Impact of socio-economic status on breast cancer screening in women with diabetes: a population-based study
Aims There is evidence to suggest that mammography rates are decreased in women with diabetes and in women of lower socio‐economic status. Given the strong association between low socio‐economic status and diabetes, we explored the extent to which differences in socio‐economic status explain lower m...
Gespeichert in:
Veröffentlicht in: | Diabetic medicine 2014-07, Vol.31 (7), p.806-812 |
---|---|
Hauptverfasser: | , , , , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
Zusammenfassung: | Aims
There is evidence to suggest that mammography rates are decreased in women with diabetes and in women of lower socio‐economic status. Given the strong association between low socio‐economic status and diabetes, we explored the extent to which differences in socio‐economic status explain lower mammography rates in women with diabetes.
Methods
A population‐based retrospective cohort study in Ontario, Canada, of women aged 50 to 69 years with diabetes between 1999 and 2010 age matched 1:2 to women without diabetes. Main outcome measure is the likelihood of at least one screening mammogram in women with diabetes within a 36‐month period, starting as of either 1 January 1999, their 50th birthday, or 2 years after diabetes diagnosis – whichever came last. Outcomes were compared with those in women without diabetes during the same period as their matched counterparts, adjusting for socio‐economic status based on neighbourhood income and other demographic and clinical variables.
Results
Of 504 288 women studied (188 759 with diabetes, 315 529 with no diabetes), 63.8% had a screening mammogram. Women with diabetes were significantly less likely to have a mammogram after adjustment for socio‐economic status and other factors (odds ratio 0.79, 95% CI 0.78–0.80). Diabetes was associated with lower mammogram use even in women from the highest socio‐economic status quintile (odds ratio 0.79, 95% CI 0.75–0.83).
Conclusions
The presence of diabetes was an independent barrier to breast cancer screening, which was not explained by differences in socio‐economic status. Interventions that target patient, provider, and health system factors are needed to improve cancer screening in this population.
What's new?
This study is the first to explore the influence of socio‐economic status on the gap in screening mammograms among women with diabetes.
While there is evidence that the presence of diabetes is associated with a decrease in breast cancer screening, no study has examined the extent to which the higher prevalence of low socio‐economic status in women with diabetes contributes to this disparity.
Using population‐based data, we showed that diabetes is an independent barrier to adequate breast cancer screening even after adjusting for socio‐economic status, and that low socio‐economic status serves as an additional obstacle to regular screening mammograms. |
---|---|
ISSN: | 0742-3071 1464-5491 |
DOI: | 10.1111/dme.12422 |