Skip to main content

Advertisement

Log in

Prevalence and Trends of Receipt of Cancer Screenings Among US Women with Diagnosed Diabetes

  • Populations at Risk
  • Published:
Journal of General Internal Medicine Aims and scope Submit manuscript

ABSTRACT

BACKGROUND

Diabetes increases the risk of breast and colorectal cancers and has an undetermined relationship to cervical cancer. Improved screenings for these cancers are effective in reducing cancer mortality.

OBJECTIVES

To examine the prevalence of receiving recommended screenings for these cancers and to assess the trends in the screening rates over time among US women with diagnosed diabetes in comparison with women without diabetes.

DESIGN

Cross-sectional.

PARTICIPANTS

A total of 63,650 to 182,168 adult women participated in the 1996−2006 (biennially) Behavioral Risk Factor Surveillance System.

METHODS

The prevalence of receiving cancer screenings was age-standardized to the 2000 US population. The adjusted prevalence and adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were estimated using logistic regression analyses. The linear trends in the screening rates were tested using orthogonal polynomial contrasts.

RESULTS

In 2006, women with diabetes had a lower adjusted prevalence (74% versus 79%, P < 0.05) and the AOR (0.73, 95% CI: 0.66−0.81) for receiving cervical cancer screenings, but had a higher adjusted prevalence (63% versus 60%, P < 0.05) and the AOR (1.14, 95% CI: 1.04−1.24) for receiving colorectal cancer screenings compared to those without. In both women with diabetes and those without, the screening rate for colorectal cancer increased linearly during 2002−2006, whereas the screening rates for breast and cervical cancers changed little during 1996−2006.

CONCLUSION

Women with diabetes were equally likely to be screened for breast cancer, less likely to be screened for cervical cancer, but more likely to be screened for colorectal cancer compared to those without. Overall, the screening rates in both groups remain below the recommended levels.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1

Similar content being viewed by others

REFERENCES

  1. Espey DK, Wu XC, Swan J, et al. Annual report to the nation on the status of cancer, 1975-2004, featuring cancer in American Indians and Alaska Natives. Cancer. 2007;110:2119–52.

    Article  PubMed  Google Scholar 

  2. American Cancer Society. Cancer Statistics 2007. Available at URL:http://www.cancer.org/downloads/STT/Cancer_Statistics_Combined_2007.ppt#256,1,Cancer Statistics. Accessed Nov. 12, 2008.

  3. Tabar L, Yen MF, Vitak B, Chen HH, Smith RA, Duffy SW. Mammography service screening and mortality in breast cancer patients: 20-year follow-up before and after introduction of screening. Lancet. 2003;361:1405–10.

    Article  PubMed  Google Scholar 

  4. Gustafsson L, Ponten J, Zack M, Adami HO. International incidence rates of invasive cervical cancer after introduction of cytological screening. Cancer Causes Control. 1997;8:755–63.

    Article  PubMed  CAS  Google Scholar 

  5. Mandel JS, Bond JH, Church TR, et al. Reducing mortality from colorectal cancer by screening for fecal occult blood. Minnesota colon cancer control study. N Engl J Med. 1993;328:1365–71.

    Article  PubMed  CAS  Google Scholar 

  6. U.S. Department of Health and Human Services. The guide to clinical preventive services, 2007: Recommendations of the U.S. Preventive Services Task Force. Available at URL: http://www.ahrq.gov/clinic/pocketgd07/pocketgd07.pdf. Accessed Nov. 12, 2008.

  7. Larsson SC, Orsini N, Wolk A. Diabetes mellitus and risk of colorectal cancer: a meta-analysis. J Natl Cancer Inst. 2005;97:1679–87.

    Article  PubMed  Google Scholar 

  8. Larsson SC, Mantzoros CS, Wolk A. Diabetes mellitus and risk of breast cancer: a meta-analysis. Int J Cancer. 2007;121:856–62.

    Article  PubMed  CAS  Google Scholar 

  9. Wolf I, Sadetzki S, Gluck I, et al. Association between diabetes mellitus and adverse characteristics of breast cancer at presentation. Eur J Cancer. 2006;42:1077–82.

    Article  PubMed  Google Scholar 

  10. Frezza EE, Wachtel MS, Chiriva-Internati M. Influence of obesity on the risk of developing colon cancer. Gut. 2006;55:285–91.

    Article  PubMed  CAS  Google Scholar 

  11. Marugame T, Lee K, Eguchi H, Oda T, Shinchi K, Kono S. Relation of impaired glucose tolerance and diabetes mellitus to colorectal adenomas in Japan. Cancer Causes Control. 2002;13:917–21.

    Article  PubMed  Google Scholar 

  12. Morita T, Tabata S, Mineshita M, Mizoue T, Moore MA, Kono S. The metabolic syndrome is associated with increased risk of colorectal adenoma development: the Self-Defense Forces health study. Asian Pac J Cancer Prev. 2005;6:485–9.

    PubMed  Google Scholar 

  13. Yoshida I, Suzuki A, Vallee M, et al. Serum insulin levels and the prevalence of adenomatous and hyperplastic polyps in the proximal colon. Clin Gastroenterol Hepatol. 2006;4:1225–31.

    Article  PubMed  CAS  Google Scholar 

  14. Cowie CC, Rust KF, Byrd-Holt DD, et al. Prevalence of diabetes and impaired fasting glucose in adults in the U.S. population: national health and nutrition examination survey 1999-2002. Diabetes Care. 2006;29:1263–8.

    Article  PubMed  Google Scholar 

  15. Centers for Disease Control and Prevention. Diabetes Data & Trends. Available at URL: http://www.cdc.gov/diabetes/statistics/prev/national/figbysex.htm. Accessed Nov. 12, 2008.

  16. Ahluwalia IB, Bolen J, Garvin B. Health insurance coverage and use of selected preventive services by working-age women, BRFSS, 2006. J Womens Health. 2007;16:935–40.

    Article  Google Scholar 

  17. Nelson DE, Holtzman D, Bolen J, Stanwyck CA, Mack KA. Reliability and validity of measures from the Behavioral Risk Factor Surveillance System (BRFSS). Soc Prev Med. 2001;46(suppl 1):S3-S42.

    Google Scholar 

  18. Martin LM, Leff M, Calonge N, Garrett C, Nelson DE. Validation of self-reported chronic conditions and health services in a managed care population. Am J Prev Med. 2000;18:215–8.

    Article  PubMed  CAS  Google Scholar 

  19. Coughlin SS, Calle EE, Teras LR, Petrelli J, Thun MJ. Diabetes mellitus as a predictor of cancer mortality in a large cohort of US adults. Am J Epidemiol. 2004;159:1160–7.

    Article  PubMed  Google Scholar 

  20. U.S. Department of Health and Human Services. Healthy People 2010. Available at URL: http://www.healthypeople.gov/Search/objectives.htm. Accessed Nov. 12, 2008.

  21. Beckman TJ, Cuddihy RM, Scheitel SM, Naessens JM, Killian JM, Pankratz VS. Screening mammogram utilization in women with diabetes. Diabetes Care. 2001;24:2049–53.

    Article  PubMed  CAS  Google Scholar 

  22. Fontana SA, Baumann LC, Helberg C, Love RR. The delivery of preventive services in primary care practices according to chronic disease status. Am J Public Health. 1997;87:1190–6.

    Article  PubMed  CAS  Google Scholar 

  23. McBean AM, Yu X. The underuse of screening services among elderly women with diabetes. Diabetes Care. 2007;30:1466–72.

    Article  PubMed  Google Scholar 

  24. Lipscombe LL, Hux JE, Booth GL. Reduced screening mammography among women with diabetes. Arch Intern Med. 2005;165:2090–5.

    Article  PubMed  Google Scholar 

  25. Tabaei BP, Herman WH, Jabarin AF, Kim C. Does diabetes care compete with the provision of women's preventive care services? Diabetes Care. 2005;28:2644–9.

    Article  PubMed  Google Scholar 

  26. Bell RA, Shelton BJ, Paskett ED. Colorectal cancer screening in North Carolina: associations with diabetes mellitus and demographic and health characteristics. Prev Med. 2001;32:163–7.

    Article  PubMed  CAS  Google Scholar 

  27. Beckles GL, Engelgau MM, Narayan KM, Herman WH, Aubert RE, Williamson DF. Population-based assessment of the level of care among adults with diabetes in the U.S. diabetes care. 1998;21:1432–8.

    Article  PubMed  CAS  Google Scholar 

  28. Lewis JD, Capra AM, Achacoso NS, et al.. Medical therapy for diabetes is associated with increased use of lower endoscopy. Pharmacoepidemiol Drug Saf. 2007;16:1195–202.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We thank Dr. Mary White from the Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, for reviewing the manuscript and providing useful comments.

The abstract was presented in the 68th American Diabetes Association (ADA) Scientific Session, June 6-10, 2008 in San Francisco, CA.

Conflict of Interest

None disclosed.

Disclaimer

The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Guixiang Zhao MD, PhD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zhao, G., Ford, E.S., Ahluwalia, I.B. et al. Prevalence and Trends of Receipt of Cancer Screenings Among US Women with Diagnosed Diabetes. J GEN INTERN MED 24, 270–275 (2009). https://doi.org/10.1007/s11606-008-0858-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11606-008-0858-8

KEY WORDS

Navigation