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A Canadian study shows that women with diabetes are significantly less likely to have mammograms, even after adjustment for socioeconomic status and other factors.
Researchers at Women’s College Hospital in Toronto, Canada, set out to study the extent to which differences in socioeconomic status explain lower mammography rates in women with diabetes and found that diabetes is an independent barrier to breast cancer screening. Notably, they found that women with diabetes are 14% less likely to receive mammograms, and that difference is not explained by socio-economic status.
Their population-based retrospective cohort study was performed in Ontario, Canada, on a group of women aged 50 to 69 years with diabetes between 1999 and 2010. Outcomes were compared with those in women without diabetes during the same period, adjusting for socioeconomic status based on neighborhood income and other demographic and clinical variables.
Of 504,288 women studied (188,759 with diabetes and 315,529 without diabetes), 63.8% had a screening mammogram. Women with diabetes were significantly less likely to have a mammogram after adjustment for socioeconomic status and other factors (OR 0.79, 95% CI 0.78–0.80). Diabetes was associated with lower mammogram use even in women from the highest socioeconomic status quintile (OR 0.79, 95% CI 0.75–0.83).
The researchers concluded, “interventions that target patient, provider, and health system factors are needed to improve cancer screening in this population.”
Dr. Lorraine Lipscombe, a staff physician at Women’s College Hospital, noted in a press release that “managing the demands of a chronic condition such as diabetes is challenging for many women, leaving other preventative actions, like screening for cancer, to fall by the wayside.”
Chan W, Yun L, Austin PC, et al. Impact of socio-economic status on breast cancer screening in women with diabetes: a population-based study. Diabet Med. 2014 Apr 11. DOI: 10.1111/dme.12422 [Epub ahead of print].