What Factors are Associated with Where Women Undergo Clinical Breast Examination? Results from the 2005 National Health Interview Survey

Coughlin, Steven S.; Sabatino, Susan A.; Shaw, Kate M.

doi:10.2174/1874189400802010032

Cited by 6 publications

(6 citation statements)

References 12 publications

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“…An additional finding was that uninsured patients (and those with Medicaid) had a more advanced stage of disease at diagnosis, as compared with patients with private insurance or Medicare (data not shown); it is in accord with what other research has indicated . The correlation between diagnoses of advance‐stage breast cancer among patients who are uninsured or have Medicaid insurance can be explained, in part, by reduced access to and/or utilization of cancer screening .…”

Section: Discussionsupporting

confidence: 80%

mentioning

confidence: 99%

“…Screening could affect the stage at diagnosis and screening rate is affected by insurance status . Insured women (68%) are more likely than uninsured women (35%) to have had a clinical breast examination . Furthermore, age‐adjusted participation rates in breast cancer screening in 2000–2005 were 78% and 45% for insured and uninsured women, respectively .…”

mentioning

confidence: 99%

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Commercial Insurance Triples Chances of Breast Cancer Survival in a Public Hospital

et al. 2013

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Breast cancer survival is affected both by endogenous factors and exogenous factors such as socioeconomic status. This study explored the relationship between insurance status and overall survival of 987 female breast cancer patients in a population served by a public hospital. All patients were offered the same level of care regardless of ability to pay. Of the 987 breast cancer patients investigated, 54.6% were African-American. 54.1% of patients were insured (commercial insurance or Medicare), 27.1% with Medicaid, and 18.8% who were uninsured. Overall median survival was 15.5 years and was not statistically significant between Caucasian and African-American women. Median survival times were 15.8, 11.3, and 8.2 years for insured, Medicaid, and uninsured groups, respectively. Uninsured patients had worse overall survival rates compared with insured patients (p < 0.05). Adjusting for other factors (e.g., stage, age, race, body mass index, and income), insurance was a significant factor affecting survival with hazard ratios of 2.24 and 3.22 for Medicaid and uninsured patients, respectively, compared with insured patients. Even in a public hospital, after adjusting for potential risk factors, insurance status still proved to be an important factor in the survival of breast cancer patients. Further research is necessary to identify causal factors related to the survival disparities associated with insurance status.

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Section: Discussionsupporting

confidence: 80%

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confidence: 99%

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Commercial Insurance Triples Chances of Breast Cancer Survival in a Public Hospital

et al. 2013

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“…Characteristics of local communities (e.g., population SES, racial/ethnic composition) often influence the types of organizations that locate in particular settings, which may lead to differential access/availability of care to certain sub-populations [29, 30]. For example, racial/ethnic groups may prefer hospitals that recognize and address language or literacy barriers by employing translators; facilities that can afford to provide such services likely have different organizational characteristics from those facilities that do not.…”

Section: Methodsmentioning

confidence: 99%

Structural/organizational characteristics of health services partly explain racial variation in timeliness of radiation therapy among elderly breast cancer patients

Wheeler

Carpenter

Peppercorn

et al. 2012

Breast Cancer Res Treat

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Observed racial/ethnic disparities in the process and outcomes of breast cancer care may be explained, in part, by structural/organizational characteristics of health care systems. We examined the role of surgical facility characteristics and distance to care in explaining racial/ethnic variation in timing of initiation of guideline-recommended radiation therapy (RT) after breast conserving surgery (BCS). We used Surveillance Epidemiology and End Results-Medicare data to identify women ages 65 and older diagnosed with stages I–III breast cancer and treated with BCS in 1994–2002. We used stepwise multivariate logistic regression to examine the interactive effects of race/ethnicity and facility profit status, teaching status, size, and institutional affiliations, and distance to nearest RT on timing of RT initiation, controlling for known covariates. Among 38,574 eligible women who received BCS, 39% received RT within 2 months, 52% received RT within 6 months, and 57% received RT within 12 months post-diagnosis, with significant variation by race/ethnicity. In multivariate models, women attending smaller surgical facilities and those with on-site radiation had higher odds of RT at each time interval, and women attending governmental facilities had lower odds of RT at each time interval (P < 0.05). Increasing distance between patients’ residence and nearest RT provider was associated with lower overall odds of RT, particularly among Hispanic women (P < 0.05). In fully adjusted models including race-by-distance interaction terms, racial/ethnic disparities disappeared in RT initiation within 6 and 12 months. Racial/ethnic disparities in timing of RT for breast cancer can be partially explained by structural/organizational health system characteristics. Identifying modifiable system-level factors associated with quality cancer care may help us target policy interventions that can reduce disparities in outcomes.

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“…Liyanage (2002) too reported a low coverage for cervical cancer screening in 2002 in the Kalutara district. These figures are quite low compared to 65% of CBE coverage within previous two years found among women over 40 years who had participated National Health Interview Survey in the United States of America in 2005 (Coughlin, 2008). Of the abnormalities detected by PHM, only the cases confirmed by the MOH are referred for specialist care and thus referral rate was only 86.8% instead of 100%.…”

Section: Discussionmentioning

confidence: 80%

Quality of Breast Cancer Early Detection Services Conducted by Well Woman Clinics in the District of Gampaha, Sri Lanka

Vithana¹,

Ariyaratne²,

Jayawardana³

2013

Asian Pacific Journal of Cancer Prevention

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What Factors are Associated with Where Women Undergo Clinical Breast Examination? Results from the 2005 National Health Interview Survey

Abstract: Background-Recent studies have suggested that clinical breast examination (CBE) rates may vary according to patient, provider and health care system characteristics.

Cited by 6 publications

References 12 publications

Commercial Insurance Triples Chances of Breast Cancer Survival in a Public Hospital

Commercial Insurance Triples Chances of Breast Cancer Survival in a Public Hospital

Structural/organizational characteristics of health services partly explain racial variation in timeliness of radiation therapy among elderly breast cancer patients

Quality of Breast Cancer Early Detection Services Conducted by Well Woman Clinics in the District of Gampaha, Sri Lanka

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