scholarly journals Does poor mental health explain socio-demographic gradients in breast cancer screening uptake? A population-based study

2019 ◽  
Vol 30 (3) ◽  
pp. 538-543
Author(s):  
Emma Ross ◽  
Aideen Maguire ◽  
Michael Donnelly ◽  
Adrian Mairs ◽  
Clare Hall ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Mental Health ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Breast Screening ◽  
Poor Mental Health ◽  
Targeted Interventions ◽  
Screening Uptake ◽  
The Uk ◽  
The Impact

Abstract Background Research from the USA indicates disparities in breast cancer screening uptake for women with poor mental health. However, no attempt has been made to examine the contribution of poor mental health to socio-demographic variations in breast screening uptake. The current study aims to examine the impact of self-reported chronic poor mental health on attendance at breast screening in the UK, and to what extent this explains socio-demographic inequalities in screening uptake. Methods Breast screening records were linked to 2011 Census records within the Northern Ireland Longitudinal Study. This identified a cohort of 57 328 women who were followed through one 3-year screening cycle of the National Health Service Breast Screening Programme. Information on mental health status, in addition to other individual and household-level attributes, was derived from the 2011 Census. Logistic regression was employed to calculate odds ratios (ORs) and 95% confidence intervals (CIs) of attendance at screening. Results 10.7% of women in the cohort reported poor mental health, and in fully adjusted analyses, these individuals were 23% less likely to attend breast screening (OR 0.77; 95% CI 0.73–0.82). Although poor mental health was a strong predictor of screening uptake, it did not explain the observed inequalities in uptake by socio-economic status, marital status, or area of residence. Conclusions This study provides novel evidence of inequalities in breast screening uptake for women with chronic poor mental health in the UK. Targeted interventions are necessary to ensure equitable screening access and to enhance overall mortality benefit.

scholarly journals Disability as a predictor of breast cancer screening uptake: A population-based study of 57,328 women

2019 ◽  
Vol 27 (4) ◽  
pp. 194-200
Author(s):  
Emma Ross ◽  
Aideen Maguire ◽  
Michael Donnelly ◽  
Adrian Mairs ◽  
Clare Hall ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Northern Ireland ◽  
Breast Cancer Screening ◽  
Breast Screening ◽  
The United States ◽  
Ageing Population ◽  
Screening Uptake ◽  
National Breast ◽  
The Impact

Objective Despite a growing body of evidence suggesting inequalities in breast cancer screening uptake in the United States for women with disabilities, few attempts have been made to examine whether this association applies to the United Kingdom. We conducted the first population-wide study investigating the impact of disability on uptake of breast cancer screening in Northern Ireland. Methods Breast screening records extracted from the National Breast Screening System were linked to the Northern Ireland Longitudinal Study. This identified a cohort of 57,328 women who were followed through one complete three-year screening cycle of the National Health Service Breast Screening Programme in Northern Ireland. The presence of disability was identified from responses to the 2011 Census. Results Within this cohort, 35.8% of women reported having at least one chronic disability, and these individuals were 7% less likely to attend compared with those with no disability (odds ratio 0.93; 95% confidence interval 0.89–0.98). Variation in the degree of disparity observed was evident according to the type and number of comorbid disabilities examined. Conclusion This is the first population-wide study in Northern Ireland to identify disparities in breast screening uptake for women with chronic disabilities, in particular, those with multimorbidity. This is of particular concern, given the projected rise in the prevalence of disability associated with the ageing population.

scholarly journals Using Record Linkage to Examine the Impact of Poor Mental Health on Breast Screening Uptake

2018 ◽  
Vol 3 (2) ◽  
Author(s):  
Emma Ross ◽  
Dermot O'Reilly
Keyword(s):  
Mental Health ◽  
Breast Screening ◽  
Census Data ◽  
Breast Cancer Mortality ◽  
Poor Mental Health ◽  
Breast Screening Programme ◽  
Screening Uptake ◽  
National Breast ◽  
The Impact ◽  
Prescribing Information

BackgroundThe UK National Breast Screening Programme is estimated to reduce breast cancer mortality by 20%. To maximise the benefits of the programme, we first need to understand the underlying factors contributing to variations in screening uptake. One potentially significant factor which may contribute to these gradients in screening uptake is poor mental health. ObjectivesThe objectives of this study were to examine the impact of poor mental health on breast screening uptake, and whether this explained any of the previously observed socio-demographic gradients in screening uptake. MethodsBreast screening records were obtained from the National Breast Screening System (NBSS) and were subsequently linked to 2011 Census data within the Northern Ireland Longitudinal Study (NILS). The NILS encompasses 28\% of Census data. This was then linked to psychotropic prescribing information from the Enhanced Prescribing Database (EPD), to produce a de-identified research dataset containing 57,328 women. FindingsWomen with self-reported poor mental health were over 20% less likely to attend screening compared to their counterparts who didn't have poor mental health. Using psychotropic prescribing information as a proxy for the presence of mental illness yielded similar results, with those taking anxiolytics, antipsychotics or hypnotics in the three months before screening invitation significantly less likely to attend than those who were not. ConclusionWomen with poor mental health were significantly less likely to attend breast screening. However, poor mental health did not explain any of the previously determined socio-demographic gradients in screening uptake.

scholarly journals Mapping variation in breast cancer screening: Where to intervene?

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
C Padilla ◽  
P Soler Michel ◽  
V Vieira
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Breast Cancer Mortality ◽  
Participation Rate ◽  
Participation Rates ◽  
Screening Uptake ◽  
Screening Participation ◽  
Cancer Screening Participation ◽  
The Impact

Abstract Introduction Mammography screening can reduce breast cancer mortality among women aged 50 years and older. Small geographic areas with lower breast cancer screening uptake may reflect gaps in screening efforts. Our objective was to identify the geographic variations of breast cancer screening uptake among women aged 50-74 years in the Lyon Metropole area, France. Methods We used spatial regression models within a generalized additive framework to determine the clusters of census blocks with significantly lower risk of breast cancer screening uptake. Census block-level data on breast cancer screening participation rates were calculated for women aged 50-74 years who did a mammography between 2015-2016 after being invited with a letter by the cancer screening organization. Using smoothed risk maps adjusting for covariates, we estimated the impact of the spatial distribution of deprivation index, part of opportunistic screening on breast cancer screening participation. Results Between 2015 and 2016, the participation rate of organized breast cancer screening was 49.9%. As hypothesized, women living in highly deprived census blocks had lower participation rates compared to less deprived. However, women living in rural areas with fewer certified mammography services than in urban areas had the highest participation rate. Spatial analyses identified four clusters, one located in an urban area and three in suburban areas. Conclusions Our analysis indicates that depending on the location of the cluster, the influence came from different variables. Knowing the impact of site-specific risk factors is important for implementing an appropriate prevention intervention. Key messages Spatial analysis for cancer screening can help to improve health initiatives. This study contributes to a better understanding of the cluster-specific factors that explain geographic disparities.

scholarly journals The role of pre-invasive disease in overdiagnosis: A microsimulation study comparing mass screening for breast cancer and cervical cancer

2016 ◽  
Vol 23 (4) ◽  
pp. 210-216 ◽  
Author(s):  
Paula A van Luijt ◽  
Kirsten Rozemeijer ◽  
Steffie K Naber ◽  
Eveline AM Heijnsdijk ◽  
Joost van Rosmalen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Cervical Cancer Screening ◽  
Invasive Disease ◽  
Disease Stage ◽  
Invasive Treatment ◽  
The Uk ◽  
The Impact

Objective Although early detection of cancer through screening can prevent cancer deaths, a drawback of screening is overdiagnosis. Overdiagnosis has been much debated in breast cancer screening, but less so in cervical cancer screening. We examined the impact of overdiagnosis by comparing two screening programmes in the Netherlands. Methods We estimated overdiagnosis rates by microsimulation for breast cancer screening and cervical cancer screening, using a cohort of women born in 1982 with lifelong follow-up. Overdiagnosis estimates were made analogous to two definitions formed by the UK 2012 breast screening review. Pre-invasive disease was included in both definitions. Results Screening prevented 921 cervical cancers (−55%) and 378 cervical cancer deaths (−59%), and 169 (−1.3%) breast cancer cases and 970 breast cancer deaths (−21%). The cervical cancer overdiagnosis rate was 74.8% (including pre-invasive disease). Breast cancer overdiagnosis was estimated at 2.5% (including pre-invasive disease). For women of all ages in breast cancer screening, an excess of 207 diagnoses/100,000 women was found, compared with an excess of 3999 diagnoses/100,000 women in cervical cancer screening. Conclusions For breast cancer, the frequency of overdiagnosis in screening is relatively low, but consequences are evident. For cervical cancer, the frequency of overdiagnosis in screening is high, because of detection of pre-invasive disease, but the consequences per case are relatively small due to less invasive treatment. This illustrates that it is necessary to present overdiagnosis in relation to disease stage and consequences.

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