Department of Epidemiology and Biostatistics, Arnold School of Public Health, The University of South Carolina, Columbia, South Carolina.
Rural and Minority Health Research Center, Arnold School of Public Health, The University of South Carolina, Columbia, South Carolina.
Prev Chronic Dis. 2021 Apr 15;18:E37. doi: 10.5888/pcd18.200315.
Many sociodemographic factors affect women's ability to meet cancer screening guidelines. Our objective was to examine which sociodemographic characteristics were associated with women meeting US Preventive Services Task Force (USPSTF) guidelines for breast, cervical, and colorectal cancer screening.
We used 2018 Behavioral Risk Factor Surveillance System data to examine the association between sociodemographic variables, such as race/ethnicity, rurality, education, and insurance status, and self-reported cancer screening for breast, cervical, and colorectal cancer. We used multivariable log-binomial regression models to estimate adjusted prevalence ratios and 95% CIs.
Overall, the proportion of women meeting USPSTF guidelines for breast, cervical, and colorectal cancer screening was more than 70%. The prevalence of meeting screening guidelines was 6% to 10% greater among non-Hispanic Black women than among non-Hispanic White women across all 3 types of cancer screening. Women who lacked health insurance had a 26% to 39% lower screening prevalence across screening types than women with health insurance. Compared with women with $50,000 or more in annual household income, women with less than $50,000 in annual household income had a 3% to 8% lower screening prevalence across all 3 screening types. For colorectal cancer, the prevalence of screening was 7% less among women who lived in rural counties than among women in metropolitan counties.
Many women still do not meet current USPSTF guidelines for breast, cervical, and colorectal cancer screening. Screening disparities are persistent among socioeconomically disadvantaged groups, especially women with low incomes and without health insurance. To increase the prevalence of cancer screening and reduce disparities, interventions must focus on reducing economic barriers and improving access to care.
许多社会人口因素会影响女性满足癌症筛查指南的能力。我们的目的是研究哪些社会人口特征与女性是否符合美国预防服务工作组（USPSTF）关于乳腺癌、宫颈癌和结直肠癌筛查的指南有关。
我们使用 2018 年行为风险因素监测系统的数据，检查社会人口变量（如种族/族裔、农村地区、教育程度和保险状况）与乳腺癌、宫颈癌和结直肠癌自我报告筛查之间的关联。我们使用多变量对数二项式回归模型来估计调整后的流行率比和 95%置信区间。
总体而言，符合 USPSTF 乳腺癌、宫颈癌和结直肠癌筛查指南的女性比例超过 70%。在所有 3 种癌症筛查中，非西班牙裔黑人女性符合筛查指南的比例比非西班牙裔白人女性高 6%至 10%。与有保险的女性相比，没有保险的女性的筛查率低 26%至 39%。与年收入在 5 万美元或以上的女性相比，年收入低于 5 万美元的女性在所有 3 种筛查类型中的筛查率低 3%至 8%。对于结直肠癌，居住在农村县的女性的筛查率比居住在大都市县的女性低 7%。
许多女性仍然不符合当前 USPSTF 关于乳腺癌、宫颈癌和结直肠癌筛查的指南。在社会经济处于不利地位的群体中，特别是收入较低和没有保险的女性中，筛查差距仍然存在。为了提高癌症筛查的普及率并减少差距，干预措施必须重点减少经济障碍并改善获得护理的机会。
