Sociodemographic predictors of delayed- versus early-stage cervical cancer in California

Saghari, Sepideh; Ghamsary, Mark; Marie-Mitchell, Ariane; Oda, Keiji; Morgan, John

doi:10.1016/j.annepidem.2015.01.008

Cited by 26 publications

(16 citation statements)

References 22 publications

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“…In this study, age was not a predictor of late presentation. This finding which contrasts with findings from earlier studies [ 8 , 10 , 16 ] agrees with a study in Uganda [ 4 ]. In terms of access to healthcare, active membership of the National Health Insurance Scheme was included in the present study.…”

Section: Discussioncontrasting

confidence: 58%

“…Previous studies have shown that low socioeconomic status is associated with late presentation of cervical cancer [ 8 , 9 ]. In addition, other factors such as race, age at diagnosis [ 8 , 10 ], insurance status [ 11 , 12 ], marital status [ 4 , 13 ], educational status [ 14 ], place of residence [ 15 , 16 ], number of children [ 4 ] and screening practices [ 17 ] have been associated with the stage at presentation, which in turn affect survival rates. The ability to identify abnormal genital tract bleeding symptoms (post-menopausal bleeding or intermenstrual bleeding) can affect health seeking behaviour, while indicative results from previous screening, family history of cervical cancer, personal history of sexually transmitted infections and smoking contribute to the development of cervical cancer [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Factors associated with late presentation of cervical cancer cases at a district hospital: a retrospective study

2018

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BackgroundCervical cancer is the leading and most common female cancer among women in Ghana. Although there are screening methods to detect premalignant lesions for treatment, screening coverage in Ghana is 2.8% and late presentation of cases complicates treatment efforts.This study examined the sociodemographic, clinical and histological characteristics associated with late presentation of cervical cancer cases attending Gynecological Oncology care at Catholic Hospital, Battor.MethodsOne hundred and fifty-seven medical records of confirmed cases of cervical cancer reporting to the Outpatient Obstetrics and Gynecology Department between 2012 and 2016 were reviewed. Relevant data were retrieved using abstraction forms. Socio demographic variables investigated were level of education attained, marital status, National Health Insurance Scheme membership, employment status, place of residence and distance from hospital. Clinical variables included intermenstrual/postmenopausal bleeding, previous screening history, previous smoking history, age at menarche and number of children. Histological variables included subtypes of tumour and characteristics of tumour. Pearson’s chi-square test and logistic regression analysis were used to determine correlates of late stage at presentation with cervical cancer. Sensitivity analysis was performed to assess the effect of missing data.ResultsApproximately two-thirds (65.97%) of the cases presented in advanced stages of cervical cancer. Level of education, age at menarche and previous screening history were included in a regression model and adjusted for age. Age at menarche (n = 66) was eliminated from the model after sensitivity analysis. Among the remaining variables, only previous screening history was predictive of late stage at presentation of cervical cancer cases. Previously unscreened cases of cervical cancer were nearly four times more likely to present late, compared to those who had been screened previously (OR 3.91; 95% CI 1.43–10.69). No association was observed with sociodemographic and histological characteristics.ConclusionLack of previous screening was associated with late presentation of cervical cancer at Catholic Hospital, Battor. Efforts to promote early cervical cancer screening should be intensified and future studies may explore an association with age at menarche.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-6065-6) contains supplementary material, which is available to authorized users.

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Section: Discussioncontrasting

confidence: 58%

Section: Introductionmentioning

confidence: 99%

Factors associated with late presentation of cervical cancer cases at a district hospital: a retrospective study

2018

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“…This study reveals that socio-demographic factors, including the CCR ecologic SES index, predict utilization of chemotherapy and HCT among acute leukemia patients, although it does not distinguish between individual and potentially actionable characteristics included in the CCR nSES index. Although age, sex, race/ethnicity and marital status each could correlate with our ecologic nSES index, these demographic variables are not included in the index and have exhibited sufficient independence to distinguish their effects from the SES index in other studies [43,44]. Furthermore, multicolinearity between age, sex, race/ethnicity or marital status and our ecologic SES index was not detected in this dataset.…”

Section: Discussionmentioning

confidence: 68%

Sociodemographic disparities in chemotherapy and hematopoietic cell transplantation utilization among adult acute lymphoblastic and acute myeloid leukemia patients

et al. 2017

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IntroductionIdentifying sociodemographic disparities in chemotherapy and hematopoietic cell transplantation (HCT) utilization for acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) may improve survival for underserved populations. In this study, we incorporate neighborhood socioeconomic status (nSES), marital status, and distance from transplant center with previously studied factors to provide a comprehensive analysis of sociodemographic factors influencing treatments for ALL and AML.MethodsUsing the California Cancer Registry, we performed a retrospective, population-based study of patients ≥15 years old with ALL (n = 3,221) or AML (n = 10,029) from 2003 through 2012. The effect of age, sex, race/ethnicity, marital status, nSES, and distance from nearest transplant center on receiving no treatment, chemotherapy alone, or chemotherapy then HCT was analyzed.ResultsNo treatment, chemotherapy alone, or chemotherapy then HCT were received by 11%, 75%, and 14% of ALL patients and 36%, 53%, and 11% of AML patients, respectively. For ALL patients ≥60 years old, HCT utilization increased from 5% in 2005 to 9% in 2012 (p = 0.03). For AML patients ≥60 years old, chemotherapy utilization increased from 39% to 58% (p<0.001) and HCT utilization from 5% to 9% from 2005 to 2012 (p<0.001). Covariate-adjusted analysis revealed decreasing relative risk (RR) of chemotherapy with increasing age for both ALL and AML (trend p <0.001). Relative to non-Hispanic whites, lower HCT utilization occurred in Hispanic [ALL, RR = 0.80 (95% CI = 0.65–0.98); AML, RR = 0.86 (95% CI = 0.75–0.99)] and non-Hispanic black patients [ALL, RR = 0.40 (95% CI = 0.18–0.89); AML, RR = 0.60 (95% CI = 0.44–0.83)]. Compared to married patients, never married patients had a lower RR of receiving chemotherapy [ALL, RR = 0.96 (95% CI = 0.92–0.99); AML, RR = 0.94 (95% CI = 0.90–0.98)] or HCT [ALL, RR = 0.58 (95% CI = 0.47–0.71); AML, RR = 0.80 (95% CI = 0.70–0.90)]. Lower nSES quintiles predicted lower chemotherapy and HCT utilization for both ALL and AML (trend p <0.001).ConclusionsOlder age, lower nSES, and being unmarried predicted lower utilization of chemotherapy and HCT among ALL and AML patients whereas having Hispanic or black race/ethnicity predicted lower rates of HCT. Addressing these disparities may increase utilization of curative therapies in underserved acute leukemia populations.

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“…Additionally, the HIV-uninfected group was slightly younger and less likely to be on social support. Given the association of cervical cancer with socioeconomic status, this difference could have also impacted our study 29, 30 .…”

Section: Discussionmentioning

confidence: 99%

Cervical HPV infection in Romanian women infected with HIV during early childhood

et al. 2016

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Human papillomavirus (HPV) is the most common cause of cervical cancer worldwide, and Romania has the highest rate of cervical cancer in Europe. Sixty-five young Romanian women infected with HIV during early childhood and 25 control subjects were evaluated for the presence of cervical HPV infection and for cytologic abnormalities. HPV infection was evaluated longitudinally in 42 HIV-infected individuals. Overall 28/65 (43.1%) of HIV-infected and 8/25 (32.0%) of uninfected subjects were infected with HPV, and 21/65 (32.3%) and 6/25 (24%) had high-risk subtypes, respectively. In HIV-infected women, those maintaining or acquiring a new subtype in follow-up were more likely to have a lower nadir ( p = 0.04) and current ( p = 0.01) CD4 cell counts. The incidence rate for HPV acquisition events was 0.69 per subject per year, and 0.52 for high-risk subtypes. In the HIV-infected group, 9/13 (69.2%) individuals with abnormal cytology progressed at follow-up. Although HPV prevalence was similar to controls, the rate of Pap smear abnormalities was much higher, possibly due to the decreased ability to mount new immune responses. Given the high rate of incident detection of vaccine preventable strains and cytologic progression in this cohort, HPV vaccination may be beneficial at any age in co-infected women.

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Sociodemographic predictors of delayed- versus early-stage cervical cancer in California

Cited by 26 publications

References 22 publications

Factors associated with late presentation of cervical cancer cases at a district hospital: a retrospective study

Factors associated with late presentation of cervical cancer cases at a district hospital: a retrospective study

Sociodemographic disparities in chemotherapy and hematopoietic cell transplantation utilization among adult acute lymphoblastic and acute myeloid leukemia patients

Cervical HPV infection in Romanian women infected with HIV during early childhood

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