervical cancer screening guidelines by family physicians in Calgary: cross-sectional analysis using demographic characteristics and lab data

Sayed

Naugler

Chen

et al. 2023

Preprint

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Background: The effectiveness of cervical cancer screening programs is well recognized; however, inappropriate screening practices result in either a woman being tested too often or not tested at the recommended intervals. The objectives of the study were to identify the characteristics of family physicians associated with over- and underscreening for eligible women aged 25-69 in Calgary, Alberta. Methods: We performed a population-based retrospective observational study linking the Calgary Laboratory Services database from 2014-2016 to the College of Physicians and Surgeons of Alberta database of family physicians practicing in Calgary. We matched physicians’ characteristics with their cervical screening practices. Panel size data was not directly available, so we used their laboratory test orders in 2016 as a proxy measure to estimate physician practice size. For the underscreening analysis, we excluded those physicians whose estimated practice size was lower than the number of screening tests ordered. Logistic regression models were applied to analyze the overscreening and underscreening patterns. Results: Among 807 physicians included in the overscreening analysis, 43% of physicians had over-screened their screen-eligible patients. Physician characteristics significantly associated with overscreening included more years of practice and having more female patients in the practice. Among the 317 physicians included in the underscreening analysis, 42% had under-screened during the three-year study period. Female physicians were less likely to underscreen their eligible female patients. Physicians practicing in the Northeast quadrant of the city also had higher odds of underscreening. Conclusions: Screening patterns of family physicians indicate both overuse and underuse, which indicates inconsistency in adherence to screening guideline recommendations. Addressing disparities and identifying strategies to improve guideline adherence among different physician demographic groups is critical for the success of screening programs.

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Patterns and correlates of cervical cancer screening initiation in a large integrated health care system

Cited by 13 publications

References 30 publications

A cross-sectional survey examining the association of clinician characteristics with perceived changes in cervical cancer screening and colposcopy practice during the COVID-19 pandemic

A cross-sectional survey examining the association of clinician characteristics with perceived changes in cervical cancer screening and colposcopy practice during the COVID-19 pandemic

Magic and mystery of microRNA‐32

Adherence to cervical cancer screening guidelines by family physicians in Calgary: cross-sectional analysis using demographic characteristics and lab data

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