Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA.
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E6133, Baltimore, MD, 21205, USA.
Cancer Causes Control. 2022 Jan;33(1):49-62. doi: 10.1007/s10552-021-01498-y. Epub 2021 Oct 6.
Cancer survivors are more likely to report having a poor health status when compared to the general population. Few studies have focused on the impact of cancer on health status and healthcare utilization/access outcomes among women from medically underserved populations.
25,741 women with and without a history of cancer from the National Health and Nutrition Examination Survey from 1999 to 2016 contributed data. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression for associations between cancer status and perceived health and healthcare utilization/access outcomes stratified by race/ethnicity, poverty status, education, and comorbidities.
1,897 (7.0%) women had a history of cancer with breast cancer as the most common (n = 671, 35.7%). While most survivors were non-Hispanic white (69.4%), 13.9% were Hispanic, 12.0% were non-Hispanic Black, and 4.6% were additional racial/ethnic groups. Survivors were 1.32 times more likely to be hospitalized within the last year (95% CI 1.11-1.58) and 1.32 times more likely to see a mental health provider within the last year (95% CI 1.05-1.66) compared to cancer-free women. Race/ethnicity was a significant effect modifier in the association between being a survivor and seeing a mental health provider, with Hispanic survivors having the highest odds (aOR 3.44; 95% CI 2.06-5.74; p-interaction < 0.00).
Our study identifies disparities in healthcare utilization among female cancer survivors, highlighting the importance of evaluating these associations among medically underserved populations. These findings can educate healthcare professionals working with these populations to inform gaps in survivorship care utilization/access.
与一般人群相比，癌症幸存者更有可能报告健康状况不佳。很少有研究关注癌症对医疗服务不足人群中女性的健康状况和医疗保健利用/获得结果的影响。
1999 年至 2016 年，来自全国健康和营养检查调查的 25741 名有和没有癌症病史的女性提供了数据。使用多变量逻辑回归估计调整后的优势比 (aOR) 和 95%置信区间 (CI)，以评估癌症状况与感知健康以及按种族/民族、贫困状况、教育程度和合并症分层的医疗保健利用/获得结果之间的关联。
1897 名（7.0%）女性有癌症病史，其中乳腺癌最常见（n=671，35.7%）。虽然大多数幸存者是非西班牙裔白人（69.4%），但 13.9%是西班牙裔，12.0%是非西班牙裔黑人，4.6%是其他种族/民族群体。与无癌症女性相比，幸存者在过去一年中住院的可能性高 1.32 倍（95%CI 1.11-1.58），在过去一年中看心理健康提供者的可能性高 1.32 倍（95%CI 1.05-1.66）。种族/民族是幸存者与看心理健康提供者之间关联的一个显著的效应修饰因素，西班牙裔幸存者的可能性最高（aOR 3.44；95%CI 2.06-5.74；p 交互 < 0.00）。
我们的研究确定了女性癌症幸存者在医疗保健利用方面的差异，强调了在医疗服务不足人群中评估这些关联的重要性。这些发现可以为与这些人群合作的医疗保健专业人员提供教育，以了解生存护理利用/获得方面的差距。
