Cancer Screening Among Current and Former U.S. Military Personnel Compared to Civilians: A Cross-Sectional Analysis of the Behavioral Risk Factor Surveillance System

ABSTRACT Introduction Approximately 3% of invasive U.S. cancer diagnoses are made among veterans in a Veterans Affairs (VA) clinic each year, while VA patients only comprise about 1.9% of the U.S. population. Although some research has shown that veterans have higher incidence rates of cancer compared to civilians, evidence is sparse regarding possible disparities in rates of cancer screening between these populations. Thus, the purpose of this study is to compare differences in rates of screening for colorectal, lung, breast, and cervical cancers between current and former U.S. Military service members and civilians. Methods Using the data extracted from the Behavioral Risk Factor Surveillance System, we assessed the rates of cancer screening among current and former U.S. Military service members compared to civilians from self-reported surveys assessing when individuals had been screened for colorectal or lung cancer among all participants and breast and cervical cancer among women participants. Persons greater than 25 years of age were included in the cervical cancer screening, 50 years of age for colon cancer screening, and 40 years of age for the breast cancer screening—the latter based on recommendations from the American Cancer Society. We used multivariate logistic regression models to determine the adjusted risk ratios (ARRs) of current and former U.S. Military service members receiving screening compared to civilians, adjusting for age, gender, race, education, and health care coverage. Results Current and former U.S. Military service members accounted for 2.6% of individuals included for the cervical cancer screening analysis, 2.2% for the breast cancer screening analyses, nearly 10% of the lung cancer screening, and 15% of the colorectal cancer (CRC) screening analyses. Prevalence of screening was higher for current and former U.S. Military service members among lung cancer and CRC. When controlling for age, race, education, and health care coverage, current and former U.S. Military service members were statistically more likely to be screened for CRC (ARR: 1.05; 95% confidence interval: 1.04–1.07) and lung cancer (ARR: 1.32; 95% confidence interval: 1.15–1.52). The odds of having completed a cervical or breast cancer screening were not significantly different between groups. Conclusion Our study showed that current and former U.S. Military service members were more likely to complete CRC and lung cancer screenings, while no significant difference existed between each population with regard to cervical and breast cancer screenings. This is one of the few studies that have directly compared cancer screening usage among civilians and current and former U.S. Military service members. Although current and former U.S. Military service members were more likely to receive several cancer screenings, improvements can still be made to remove barriers and increase screening usage due to the disproportionate rates of cancer mortality in this population. These solutions should be comprehensive—addressing personal, organizational, and societal barriers—to improve prognosis and survival rates among current and former U.S. Military service members.

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Factors and trends in cancer screening in the United States from 2004 to 2010.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.1565 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 1565-1565

Author(s):

Thanyanan Reungwetwattana ◽

Julian R. Molina ◽

Jeanette Y. Ziegenfuss

Keyword(s):

Breast Cancer ◽

Prostate Cancer ◽

Cervical Cancer ◽

Cancer Screening ◽

Breast Cancer Screening ◽

Cervical Cancer Screening ◽

Prostate Cancer Screening ◽

Cancer Screenings ◽

The Us ◽

Race Ethnicity

1565 Background: Understanding the prevalence of cancer screening in the US and the factors associated with its accessibility is important for public health promotion. Methods: The 2004 and 2010 Behavioral Risk Factor Surveillance Systems were used to ascertain cancer screening rates among populations indicated for each test by age, gender, and the American Cancer Society recommendation for cancer screenings [fecal occult blood test (FOBT) or endoscopy for colorectal cancer (CRC) screening, digital rectal examination (DRE) or prostate specific antigen (PSA) for prostate cancer screening, clinical breast examination (CBE) or mammogram for breast cancer screening, and Papanicolaou (Pap) test for cervical cancer screening]. Results: Over this period, CRC and breast cancer screening rates significantly increased (15.9%, 13.9%) while prostate and cervical cancer screening rates significantly decreased (1.2%, 5.2%). Race/ethnicity might be an influence in CRC and cervical cancer screening accessibility. Prostate cancer screening accessibility might be influenced by education and income. The older-aged populations (70-79, >79) had high prevalence of CRC, prostate and breast cancer screenings even though there is insufficient evidence for the benefits and harms of screenings in the older-aged group. Conclusions: The disparities in age, race/ethnicity, health insurance, education, employment, and income for the accession to cancer screening of the US population have decreased since 2004. The trajectory of increasing rates of CRC and breast cancer screenings should be maintained. To reverse the trend, the causes of the decreased rate of cervical cancer screening and the high rates of screenings in older-aged populations should, however, be further explored. [Table: see text]

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Breast Cancer Screening Among Women with Disabilities: Data from the California Behavioral Risk Factor Survey 2002

PsycEXTRA Dataset ◽

10.1037/e611922007-001 ◽

2004 ◽

Cited By ~ 1

Author(s):

Galatea King

Keyword(s):

Breast Cancer ◽

Risk Factor ◽

Cancer Screening ◽

Breast Cancer Screening ◽

Behavioral Risk ◽

Behavioral Risk Factor ◽

Women With Disabilities

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Estimation of the risk of lung cancer in women participating in a population-based breast cancer screening program

Archivos de Bronconeumología (English Edition) ◽

10.1016/j.arbr.2020.03.001 ◽

2020 ◽

Vol 56 (5) ◽

pp. 277-281 ◽

Cited By ~ 1

Author(s):

Adrián González-Marrón ◽

Juan Carlos Martín-Sánchez ◽

Ferrán Garcia-Alemany ◽

Encarna Martínez-Martín ◽

Nuria Matilla-Santander ◽

...

Keyword(s):

Breast Cancer ◽

Lung Cancer ◽

Cancer Screening ◽

Breast Cancer Screening ◽

Screening Program ◽

Population Based ◽

Breast Cancer Screening Program ◽

Cancer Screening Program

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CORRELATES OF BREAST CANCER SCREENING BEHAVIORS AMONG INDIGENOUS WOMEN

Innovation in Aging ◽

10.1093/geroni/igz038.923 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S246-S246

Author(s):

Soonhee Roh ◽

Yeon-Shim Lee ◽

Kyoung Hag Lee ◽

Jung Sim Jun

Keyword(s):

Breast Cancer ◽

Cervical Cancer ◽

Native American ◽

Cancer Screening ◽

South Dakota ◽

Breast Cancer Screening ◽

Service Use ◽

Cultural Practice ◽

Indigenous Women ◽

Cancer Knowledge

Abstract Cervical cancer remains a significant cause of morbidity and mortality among women globally; yet cancer burden is unevenly distributed among racial/ethnic groups. With 12,820 new cases in 2017 in the U.S., cervical cancer is the top cause of death among Indigenous women. Indeed, cervical cancer mortality rates among AI women in South Dakota are five times the national average and 79% higher compared to Whites in that region. This study examined predictive models of utilization of mammograms among Indigenous women adapting Andersen’s behavioral model. Using a sample of 285 Indigenous women residing in South Dakota, nested logistic regression analyses were conducted to assess predisposing (age and marital status), need (personal and family cancer history), and enabling factors (education, monthly household income, mammogram screening awareness, breast cancer knowledge, self-rated health, and cultural practice to breast cancer screening). Results indicated that only 55.5% of participants reported having had a breast cancer screening within the past 2 years, whereas 21.0% never had a mammogram test. After controlling for predisposing and need factors, higher education, greater awareness of mammogram, and higher utilization of traditional Native American approaches were significant predictors of mammogram uptake. The results provide important implications for intervention strategies aimed at improving breast cancer screening and service use among Indigenous women. Educating health professionals and Indigenous community members about the importance of breast cancer screening is highly needed. It is critical to assess a woman’s level of traditional beliefs and practices and its possible influence on screening participation and future screening intention.

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Food security status and breast cancer screening among women in the United States: Evidence from Health and Retirement Study and Health Care and Nutrition Study

10.21203/rs.3.rs-176608/v1 ◽

2021 ◽

Author(s):

Asos Mahmood ◽

Satish Kedia ◽

Patrick Dillon ◽

Hyunmin kim ◽

Hassan Arshad ◽

...

Keyword(s):

Breast Cancer ◽

Health Care ◽

Cancer Screening ◽

Food Insecurity ◽

Breast Cancer Screening ◽

The United States ◽

The Past ◽

Cancer Screenings ◽

Nutrition Study ◽

Retirement Study

Abstract Purpose: To assesses the impact of food insecurity on biennial breast cancer screenings (i.e., mammography or breast x-ray) among older women in the United States (US).Methods: Data from the 2014 and 2016 waves of the Health and Retirement Study and the 2013 Health Care and Nutrition Study were used. The analyses were limited to a nationally representative sample of 2,861 women between 50 to 74 years of age, residing in the US. We employed a propensity score weighting method to balance observed confounders between food-secure and food-insecure women and fitted a binary logistic regression to investigate population-level estimates for the association between food security and breast cancer screening.Results: Food insecurity was significantly associated with failure to obtain a mammogram or breast x-ray within the past two years. Food-insecure women had 54% lower odds of reporting breast cancer screening in the past two years (OR=0.46; 95% CI: 0.30-0.70, P-value <.001) as compared to food-secure women. Additional factors associated with a higher likelihood of receiving breast cancer screenings included greater educational attainment, higher household income, regular access to health care/advice, not smoking, and not being physically disabled or experiencing depressive symptoms.Conclusion: Results demonstrate a socioeconomic gradient existing in regard to the utilization of regular breast cancer screenings among women. Those who tend to have lower education, lower-income and lack of reliable healthcare access are more likely to be food insecure. Thus, more likely to face the financial, logistical, or environmental barriers in obtaining screening services that accompany food insecurity.

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Accuracy of Self-report for Cervical and Breast Cancer Screening: A Systematic Review and Meta-analysis

10.21203/rs.2.13814/v1 ◽

2019 ◽

Author(s):

Johanna Anderson ◽

Donald S. Bourne ◽

Kim A. Peterson ◽

Katherine M. Mackey

Keyword(s):

Breast Cancer ◽

Systematic Review ◽

Cervical Cancer ◽

Cancer Screening ◽

Breast Cancer Screening ◽

Cervical Cancer Screening ◽

Medical Records ◽

Meta Analysis ◽

Self Report ◽

System Level

Abstract Background: Guideline-based breast and cervical cancer screenings are fundamental components of high-quality preventive women’s health care services. Accurate measurement of screening rates is vital to ensure all women are adequately screened. Our systematic review and meta-analysis aims to provide an updated synthesis of the evidence on the accuracy of self-reported measures of cervical and breast cancer screening compared to medical records. Methods: To identify studies, we searched MEDLINE®, Cochrane Database of Systematic Reviews, and other sources up to July 2019. Two reviewers sequentially selected studies, abstracted data, and assessed internal validity and strength of the evidence. Adjusted summary numbers for sensitivity and specificity were calculated using a bivariate random-effects meta-analysis. Results: Unscreened women tended to over-report screening among 39 included studies examining the accuracy of self-report for cervical and/or breast cancer screening. The specificity of self-report was 48% (95% CI 41 to 56) for cervical cancer screening and 61% (95% CI 53 to 69) for breast cancer screening while the sensitivity of self-report was much higher at 96% (95% CI 94 to 97) for cervical cancer screening and 96% (95% CI 95 to 98). We have moderate confidence in these findings, as they come from a large number of studies directly assessing the accuracy of self-report compared to medical records and are consistent with findings from a previous meta-analysis. Conclusions: Unscreened women tend to over-report cervical and breast cancer screening, while screened women more accurately report their screening. Future research should focus on assessing the impact of over-reporting on clinical and system-level outcomes.

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Adherence to Cancer Screening

Cancer Control ◽

10.1177/107327489500200604 ◽

1995 ◽

Vol 2 (6) ◽

pp. 510-517 ◽

Cited By ~ 2

Author(s):

Barbara K. Rimer

Keyword(s):

Breast Cancer ◽

Cervical Cancer ◽

Cancer Screening ◽

Skin Cancer ◽

Breast Cancer Screening ◽

Skin Cancer Screening ◽

Pap Tests ◽

Risk Of Death ◽

Screening Procedures

Routine breast cancer screening for women 50 years of age and older can reduce mortality from breast cancer by 30% to 35%. Regular Papanicolaou tests can decrease mortality from cervical cancer dramatically, and skin cancer screening could decrease deaths from melanoma. Adherence to recommended screening procedures for breast, cervical, and skin cancer screening increases the potential to lower the risk of death and disability from these diseases. The National Cancer Institute's goals include increasing the proportion of women who get regular mammograms to 80%, and similar goals have been issued for Pap tests. Yet, most women still are not being screened for breast or cervical cancer on a regular basis, and most people do not have regular skin checks for cancer.

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