RESUMO
The National Cancer Database from 2004 to 2015 was analyzed to identify cervical cancer outcomes associated with demographic and clinical characteristics measured by types of facility. Chi-Square tests were used to compare proportions and logistic regression to determine factors associated with cervical cancer outcomes. Women treated at Academic/Research Programs (ARPs) were younger at diagnosis, more likely black, less educated and more in Stage 2, lived further away from treatment facilities, had less comorbidities and better 5-year survival, and were more likely to be alive at 30 and 90 days after surgery compared to other programs. Women treated at Community Cancer Programs were more likely 75 and older at diagnosis, more likely to receive radiation treatment and more in Stage 4, more living in rural areas and less than 10 miles from the facility, and had more comorbidities, and lower 5-year survival compared to other programs. Women treated at Comprehensive Community Cancer Programs were more likely white and educated, had more private insurance, and underwent surgery. Women treated at Integrated Network Cancer Programs were more likely to live in urban, south region, and in Stage 1B2, had more surgery and one comorbidity, and died fewer than 30 days after surgery. The type of facility and treatment had varied effects on mortality and 5-year survival. Considering the different cervical cancer outcomes from different health care facilities, further research is needed to identify what factors influence women to choose a health care facility for their treatment and how this choice can affect different health outcomes.
RESUMO
There is a need to investigate the impact of social media use on patient compliance with important health screenings due to the inconsistency of research findings on the effect of using social media on cervical cancer screenings. This study assessed associations between social media use and adherence in women at risk for breast and cervical cancer to mammograms and Pap smear screenings. A total of 6695 respondents from the Health Information National Trends Survey (HINTS) 5 Cycle 1 and 2 datasets were used for data analysis. Chi-square tests were used to explore social network activities and cancer screening compliance, and multivariate logistic regressions were used to identify factors associated with cancer screening compliance. Among respondents, 68% of women and 84% of women complied with mammograms and Pap smears, respectively. Women who used the Internet during last 12 months to visit a social networking site, participate in a forum support group for medical issue, or watch a health-related video on YouTube complied with Pap smears more significantly than women who did not use the Internet (p <.05, p <.0001, and p <.001, respectively). Variables associated with mammogram and Pap smear screening compliance were age, health insurance, regular provider, marital status, and internet use. There was no significant association between social network activities and compliance with mammogram screenings. It is critical to use the same and up-to-date guidelines when reporting cancer screening rates to effectively promote adherence to cancer prevention programs and make valid and reliable comparisons across studies.
RESUMO
The aim of this study was to investigate the association between geographic regions and ovarian cancer disparities in the United States. Data from the Surveillance, Epidemiology, and End Results (SEER) Program was used to identify women diagnosed with ovarian cancer. 18 registries were divided into two groups: South region and US14 region. Chi-Square tests were used to compare proportions, the logistic regression model to evaluate the association between 5-year survival and other variables, and the Cox proportional hazards model to estimate hazard ratios. The South region had a lower incidence rate than the US14 region (12.0 vs. 13.4 per 100,000), and a lower 5-year observed survival rate (37.5% vs. 39.8%). White women living in the US14 region had the best overall survival, compared to white women living in the South region, and black women living in both regions. Women in the South region were less likely to have insurance (6.6% vs. 2.7%, p<0.0001) and surgery (73.4% vs. 76.2%, p<0.0001). Women living in the South were 1.4 times more likely to die after five years of diagnosis than women living in the US14 region. The data confirmed regional disparities in ovarian cancer in the United States, showing women living in the South region were disadvantaged in ovarian cancer survival regardless of race, black or white. Future research focusing on the identification of contributing factors to regional disparity in ovarian cancer is necessary to develop practical approaches to improve health outcomes related to this lethal disease.