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APHA Scientific Session and Event Listing

Recorded presentation

Janet Marshall, DNSc, RN¹, Julia Muennich Cowell, PhD, RNC, FAAN¹, Diane McNaughton, PhD, RN¹, and Ellen Campbell, PhD². (1) College of Nursing, Community and Mental Health Nursing, Rush University, 600 South Paulina, 1080 Armour Academic Center, Chicago, IL 60612, (850)894-4710, jgmarsh@aol.com, (2) School of Pharmacy, Florida A&M University, MLK Boulevard, Tallahassee, FL 32307

Using a national database for secondary analysis, the purpose of this investigation was to determine if women with diabetes have different patterns of screening for breast and cervical cancer than women of the general population; and, if so, identify the determinants of the screening pattern. The PRECEDE Model was the organizing framework for this investigation of the complex issues related to cancer screening. The 12 states utilizing the optional women's health module for the 2003 Behavioral Risk Factor Surveillance System (BRFSS) was downloaded into STATA Software. Inclusion criteria were women who self-report that they have diabetes in comparison to women who report not having diabetes. For mammography, selected women were 40 years of age or older which provided a weighted population size of 9,017,661. Pap screening age of 21 and older yielded a weighted population size of 13,025,863. Contingency tables were used to identify the prevalence of cancer screening in women with and without diabetes. No significant association was found between having a diagnosis of diabetes and mammography screening rates (F =1.5, p-value = .22). Cervical cancer screening rates were statistically significantly different among women with diabetes and those without diabetes (F=39.01, p-value= .00). Regional exceptions were noted when the 12 states were viewed individually. The states demonstrating inadequate screening rates were the states with the most negative predisposing and enabling factors. Using logistic regression, 10 of the 11 PRECEDE variables demonstrated a significant association with Pap screening rates. Women with poorer perceptions of general and mental health, unemployment, low income, decreased education, lack of health plan coverage, not having a personal physician, having a disability that limits activity or requires the use of special equipment had lower Pap screening rates. Whites were less likely to be screened than non-whites. This study represented an improvement over other studies limited to a single practice or region. Further studies utilizing secondary analysis of state and national data will assist in confirming these findings and promote the development of trend data to evaluate the success of current local, state and national cancer screening programs that will guide the direction of future programs.

Learning Objectives:

• Participants will identify the regional gaps found in cancer screening among women with diabetes.
• Participants will describe the predisposing and enabling determinants related to cancer screening among women with diabetes.

Keywords: Cancer Screening, Diabetes

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation