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Non-communicable chronic diseases and timely breast cancer screening among women of the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study

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Abstract

Purpose

The Caribbean population faces a growing burden of multiple non-communicable chronic diseases (NCDs). Breast cancer is the leading cause of cancer death for women in the Caribbean. Given the substantial burden of NCDs across the region, cancer prevention and control strategies may need to be specifically tailored for people with multiple co-morbidities. Preventive screening, such as timely mammography, is essential but may be either facilitated or hampered by chronic disease control. The main objective of this study is to examine the relationship between a chronic disease and timely breast cancer screening.

Methods

We conducted a cross-sectional data analysis using baseline data from the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study—ECS. Our independent variables were presence of chronic diseases (hypertension or diabetes), defined as having been told by a clinical provider. Our dependent variable was timely screening mammography, as defined by receipt of mammography within the past 2 years. We examined bivariate and multivariate associations of covariates and timely screening mammography.

Results

In our sample (n = 841), 52% reported timely screening mammography. Among those with timely screening, 50.8% reported having hypertension, and 22.3% reported having diabetes. In our bivariate analyses, both diabetes and hypertension were associated with timely screening mammography. In partially adjusted models, we found that women with diabetes were significantly more likely to report timely screening mammography than women without diabetes. In our fully adjusted models, the association was no longer significant. Having a usual source of healthcare and a woman’s island of residence were significantly associated with timely screening mammography (p < 0.05).

Conclusions

We found that half of eligible women received timely screening mammography. Diabetes and hypertension, though common, are not associated with timely screening mammography. Usual source of care remains an important factor to timely breast cancer screening.

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References

  1. Women’s cancer and comprehensive care in the Caribbean: situation and challenges. (2016) World Health Organization, Pan American Health Organization

  2. Razzaghi H et al (2016) Leading causes of cancer mortality—Caribbean region, 2003-2013, in morbidity and mortality weekly report. Center for Disease Control and Prevention

  3. Armstrong H Breast and cervical cancers in Barbados: a situational analysis. Barbados Ministry of Health

  4. Wells KJ, Roetzheim RG (2007) Health disparities in receipt of screening mammography in Latinas: a critical review of recent literature. Cancer Control 14(4):369

    PubMed  Google Scholar 

  5. Consedine NS et al (2015) Beyond the black box: a systematic review of breast, prostate, colorectal, and cervical screening among native and immigrant African-descent Caribbean populations. J Immigr Minor Health 17(3):905–924

    PubMed  Google Scholar 

  6. Aldridge ML, Daniels JL, Jukic AM (2006) Mammograms and healthcare access among US Hispanic and non-Hispanic women 40 years and older. Fam Community Health 29(2):80–88

    PubMed  Google Scholar 

  7. Reyes-Ortiz CA et al (2007) The impact of education and literacy levels on cancer screening among older Latin American and Caribbean adults. Cancer Control 14(4):388–395

    PubMed  Google Scholar 

  8. Banegas MP, Li CI (2012) Breast cancer characteristics and outcomes among Hispanic Black and Hispanic White women. Breast Cancer Res Treat 134(3):1297–1304

    PubMed  PubMed Central  Google Scholar 

  9. Constantinou P, Dray-Spira R, Menvielle G (2016) Cervical and breast cancer screening participation for women with chronic conditions in France: results from a national health survey. BMC Cancer 16(1):255

    PubMed  PubMed Central  Google Scholar 

  10. Beckman TJ et al (2001) Screening mammogram utilization in women with diabetes. Diabetes Care 24(12):2049–2053

    CAS  PubMed  Google Scholar 

  11. Diaz A et al (2017) Association between comorbidity and participation in breast and cervical cancer screening: a systematic review and meta-analysis. Cancer Epidemiol 47:7–19

    PubMed  Google Scholar 

  12. Kiefe CI et al (1998) Chronic disease as a barrier to breast and cervical cancer screening. J Gen Intern Med 13:357–365

    CAS  PubMed  PubMed Central  Google Scholar 

  13. Chan W et al (2014) Impact of socio-economic status on breast cancer screening in women with diabetes: a population-based study. Diabet Med 31(7):806–812

    CAS  PubMed  Google Scholar 

  14. Lafata JE et al (2001) Provider type and the receipt of general and diabetes-related preventive health services among patients with diabetes. Med Care 39:491–499

    CAS  PubMed  Google Scholar 

  15. Martinez-Huedo MA et al (2012) Adherence to breast and cervical cancer screening in Spanish women with diabetes: associated factors and trend between 2006 and 2010. Diabetes Metab 38:142–148

    Google Scholar 

  16. Lipscombe LL, Hux JE, Booth GL (2005) Reduced screening mammography among women with diabetes. Arch Intern Med 165(18):2090–2095

    PubMed  Google Scholar 

  17. Tabaei BP et al (2005) Does diabetes care compete with the provision of women’s preventive care services?. Diabetes Care 28:2644–2649

    Google Scholar 

  18. Sarfati D, Koczwara B, Jackson C (2016) The impact of comorbidity on cancer and its treatment. CA: Cancer J Clin 66(4):337–350

    Google Scholar 

  19. López-de-Andrés A et al (2010) Predictors of breast and cervical cancer screening in a Spanish metropolitan area. J Women’s Health 19(9):1675–1681

    Google Scholar 

  20. Guo F, Hirth JM, Berenson AB (2015) Effects of cardiovascular disease on compliance with cervical and breast cancer screening recommendations among adult women. J Womens Health (Larchmt) 24(8):641–647

    Google Scholar 

  21. Bostick RM et al (1994) Predictors of cancer prevention attitudes and participation in cancer screening examinations. Prev Med 23(6):816–826

    CAS  PubMed  Google Scholar 

  22. Center for Disease Control, U.S. National Health Interview Survey. (2016) Washington, DC

  23. Smith RA et al (2010) Cancer screening in the United States, 2010: a review of current American Cancer Society guidelines and issues in cancer screening. CA Cancer J Clin 60(2):99–119

    PubMed  Google Scholar 

  24. WHO guidelines approved by the guidelines Review Committee, in WHO position paper on mammography screening. (2014), World Health Organization Copyright (c) World Health Organization 2014: Geneva

  25. Final recommendation statement: breast cancer: screening. (2014) U.S. Preventive Services Task Force

  26. Wang CCL et al (2016) Clinical update: cardiovascular disease in diabetes mellitus. Circulation 133(24):2459–2502

    Google Scholar 

  27. James PA et al (2014) 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA 311(5):507–520

    Article  CAS  PubMed  Google Scholar 

  28. Kilpatrick FP, Cantril H (1960) Self-anchoring scaling: a measure of individuals’ unique reality worlds. J Individ Psychol 16(2):158

    Google Scholar 

  29. Ahmad F et al (2014) Single item measures of self-rated mental health: a scoping review. BMC Health Serv Res 14(1):398

    PubMed  PubMed Central  Google Scholar 

  30. Hosmer DW, Lemeshow S, Klar J (1988) Goodness-of-fit testing for the logistic regression model when the estimated probabilities are small. Biom J 30(8):911–924

    Google Scholar 

  31. Corbie-Smith G et al (2002) Influence of usual source of care on differences by race/ethnicity in receipt of preventive services. J Gen Intern Med 17(6):458–464

    PubMed  PubMed Central  Google Scholar 

  32. Martínez-Donate A et al (2013) Prevalence and correlates of breast and cervical cancer screening among a midwest community sample of low-acculturated Latinas. J Health Care Poor Underserved 24(4):1717–1738

    PubMed  PubMed Central  Google Scholar 

  33. Grady KE et al (1992) The importance of physician encouragement in breast cancer screening of older women. Prev Med 21(6):766–780

    CAS  PubMed  Google Scholar 

  34. Vrinten C, Wardle J, Marlow LA (2016) Cancer fear and fatalism among ethnic minority women in the United Kingdom. Br J Cancer 114(5):597

    PubMed  PubMed Central  Google Scholar 

  35. Consedine NS, Magai C, Neugut AI (2004) The contribution of emotional characteristics to breast cancer screening among women from six ethnic groups. Prev Med 38(1):64–77

    PubMed  Google Scholar 

  36. Ahmad F, Cameron J, Stewart DE (2005) A tailored intervention to promote breast cancer screening among South Asian immigrant women

  37. Boxwala FI et al (2010) Factors associated with breast cancer screening in Asian Indian women in metro-Detroit. J Immigr Minor Health 12(4):534–543

    PubMed  PubMed Central  Google Scholar 

  38. Camacho-Rivera M et al (2015) Breast cancer clinical characteristics and outcomes in Trinidad and Tobago. J Immigr Minor Health 17(3):765–772

    PubMed  Google Scholar 

  39. Joseph MD et al (2014) Breast cancer diagnosis from screening in Trinidad and Tobago: opportunities for cancer prevention. J Immigr Minor Health 16(3):409–415

    Google Scholar 

  40. Granado MN et al (2014) Exploring breast cancer screening barriers among Barbadian women: a focus group study of mammography in a resource-constrained setting. Criti Public Health 24(4):429–444

    Google Scholar 

  41. Plan of action for the prevention and control of noncommunicable diseases in the Americas 2013-2019. (2014) Pan American Health Organization, World Health Organization

  42. Granado MN et al (2014) Exploring breast cancer screening barriers among Barbadian women: a focus group study of mammography in a resource-constrained setting. Crit Public Health 24(4):429–444

    Google Scholar 

  43. Hiatt RA et al (2001) Community-based cancer screening for underserved women: design and baseline findings from the breast and Cervical Cancer Intervention Study. Prev Med 33(3):190–203

    CAS  PubMed  Google Scholar 

  44. Goss PE et al (2013) Planning cancer control in Latin America and the Caribbean. Lancet Oncol 14(5):391–436

    PubMed  Google Scholar 

  45. Champion VL et al (2006) Comparison of three interventions to increase mammography screening in low income African American women. Cancer Detect Prev 30(6):535–544

    PubMed  Google Scholar 

  46. Taioli E et al (2010) Breast cancer survival in women of African descent living in the US and in the Caribbean: effect of place of birth. Breast Cancer Res Treat 122(2):515–520

    PubMed  Google Scholar 

  47. Colón-Ramos U et al (2016) Transnational mortality comparisons between Archipelago and Mainland Puerto Ricans. J Immigr Minor Health 19:1009–1017

    Google Scholar 

  48. Mutetwa B et al (2010) Prostate cancer characteristics and survival in males of African Ancestry according to place of birth: data from Brooklyn—New York, Guyana, Tobago and Trinidad. Prostate 70(10):1102–1109

    PubMed  PubMed Central  Google Scholar 

  49. Felix A et al (2009) Cancer screening and cancer mortality in Nevis, West Indies: Pesquisaje de cáncer y mortalidad por cáncer en Nevis, West Indies. West Indian Med J 58(4):311–318

    CAS  PubMed  Google Scholar 

  50. Nemesure B et al (2009) Risk factors for breast cancer in a black population—The Barbados National Cancer Study. Int J Cancer 124(1):174–179

    CAS  PubMed  PubMed Central  Google Scholar 

  51. Ragin CC et al (2007) African-Caribbean cancer consortium for the study of viral, genetic and environmental cancer risk factors. Infect Agent Cancer 2:17

    PubMed  PubMed Central  Google Scholar 

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Acknowledgments

All authors were supported in part by U24 MD006938 and U54MD010711 from the National Institute on Minority Health and Health Disparities. The funders had no role in the design or conduct of the study. Views expressed are those of the authors and do not represent those of the funding source.

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Authors and Affiliations

  1. Equity Research and Innovation Center, Yale University School of Medicine, New Haven, USA

    K. H. Wang, T. A. Thompson, D. Galusha, H. Friedman & M. Nunez-Smith

  2. School of Public Health, University of Puerto Rico, San Juan, Puerto Rico

    C. M. Nazario

  3. School of Nursing, University of the Virgin Islands, Saint Thomas, US Virgin Islands

    M. Nunez

  4. Faculty of Medical Sciences, University of the West Indies at St. Augustine, Saint Augustine, Trinidad and Tobago

    R. G. Maharaj

  5. Faculty of Medical Sciences, University of the West Indies at Cave Hill, Cave Hill, Barbados

    O. P. Adams

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  1. K. H. Wang
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on behalf of the ECHORN Writing Group

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Correspondence to K. H. Wang.

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Wang, K.H., Thompson, T.A., Galusha, D. et al. Non-communicable chronic diseases and timely breast cancer screening among women of the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study. Cancer Causes Control 29, 315–324 (2018). https://doi.org/10.1007/s10552-018-1005-4

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