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Ewing AP, Alalwan MA, Brown JA, Adekunle TE, Korley ND, Nafiu TC, Coughlin EC, Parvanta CP, Meade CD, Gwede CK, Best AL. Physically fit with a higher cancer risk? Influences of cervical cancer screening among a sample of physically active women ages 21-49 living in the United States. Prev Med Rep 2022; 30:101978. [PMID: 36157713 PMCID: PMC9494240 DOI: 10.1016/j.pmedr.2022.101978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 08/31/2022] [Accepted: 09/02/2022] [Indexed: 11/17/2022] Open
Abstract
To achieve the lowest risk level for various cancers, individuals would engage in several healthy lifestyle behaviors and age-eligible cancer screenings as recommended. Nonetheless, research has largely omitted exploration of concurrent primary and secondary prevention behaviors. This study was designed to explore influences of cervical cancer screening among physically active women who reported participation in recreational sports. U.S. based women between the ages of 21–49, who had never been diagnosed with cancer, were eligible to complete a web-based survey. Logistic regression analyses were conducted using SAS 9.4. On average, women were 31 years of age (N = 394) and self-identified as Black (51.3 %). Although low overall (30.7 %), higher odds of cervical cancer screening were associated with age (OR = 1.06, 95 % CI = 1.03–1.10), employment (OR = 2.43, 95 % CI = 1.14–5.18), knowledge of cancer-related risk behaviors (OR = 4.04, 95 % CI = 1.33–12.28), routine doctor’s visit (OR = 4.25, 95 % CI = 1.56–11.54), and team-based vs individual-based sport participation (OR = 1.95, 95 % CI = 1.13–3.34). Our study provides insight into the health profile of physically active women, ages 21–49, as it relates to risks for cervical cancer. Screening uptake among this diverse sample was much lower than the general population and national goals set by Healthy People 2030. Interventions should be tailored to increase knowledge of cancer-related risk behaviors, access to healthcare, and recommended cervical cancer screenings among even assumed-to-be healthy populations.
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Affiliation(s)
- A P Ewing
- The Ohio State University College of Public Health, Division of Epidemiology (APE, MAA, NDK, TCN), 1841 Neil Ave Building 293, Columbus OH 43210, USA
| | - M A Alalwan
- The Ohio State University College of Public Health, Division of Epidemiology (APE, MAA, NDK, TCN), 1841 Neil Ave Building 293, Columbus OH 43210, USA
| | - J A Brown
- University of North Carolina Chapel Hill, Department of Epidemiology, Gillings School of Global Public Health (JAB) CB # 7400 135 Dauer Drive, Chapel Hill NC 27599, USA
| | - T E Adekunle
- School of Public Health and Information Sciences (SPHIS), University of Louisville (TEA) 485 E Gray St, Louisville KY 40202, USA
| | - N D Korley
- The Ohio State University College of Public Health, Division of Epidemiology (APE, MAA, NDK, TCN), 1841 Neil Ave Building 293, Columbus OH 43210, USA
| | - T C Nafiu
- The Ohio State University College of Public Health, Division of Epidemiology (APE, MAA, NDK, TCN), 1841 Neil Ave Building 293, Columbus OH 43210, USA
| | - E C Coughlin
- College of Public Health, University of South Florida (ECC, CPP, ALB) 13201 Bruce B Downs Blvd, Tampa, FL 33612, USA
| | - C P Parvanta
- College of Public Health, University of South Florida (ECC, CPP, ALB) 13201 Bruce B Downs Blvd, Tampa, FL 33612, USA
| | - C D Meade
- Moffitt Cancer Center, Population Science, Health Outcomes and Behavior (CDM, CKG) 4117 E Fowler Ave, Tampa, FL 33612, USA
| | - C K Gwede
- Moffitt Cancer Center, Population Science, Health Outcomes and Behavior (CDM, CKG) 4117 E Fowler Ave, Tampa, FL 33612, USA
| | - A L Best
- College of Public Health, University of South Florida (ECC, CPP, ALB) 13201 Bruce B Downs Blvd, Tampa, FL 33612, USA
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Garcia A, Juarez M, Sacuj N, Tzurec E, Larson K, Miller A, Rohloff P. Loss to Follow-Up and the Care Cascade for Cervical Cancer Care in Rural Guatemala: A Cross-Sectional Study. JCO Glob Oncol 2022; 8:e2100286. [PMID: 35113733 PMCID: PMC8853617 DOI: 10.1200/go.21.00286] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE More than 80% of cervical cancer cases and deaths occur in low- and middle-income countries. Here, we analyze a large geographically extensive cross-sectional data set from the Western rural highlands of Guatemala. Our objective is to better characterize weak points in care along the cervical cancer care continuum and investigate sociodemographic and clinical correlates of loss to follow-up. METHODS We conducted a retrospective review of electronic health records data from July 21, 2015, through December 10, 2020 for a cytology-based screening and cervical cancer treatment program. We used a care cascade analysis to characterize the progression of individuals through screening, confirmatory testing, and treatment. We examined demographic and clinical factors correlated with screening and loss to follow-up using multivariate logistic regression. RESULTS A total of 8,872 individuals were included in the analysis. Five thousand nine hundred thirteen cervical cancer screenings were conducted. 4.1% of all screening tests were abnormal, including 0.61% cervical intraepithelial neoplasia or overt cervical cancer. Care cascade analysis showed that 67% of eligible women accepted screening. Of those requiring confirmatory testing or treatment, 73% completed recommended follow-up. In adjusted multivariable analysis, prior history of sexual transmitted infection, prior experience with cervical cancer screening, older age, and current contraceptive use were associated with accepting screening. Age and contraceptive use were also associated with retention in care after a positive first screen. CONCLUSION In a large rural Guatemalan retrospective cohort, a care continuum analysis showed that both declining the opportunity to receive cervical cancer screening as well as declining confirmatory testing after a first positive screen were both important weak points along the care continuum. These data support the need for comprehensive and culturally appropriate initiatives to improve screening uptake and retention in care.
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Affiliation(s)
- Andrea Garcia
- Center for Indigenous Health Research, Wuqu' Kawoq, Maya Health Alliance, Tecpán, Guatemala
| | - Michel Juarez
- Center for Indigenous Health Research, Wuqu' Kawoq, Maya Health Alliance, Tecpán, Guatemala
| | - Neftali Sacuj
- Center for Indigenous Health Research, Wuqu' Kawoq, Maya Health Alliance, Tecpán, Guatemala
| | | | - Karen Larson
- Friendship Bridge, Panajachel, Sololá, Guatemala
| | - Ann Miller
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA
| | - Peter Rohloff
- Center for Indigenous Health Research, Wuqu' Kawoq, Maya Health Alliance, Tecpán, Guatemala
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