Rural-urban disparities in preventive breast and cervical cancer screening among women with early-onset dementia.
Rural-urban disparities in preventive breast and cervical cancer screening among women with early-onset dementia.
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DOI：
10.1186/s12905-023-02301-7
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发表时间：
2023-05-11
影响因子：
2.5
通讯作者：
Lee, Sunmin
中科院分区：
文献类型：
--
作者：
Xu, Wendy Y. Y.;Raver, Eli;Jung, Jeah;Li, Yiting;Thai, Gaby;Lee, Sunmin
关键词：
阿尔茨海默病和相关痴呆症（ADRD）在65岁之前的早期发作可能会引起生活和健康护理并发症。保持早发性ADRD患者的日常功能更长，并延迟非ADRD条件下的健康下降成为重要的预防目标。本研究检查了早发性ADRD患者和非早发性ADRD患者之间预防性癌症筛查利用率的差异，并比较了美国早发性ADRD女性在农村与城市地区筛查的利用率。我们对2012年至2018年期间有资格使用商业保险索赔进行乳房X光检查和宫颈癌筛查的40至64岁女性进行了一项横断面研究。我们测量了50至64岁女性每两年进行一次乳房X光检查的情况，以及40至64岁女性每三年进行一次巴氏涂片检查的情况。我们使用逆概率加权逻辑回归来估计早发性ADRD或认知障碍（CI）的存在下接受预防性癌症筛查的几率。我们使用多变量logistic回归来估计早发性ADRD/CI女性中农村或城市居民接受预防性癌症筛查的几率。在乳腺癌筛查样本中的6，349，308名女性（平均[SD]年龄，56.52 [4.03]岁）中，36，131名患有早发性ADRD/CI（平均[SD]年龄，57.99 [3.98]岁）。在宫颈癌筛查样本中的6，583，088名女性（平均[SD]年龄，52.37 [6.81]岁）中，30，919名患有早发性ADRD/CI（平均[SD]年龄，55.79 [6.22]岁）。早发ADRD/CI与乳腺X线检查利用率降低相关（OR：0.92，95%CI：0.90-0.95）。早发性ADRD/CI与非早发性ADRD/CI患者的巴氏涂片筛查结果无显著性差异（OR：0.99，95%CI：0.96-1.02）。在早发ADRD/CI患者中，农村患者接受乳房X线检查（OR：0.91，95%CI：0.85-0.97）和巴氏涂片检查（OR：0.65，95%CI：0.61-0.71）的可能性低于城市患者。在我们的研究中观察到的癌症筛查城乡差异模式强调了在早发ADRD人群中努力促进循证、个体化决策过程的必要性。
The early onset of Alzheimer’s disease and related dementias (ADRD) before age 65 can introduce life and health care complications. Preserving an early-onset ADRD patient’s daily functioning longer and delaying declines in health from non-ADRD conditions become important preventive goals. This study examined the differences in utilization of preventive cancer screenings between patients with and without early-onset ADRD, and compared utilization of the screenings in rural versus urban areas among women with early-onset ADRD in the United States. We conducted a cross-sectional study of women aged 40 to 64 years eligible for mammogram and cervical cancer screenings using commercial insurance claims from 2012 to 2018. We measured the use of biennial mammogram among women 50 to 64 years old, and the use of triennial Pap smear test among women 40 to 64 years old. We used inverse probability weighted logistic regressions to estimate the odds of receiving preventive cancer screenings by the presence of early-onset ADRD or cognitive impairments (CI). We used multivariable logistic regressions to estimate the odds of receiving preventive cancer screenings by rural or urban residence among women with early-onset ADRD/CI. Among 6,349,308 women in the breast cancer screening sample (mean [SD] age, 56.52 [4.03] years), 36,131 had early-onset ADRD/CI (mean [SD] age, 57.99 [3.98] years). Among 6,583,088 women in the cervical cancer screening sample (mean [SD] age, 52.37 [6.81] years), 30,919 had early-onset ADRD/CI (mean [SD] age, 55.79 [6.22] years). Having early-onset ADRD/CI was associated with lower utilization of mammogram (OR: 0.92, 95% CI: 0.90–0.95). No significant difference was observed in Pap smear screening (OR: 0.99, 95% CI: 0.96–1.02) between patients with and without early-onset ADRD/CI. Among patients with early-onset ADRD/CI, those in rural areas were less likely than those in urban areas to have mammograms (OR: 0.91, 95% CI: 0.85–0.97) and Pap smears (OR: 0.65, 95% CI: 0.61–0.71). The observed pattern of rural-urban differences in cancer screening in our study emphasizes the need for efforts to promote evidence-based, individualized decision-making processes in the early-onset ADRD population.
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影响因子：
4.9
作者：
Bethea, Traci N.;Lopez, Russell P.;McClean, Michael D.
通讯作者：
McClean, Michael D.
影响因子：
5.5
作者：
Benavidez GA;Zgodic A;Zahnd WE;Eberth JM
通讯作者：
Eberth JM
影响因子：
2.3
作者：
Tran，Lam;Tran，Phoebe
通讯作者：
Tran，Phoebe
DOI：
10.1111/jrh.12465
发表时间：
2021-06
期刊：
The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association
影响因子：
--
作者：
Wang N;Albaroudi A;Chen J
通讯作者：
Chen J
影响因子：
2.5
作者：
Orwat, John;Caputo, Nadine;De Sa, Jeanne
通讯作者：
De Sa, Jeanne