Predictors of Non-Adherence to Breast Cancer Screening among Hospitalized Women

Abstract

ObjectiveDisparities in screening mammography use persists among low income women, even those who are insured, despite the proven mortality benefit. A recent study reported that more than a third of hospitalized women were non-adherent with breast cancer screening. The current study explores prevalence of socio-demographic and clinical variables associated with non-adherence to screening mammography recommendations among hospitalized women.Patients and MethodsA cross sectional bedside survey was conducted to collect socio-demographic and clinical comorbidity data thought to effect breast cancer screening adherence of hospitalized women aged 50–75 years. Logistic regression models were used to assess the association between these factors and non-adherence to screening mammography.ResultsOf 250 enrolled women, 61% were of low income, and 42% reported non-adherence to screening guidelines. After adjustment for socio-demographic and clinical predictors, three variables were found to be independently associated with non-adherence to breast cancer screening: low income (OR = 3.81, 95%CI; 1.84–7.89), current or ex-smoker (OR = 2.29, 95%CI; 1.12–4.67), and history of stroke (OR = 2.83, 95%CI; 1.21–6.60). By contrast, hospitalized women with diabetes were more likely to be compliant with breast cancer screening (OR = 2.70, 95%CI 1.35–5.34).ConclusionBecause hospitalization creates the scenario wherein patients are in close proximity to healthcare resources, at a time when they may be reflecting upon their health status, strategies could be employed to counsel, educate, and motivate these patients towards health maintenance. Capitalizing on this opportunity would involve offering screening during hospitalization for those who are overdue, particularly for those who are at higher risk of disease.

<p>Morbidity as a Predictor for Participation in the Danish National Mammography Screening Program: A Cross-Sectional Study</p>

“…12,23 In our assessment of morbidity, we relied on diagnoses from hospital contacts, hence excluding chronic conditions that only receive medical care in general practice. Further, it should be noted that we did not include information on socioeconomic status, even though some studies have shown it to be a predictor of screening participation [6][7][8]15 and associated with multimorbidity. 24 However, in a study by Jensen et al, the association between multimorbidity and participation was still present after adjusting for socioeconomic status.…”

“…Studies indicate that women with a high level of education, a high income, or being married are most likely to participate. [6][7][8] Although, one Danish study showed that the educational gradient in women never participating was U-shaped. 9 Multimorbidity, defined as the occurrence of multiple chronic conditions in the same individual, is a growing problem.…”

“…12 Two studies based on self-assessed health found that women with increased morbidity had a higher participation rate compared to those without morbidity. 6,8 Another study reported that even though poor self-assessed health was associated with low screening participation, having one or more chronic conditions increased participation. These women may have frequent contact with the healthcare system and therefore be more likely to be compliant.…”

Analyzing Factors of Breast Cancer Screening Adherence among Korean American Women Using Andersen’s Behavioral Model of Healthcare Services Utilization

“…3 Such underutilization of BC screening poses an increased risk of diagnosis of advanced BC, 7 resulting in poor prognosis after treatment and low survival rates. 8 It is critical to understand BC screening behavior and factors associated with BC screening uptake for KA women. Our study employed the Andersen's Behavioral Model of Healthcare Services Utilization (hereafter, Andersen's Model) as a theoretical framework to examine BC screening behavior among KA women.…”

Awareness and Knowledge of Self-Assessment Tools for Breast Cancer among Female Students in Lahore, Pakistan

“…Women above age of 45 years are at risk but morality rate is higher in younger females due to delay in diagnosis (2,3). According to WHO report, 1.15 million females annually diagnosed with breast cancer with 0.5 million ends up in death (4).In Pakistan, due to delay in diagnosis and lack of awareness of knowledge and self-assessment tools of breast cancer, situation is becoming worse day by day (5). Study reveals that every 1 in 9 women is diagnosed as victim of breast cancer (6).…”