Non-communicable chronic diseases and timely breast cancer screening among women of the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study

• Published in: Cancer causes & control Vol. 29; no. 3; pp. 315 - 324
• Main Authors: Wang, K. H., Thompson, T. A., Galusha, D., Friedman, H., Nazario, C. M., Nunez, M., Maharaj, R. G., Adams, O. P., Nunez-Smith, M.
• Format: Journal Article
• Language: English
• Published: Cham Springer Science + Business Media 01.03.2018; Springer International Publishing; Springer Nature B.V
• Subjects: Adult; Aged; Biomedical and Life Sciences; Biomedicine; Bivariate analysis; Breast cancer; Breast Neoplasms - diagnosis; Breast Neoplasms - epidemiology; Breasts; Cancer; Cancer Research; Cancer screening; Caribbean Region; Chronic Disease; Chronic illnesses; Cohort analysis; Cohort Studies; Cross-Sectional Studies; Data analysis; Data processing; Dependent variables; Diabetes mellitus; Diabetes Mellitus - epidemiology; Disease control; Early Detection of Cancer; Epidemiology; Female; Health care; Hematology; Humans; Hypertension; Hypertension - epidemiology; Independent variables; Mammography; Medical screening; Middle Aged; Noncommunicable Diseases - epidemiology; Oncology; ORIGINAL PAPER; Outcome Assessment, Health Care; Population studies; Public Health; Womens health; Caribbean Region; Social determinants of health; Non-communicable chronic diseases; Screening mammography; Caribbean
• DOI: 10.1007/s10552-018-1005-4
• ISSN: 0957-5243; 1573-7225

Purpose The Caribbean population faces a growing burden of multiple non-communicable chronic diseases (NCDs). Breast cancer is the leading cause of cancer death for women in the Caribbean. Given the substantial burden of NCDs across the region, cancer prevention and control strategies may need to be specifically tailored for people with multiple co-morbidities. Preventive screening, such as timely mammography, is essential but may be either facilitated or hampered by chronic disease control. The main objective of this study is to examine the relationship between a chronic disease and timely breast cancer screening. Methods We conducted a cross-sectional data analysis using baseline data from the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study—ECS. Our independent variables were presence of chronic diseases (hypertension or diabetes), defined as having been told by a clinical provider. Our dependent variable was timely screening mammography, as defined by receipt of mammography within the past 2 years. We examined bivariate and multivariate associations of covariates and timely screening mammography. Results In our sample ( n  = 841), 52% reported timely screening mammography. Among those with timely screening, 50.8% reported having hypertension, and 22.3% reported having diabetes. In our bivariate analyses, both diabetes and hypertension were associated with timely screening mammography. In partially adjusted models, we found that women with diabetes were significantly more likely to report timely screening mammography than women without diabetes. In our fully adjusted models, the association was no longer significant. Having a usual source of healthcare and a woman’s island of residence were significantly associated with timely screening mammography ( p  < 0.05). Conclusions We found that half of eligible women received timely screening mammography. Diabetes and hypertension, though common, are not associated with timely screening mammography. Usual source of care remains an important factor to timely breast cancer screening.