Early detection of colon cancer through screening is critical for improving long-term survival outcomes; however, only 54 % of the United States (U.S.) population that is eligible to have a colon cancer screening receive one. Previous research found that people who participate in physical activity (PA) are less likely to get screened due perception of having low risk. However, health organizations have lowered the age to initiate screening as more cases are being reported among younger U.S. residents. This study aimed to examine the association between colon cancer screening and self-reported health status for individuals meeting aerobic PA guidelines among individuals aged 45-54. We conducted a cross-sectional analysis of the 2023 Behavioral Risk Factor Surveillance System (BRFSS) data. We included all participants between the ages of 45 and 54 who responded to the questionnaire regarding colonoscopy and sigmoidoscopy examinations, and the supplementary module that features PA and sedentary behaviors. Among 1118 respondents, 503 (45.5 %) reported having undergone colon cancer screening via colonoscopy or sigmoidoscopy, whereas 615 (54.5 %) had not. Screening prevalence differed by insurance status (p=0.002), with higher rates among insured individuals (483/1034; 47.2 %) compared with uninsured individuals (11/65; 19.2 %). Screening also varied by race/ethnicity (p=0.022); rates were highest among White respondents (353/732; 49.9 %) and lowest among Asian respondents (16/60; 27.3 %). Screening did not significantly differ by education, sex, overweight/obesity status, transportation access, place of residence, or PA status (all p>0.05). Among respondents meeting aerobic PA guidelines (n=1048), 489 (47.0 %) reported screening. Neither cardiovascular disease (CVD) risk (adjusted odds ratio [AOR]=1.22, 95 % confidence interval [CI]: 0.87-1.70) nor self-reported good health (AOR=0.89, 95 % CI: 0.52-1.51) was associated with screening. Among those meeting both aerobic and strength training guidelines (n=541), 255 (48.8 %) reported screening. In this group, reporting good or better health was associated with lower odds of screening (AOR=0.37, 95 % CI: 0.15-0.90), while CVD risk remained nonsignificant (AOR=1.33, 95 % CI: 0.80-2.23). Our analysis found no link between colon cancer screening and self-reported health status for those meeting aerobic guidelines, but those who met both aerobic and strength training guidelines were less likely to get screened. Uninsured individuals and Asian Americans also had lower screening rates. These findings highlight the need for targeted public health campaigns to address screening disparities, particularly among active individuals and underserved communities.

Targeted Delirium Screening in At-risk Older Adults in the Emergency Department Improves Screening Rates

Sexual Orientation and Healthcare Access Factors Associated With Prostate-Specific Antigen Screening in the United States.

Our objective was to characterize individual-level screening patterns during a fourteen-year period spanning changing breast cancer screening guidelines and the COVID-19 pandemic. We conducted a retrospective analysis of mammography screening in women ages 40 and older using 2010-2023 data from the Vermont Health Care Uniform Reporting and Evaluation System, a statewide all-payer insurance claims database. Biennial mammography screening adherence declined between 2010-2023 by 20.7 and 6.7 percentage points for women aged 40-49 and 50-74 years, respectively. Younger birth cohorts consistently had lower screening rates at any given age compared to older cohorts. Cohorts under age 50 during the COVID-19 pandemic have had the largest post-pandemic recoveries, with post-pandemic screening rates exceeding pre-pandemic screening adherence. While mammography screening rates have been declining both between and within birth-cohorts, pandemic disruptions have narrowed the gaps resulting from these trends. Sustaining post-pandemic screening momentum may be critical to reversing long-term declines in adherence.

Problem-solving tools to encourage cancer screening among low health literacy populations in Western New York.

Despite the availability of multiple screening options, rates of colorectal cancer (CRC) screening remain suboptimal. With recent approval of a blood test for CRC screening, there is an urgent need to understand screening preferences of populations with low screening rates. Between October 2023 and June 2024, we conducted a survey on preferences for CRC screening modalities of stool test, blood test and colonoscopy among adults aged 45-75 at ambulatory primary care clinics across multiple community health centers and federally qualified healthcare centers across the city as well as in community settings regardless of prior screening. A total of 1,014 individuals completed the survey. Respondents were 12.8% Black/African American, 51.6% White, 23.4% Hispanic, 15.8% South Asian, and 4.2% Asian. Overall, the highest test preference was for screening colonoscopy (45.5%) followed by blood test (29.9%). Colonoscopy was preferred by individuals under age 70 (47.5%), while stool-based (20.2%) and blood-based (31.9%) tests were the most preferred among above 70 years (p = 0.0429. Whites (54.6%), Blacks (44.6%), and Hispanics (35.9%, p < 0.001) preferred colonoscopy, while Asians (37.2%) and South Asians (24.4%) favored blood tests. Factors associated with preference for a colonoscopy over other screening tests were younger age: respondents aged below 70years were more likely to prefer colonoscopy, compared to respondents aged above 70years (OR 1.72, 95% CI [1.20-2.47], p = 0.003); Nonsmoker compared to former/current smokers (OR 2.04, 95% CI [1.10-3.94], p = 0.028); Having undergone a prior colonoscopy (OR 6.83, 95% CI [4.52-10.6], p = < 0.001) or not having a prior stool test (OR 1.56, 95% CI [1.52-2.11], p = < 0.001). Factors associated with preference for a blood test over other screening tests were education level: respondents without any college experience were more likely to prefer blood test compared to respondents with college experience (OR 1.46, 95% CI 1.02-2.07, p = 0.038); Nonsmoker compared to former/current smokers (OR 1.73, 95% CI [1.00-2.99], p = 0.048); Never undergone a prior colonoscopy (OR 1.76, 95% CI [1.23-2.51], p = 0.002). Factors associated with preference for a stool test over other screening tests were: age over 80years compared to respondents aged below 80 (OR 3.34, 95% CI 1.67-6.55, p < 0.001); respondents with college experience were more likely to prefer blood test compared to respondents without college experience (OR 1.62, 95% CI 1.02-2.66, p = 0.048). Colonoscopy was the preferred test option, followed by blood test. Preferences for screening test varied by age, race, ethnicity, education and prior screening. The study underscores importance of patient preference in deciding which tests to offer based on the patient characteristics. Nonsmokers, those without any college education and those without prior screening preferred blood test for screening.

IntroductionWomen residing in rural areas or belonging to lower socioeconomic status (SES) strata experience disproportionately low rates of breast cancer screening, contributing to delayed diagnoses and poorer prognoses. In addition, their participation in clinical trials remains markedly limited, reducing opportunities to access preventive and screening interventions. Promoting research preparedness among women before disease onset may empower them to make informed decisions regarding their health and willingness to participate in clinical research with fewer emotional and logistical barriers.Methods and analysisThis project applies a community-based participatory research approach to develop and refine the WeCARE (Women’s Engagement for Cancer Awareness, Resources and Education) intervention for women aged 50–74 years who have either never undergone breast cancer screening or have not received screening in the past 5 years and who reside in rural areas or belong to low SES groups. The intervention consists of two components. Component 1 is a single-day, in-person community forum that includes (a) an educational seminar led by an oncologist to address breast cancer risk and screening guidelines, (b) survivor storytelling to enhance emotional engagement and cultural resonance and (c) facilitated navigation to breast cancer screening and future research participation. Component 2 involves structured post-forum follow-up through multiple touchpoints (phone calls and mailed boosters) to reinforce knowledge, address barriers and support screening completion and research enrolment. Quantitative data (eg, screening completion, satisfaction and follow-up engagement) will be summarised using descriptive statistics to assess feasibility and reach on 50 participants. Qualitative feedback from participants will undergo thematic analysis to identify barriers, facilitators and perceived cultural relevance. Integrated mixed-method interpretation will inform iterative refinement of the WeCARE intervention and guide design of subsequent larger trials.Ethics and disseminationApproved by the Mayo Clinic Institutional Review Board (IRB #25–008934). All participants will provide informed consent. Procedures ensure confidentiality, cultural sensitivity and participant safety. Data will be stored in REDCap and disseminated through publications, conferences, local town halls and community reports.

Health beliefs and lung cancer screening uptake among eligible Asian Americans in Philadelphia, Pennsylvania, United States

People with HIV have a higher incidence and mortality from screenable cancers than the general population. Among women, the 4 most common cancers are breast, colorectal, lung, and cervical cancers. This study examined breast, colorectal, lung, and cervical cancer screening rates among Black women with HIV and disparities that exist by immigration status. With a sample of 604 women, we examined cancer screening rates for breast, colorectal, lung, and cervical cancers and examined the rates by country of origin. Generalized linear mixed models were used to examine potential factors affecting these rates and the odds of screening by country of origin: US-born women (USBW) and non-US-born women (NUSBW). Cancer screening rates were low for all cancer categories for both groups. A screening rate of 48.7% was estimated for breast cancer (NUSBW-35.9% versus USBW-50.4%), 6.3% for lung cancer, 25.5% for colorectal cancer, and 72.8% for cervical cancer. NUSBW had lower screening rates for all 4 cancers compared with USBW. Possible predictors for cancer screenings were years of living with HIV [odds ratios (OR) 1.11; 95% CI: 1.07 to 1.14] and no viral suppression (OR 0.34; 95% CI: 0.15 to 0.76). Black women with HIV and much more immigrant subgroups may face additional barriers to accessing required cancer screening services in addition to being disproportionately affected by HIV. This emphasizes the urgent need for tailored, culturally relevant outreach and education to enhance cancer screening.

ABSTRACTIntroductionMammography screening rates in rural counties are lower compared to urban counties. We hypothesized that social associations may help ameliorate this rural–urban disparity. Thus, the purpose of this ecological study was to explore the relationships among rurality, social associations, and mammography screening.MethodsWe conducted a secondary, county‐level analysis of the 2022 County Health Rankings and Roadmaps data. We classified counties as rural or urban (rural–urban continuum code of 4+ vs. others), and we gathered the number of social organizations per 10,000 residents (i.e., “social associations”). We used a structural equation model to examine the direct and indirect effects of rurality and social associations on the mammography screening.ResultsOf 3143 U.S. counties, 1976 (62.9%) were rural. Rural counties have greater social associations compared to urban counties (β = 0.20, SE = 0.02, p < 0.0001). Counties with greater social associations had higher mammography screening rates (β = 0.34, SE = 0.02, p < 0.0001) while rural counties had lower screening rates (β = −0.24, SE = 0.02, p < 0.0001). There was a significant indirect effect of rurality through social associations on mammography screening (β = 0.07, SE = 0.01, p < 0.0001). Living in a rural area in the presence of increased social associations led to increased mammography screening.ConclusionsRural counties have more social associations but a lower rate of mammography screening. These analyzes revealed, however, that social associations buffer the negative relationship between rurality and mammography, leading to increased mammography screening rates. Clinical‐community partnerships leveraging social associations could minimize rural mammography screening disparities.

Cervical cancer remains a significant health concern for women, with the U.S. Preventive Services Task Force (USPSTF) recommending routine screenings for women ages 21-65 years. This study aims to evaluate cervical cancer screening rates among active-duty servicewomen (ADSW) in the U.S. military and assess the proportion meeting USPSTF guidelines during fiscal year (FY) 2017-2022. We conducted a retrospective cohort study of ADSW ages 21-60 years screened for cervical cancer in FY 2017, who were then followed through FY 2022. Excluded from the study were reservists, National Guard, and Coast Guard personnel. Screening compliance was determined based on the USPSTF age-based guidelines. We performed descriptive statistics and logistic regression to examine screening rates and compliance likelihood. We identified 212,081 ADSW during FY 2017 (62% were ages 21-29 years and 38% were ages 30-60 years). Overall, 76.5% of eligible ADSW received cervical cancer screenings. ADSW in the 30-60 years age group were less likely to undergo screening (odds ratio [OR]: 0.73, 95% confidence intervals [CI]: 0.71-0.74) compared with those aged 21-29 years. Similarly, senior officers showed lower screening rates compared with junior-enlisted personnel (OR: 0.78, 95% CI: 0.74-0.82). Compliance with USPSTF guidelines varied by age group, race, and military branch, with Black (OR: 0.88, 95% CI: 0.83-0.93), Asian American, and Pacific Islanders (OR: 0.85, 95% CI: 0.77-0.93), and those in the Air Force (OR: 0.64, 95% CI: 0.61-0.68) and Navy (OR: 0.84, 95% CI: 0.79-0.90) showing lower compliance rates compared with White and Army ADSW, respectively. Compliance rates were higher among ADSW opting for 5-year screening intervals (98%) compared with 3-year intervals (85%). Our results show that about three-fourths of the ADSW had a cervical cancer screening, and more than 90% of those screened were USPSTF compliant. Despite overall progress, disparities persist across military branches, rank, and racial groups, highlighting the need for targeted interventions to enhance screening rates among specific groups.

Gender disparities persist across cardiac and thoracic surgical care, influencing access, procedural selection, perioperative risk, and long-term outcomes. Despite major advances in operative technique and perioperative pathways, women continue to experience delayed diagnosis, lower procedural referral rates, and distinct complication profiles after high-risk procedures, including coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), surgical aortic valve replacement (SAVR), transcatheter aortic valve replacement (TAVR), and transcatheter edge-to-edge repair (TEER). These patient-level disparities parallel persistent inequities within the cardiothoracic surgery workforce, raising the possibility that structural workforce imbalances may influence clinical outcomes. This study aimed to synthesize contemporary evidence (2020-2025) characterizing sex- and gender-based disparities across cardiac and thoracic surgery, identify interconnected root causes, and outline strategies and research priorities for reducing inequities. A narrative review (2020-2025) combined structured database searches of trials and registries with synthesis of mechanistic and health-system literature to interpret heterogeneous evidence. Women undergoing cardiothoracic procedures often present at older age with greater frailty, smaller anatomical dimensions, and more atypical symptoms, increasing procedural complexity and perioperative risk. CABG and SAVR show higher early morbidity in women, while PCI disparities have narrowed but persist due to delayed recognition; TAVR demonstrates higher early complications yet better mid- and long-term survival. In thoracic surgery, women generally have lower perioperative mortality, but experience delayed diagnosis, lower screening rates, and reduced use of minimally invasive approaches. These outcome differences occur alongside persistent workforce inequities, including the underrepresentation of women in surgical practice, leadership, and academia. Gender disparities in cardiac and thoracic surgery are multifactorial and closely intertwined with systemic workforce inequities. Solutions require sex-aware risk assessment, equitable referral pathways, inclusive device development, mandated sex-stratified reporting, and targeted workforce reforms. Addressing both patient-level and structural contributors is essential to achieve durable gender equity in cardiothoracic surgical care.

Diabetes mellitus type 2 (T2D) is a growing burden in Switzerland, where general practitioners (GPs) face increasing workload. To evaluate the quality of T2D care, the Swiss Society of Endocrinology and Diabetology (SGED) developed the SGED score to help GPs overview aggregated patient parameters at the practice level. However, the practical use of the SGED score is hampered by paper-based workflows and fragmented documentation. Currently, no dashboard exists to specifically visualize the SGED score, which overviews aggregated population parameters such as HbA1c or blood pressure. To address this gap, this study examined: (1) what functional requirements healthcare professionals consider essential for such a potential SGED dashboard, and (2) how do healthcare professionals evaluate the usability and clinical relevance of an iteratively developed dashboard prototype. We employed an iterative, user-centered three-step approach involving 10 semi-structured interviews with 14 Swiss T2D healthcare professionals. Step 1 involved defining the project scope, identifying predefined functional requirements, and developing an initial SGED score dashboard prototype. Step 2 collected user-generated requirements and prioritized all requirements using the "Must Have", "Should Have", "Could Have", "Won't Have" (MoSCoW) method. In step 3, the high-fidelity Figma dashboard prototype was iteratively refined based on the requirements and interviewee feedback. Key functional requirements of the digital SGED score included reminder and alert functions for missing or overdue SGED-relevant assessments, color-coded critical values such as low nephropathy screening rates, demographic overviews, trend analyses of SGED indicators at practice level, benchmarking within practice networks, and exportable reports. Additional needs emerged for patient-level views, integrated checklists, inclusion of comorbidities, and personal or practice-specific goal-setting features. Iterative refinements based on user feedback improved clarity, usability, and visual appeal. Some participants highlighted the dashboard's intuitive design, clear and diverse visualizations, and benchmarking functionalities, describing it as both engaging and efficient. Others raised concerns about limited suitability for daily clinical workflows, potential integration challenges with existing systems, and the need for interactive, patient-centered features to support routine care. The proposed SGED score dashboard could enhance T2D care through features like population overviews, long-term visualizations, and anonymized benchmarking, meaning the ability to compare a practice's SGED performance with those of other practices. Successful clinical adoption will heavily depend on interoperability and seamless integration into existing workflows. The identified requirements provide a foundation for future digital T2D management systems.

A multiparameter model (OsteoSC-M3) for early detection and risk stratification of osteoporosis in women: a multicentre cohort study in China.

BACKGROUND: Breast cancer is the most diagnosed cancer among Asian American women, with rising incidence, persistently low screening rates in many subgroups, and limited progress in improving survival. Culturally tailored patient education prevention programs are needed to address these disparities. This paper describes the Breast Cancer Awareness and Risk Education for Asian Americans (Breast CARE) program, a patient educational program to reduce risk behaviors, improve breast cancer screening uptake, and increase awareness while empowering Asian American women to engage in informed health decisions. METHODS: Guided by community-based participatory research principles, we developed Breast CARE, a community-based, culturally tailored breast cancer prevention program. Breast CARE followed an iterative, multi-phase process including gaps identification and literature review, adaptation of an existing culturally validated breast cancer prevention program, research team deliberation, Community Advisory Board (CAB) co-development, and integration of CAB contributions. RESULTS: The Breast CARE curriculum consists of three main domains addressing: (1) Breast Cancer 101, which provides culturally specific breast cancer statistics and foundational knowledge, addresses myths, and contextualizes breast cancer risk; (2) Breast Cancer Screening, which emphasizes early detection, reviews screening modalities and guidelines, and incorporates skill-based activities; and (3) Risk Reduction Strategies, which centers on physical activity as primary prevention strategy through education, demonstration, and individualized goal setting. Teaching strategies were informed by multimodal instructional principles and incorporated didactic education, interactive discussion, visual aids, narrative testimonials, and experiential learning activities to support comprehension and behavior change. CONCLUSION: The Breast CARE curriculum development process offers a practical model for combining community-engaged approaches with evidence-based pedagogy in cancer prevention education.

Early detection of Alzheimer disease and related dementias (ADRD) may influence outcomes for both patients and their family members, yet the risks and benefits of screening for family members are not established. To evaluate the benefits and risks of ADRD screening for family members of older adults screened in primary care (PC). This multisite randomized clinical trial was conducted in 29 PC clinics from October 2018 to September 2023. Dyads of patients aged 65 years and older and a family member were randomized into 1 of 3 groups: screening only, screening plus referral for diagnostic follow-up, and no-screening control. Data were collected at baseline and at 6, 12, 18, and 24 months. Cognitive screening was conducted in-person, by telephone, or secure video using the Mini-Cog, the Memory Impairment Screen Telephone version (MIS-T), or the MIS-T with the clock drawing test. The primary outcome was family member health-related quality of life at 24 months measured using the Short Form Health Survey (SF-36) physical and mental component summary scores. Secondary outcomes included family member depressive and anxiety symptoms, caregiver preparedness, and caregiving self-efficacy, as well as patient health-related quality of life and depressive and anxiety symptoms. A total of 1808 dyads completed baseline assessments. Mean (SD) patient age was 73.7 (5.7) years and 959 (53%) were female. Among family members, 1171 (64.8%) were spouses, 1224 (67.7%) were female, and mean [SD] age was 64.2 [12.9] years. Overall, 62 patients (5.1%) screened positive for cognitive impairment. Among dyads assigned to screen plus, 10 (35.7%) did not pursue diagnostic follow-up. There were no significant differences between the combined screening groups and no-screening group in SF-36 physical (24-month predicted difference, -0.21; 95% CI, -1.26-0.85) or mental (24-month predicted difference, 0.58; 95% CI, -0.18-1.33) component scores. No differences were observed in patient secondary outcomes at 24 months. This randomized clinical trial found that ADRD screening in PC was not associated with improvement in family member health-related quality of life, caregiver preparedness, or caregiving self-efficacy. Screening was also not associated with increased family member depression or anxiety. Low rates of positive screening and high rates of refusal for follow-up diagnostic assessment may help explain these findings. ClinicalTrials.gov Identifier: NCT03300180.

Variations in transcranial doppler among pediatric patients with sickle cell disease in the Brazilian Northeast: a cross-sectional study.

Gastric cancer (GC) is often diagnosed at an advanced stage due to the absence of early symptoms and low screening rates, resulting in poor prognosis. The progression of GC is closely related to the immune response within the tumor microenvironment (TME). Tumor-associated macrophages (TAMs), particularly the M2 subtype, are the most prevalent inflammatory cells in the TME and play a crucial role in GC. Tumor cells also evade immune surveillance by upregulating CD274. OTUB2, a deubiquitinase, regulates tumor progression by deubiquitinating substrate proteins. However, the role of OTUB2 in TAMs polarization and immune evasion in GC remains unclear. Stable OTUB2 overexpression and knockdown cells were cocultured with M0 macrophages to study TAMs polarization. Flow cytometry was used to analyze M2 TAMs and CD274 expression on GC cells. Cytokine secretion was evaluated by ELISA. T cell killing assays were performed by co-culturing GC cells with CD8+ T cells. Co-immunoprecipitation and Western blotting assessed the ubiquitination levels of YAP, TAZ and CD274. In vivo studies were conducted to evaluate OTUB2’s effect on TAMs polarization, immune evasion and GC progression. Immunohistochemistry of GC tissues was performed to investigate the correlation between OTUB2 and TME components. OTUB2 overexpression activated YAP/TAZ to increase TGF-β1 and M2 TAMs polarization by inhibiting SMAD7. It also enhanced CD274 expression, promoting immune evasion. OTUB2 deubiquitinated YAP, TAZ, and CD274, preventing their degradation. In vivo, OTUB2 increased M2 TAMs polarization and CD274 expression, exacerbating GC progression. Immunohistochemistry confirmed a positive correlation between OTUB2, M2 TAMs infiltration and CD274 levels and a negative correlation with CD8+ T cell infiltration. Kaplan–Meier analysis showed reduced overall survival in GC patients with high OTUB2 expression. OTUB2 promotes M2 TAMs polarization and immune evasion in GC. Targeting OTUB2 offers a promising strategy to reshape the GC TME and improve the efficacy of immune checkpoint inhibitors.

Identification of health care access-related factors associated with lower rates of cancer screening may help inform targeted interventions to mitigate barriers and ameliorate screening disparities. To examine the multifaceted obstacles associated with screening for breast, cervical, colorectal, lung, and prostate cancer in a diverse population. This cohort study included longitudinal data from the National Institutes of Health's All of Us (AoU) Research Program (2017-2023). Nonincarcerated individuals aged 18 years or older residing in the US were eligible to participate by enrolling either online or through 1 of approximately 67 health care organizations. Identified participants within the AoU Research Program met US Preventive Services Task Force screening criteria for breast, colorectal, cervical, lung, or prostate cancer. Data were analyzed from October 2024 to January 2026. Participants self-reported whether 9 potential barriers delayed their medical care in the past year. Multivariable-adjusted odds ratios were estimated for the association between each barrier, the barrier burden, as well as for patterns of interrelated barriers identified using factor analysis and adherence to cancer screening recommendations. In total, 160 691 participants were eligible for cancer screening including 42 908 participants in the breast (median age at last follow-up, 60 [IQR, 52-67] years; 100% female), 45 791 in the cervical (median age at last follow-up, 46 [IQR, 35-56] years; 100% female), 55 986 in the colorectal (median age at last follow-up, 66 [IQR, 57-73] years; 63% female), 3358 in the lung (median age at last follow-up, 66 [IQR, 59-72] years; 53% female), and 12 648 in the prostate cancer (median age at last follow-up, 63 [IQR, 59-66] years; 100% male) screening cohorts. Out-of-pocket costs, nervousness about seeing clinicians, and inability to get time off work were the most cited barriers. Participants reporting 3 or more barriers to care had significantly lower screening rates compared with those who reported no barriers for all cancer types, ranging from 18% (odds ratio [OR], 0.82; 95% CI, 0.76-0.88) for colorectal cancer to 32% (OR, 0.68; 95% CI, 0.46-0.97) for lung cancer. Three latent factors were consistently identified across cancer sites reflecting cost concerns, logistical barriers (eg, transportation), and competing obligations (eg, time off work). In multivariable analyses, cost concerns were associated with odds of screening for breast cancer (OR, 0.73; 95% CI, 0.66-0.80), cervical cancer (OR, 0.80; 95% CI, 0.73-0.87), and colorectal cancer (OR, 0.85; 95% CI, 0.77-0.94) and logistical barriers for breast cancer (OR, 0.75; 95% CI, 0.63-0.89), cervical cancer (OR, 0.78; 95% CI, 0.65- 0.93), and colorectal cancer (OR, 0.78; 95% CI, 0.65-0.94). In this cohort study of participants eligible for cancer screening, barriers to access and barriers related to cost concerns and logistics were associated with lower screening rates. Policies and interventions must target multiple dimensions of access simultaneously to increase cancer screening.

Diabetes mellitus (DM), both type 1 (T1DM) and type 2 (T2DM), complicates about 1% of pregnancies in the US. Current research frequently focuses on the effects of DM on pregnancy outcomes, overlooking the opportunity to examine a woman's health prior to pregnancy despite the significance of pre-conception health on pregnancy outcomes. Recognizing the importance of a woman's overall health, and not just the period in which a woman is pregnant, we set out to explore whether women with DM received recommended preventive health services at the same rates as women without DM. PubMed, Web of Science Core Collection, and Cochrane Library of Systematic Reviews and Trials were searched using search terms related to four areas of preventive health services for women with T1DM or T2DM: contraceptive counseling, age-appropriate cancer screening, pre-conception counseling, and recommended sexually transmitted infection (STI) screening. Most studies confirmed that women with DM consistently received less contraception management or contraception counseling compared to women without DM. Women with DM also had lower rates of breast and cervical cancer screening. Studies of pre-conception counseling suggest low rates of counseling provided to women with DM. No studies comparing STI screening rates between women with and without DM could even be identified. We also identified a paucity of evidence-based interventions directed at expanding the provision of these preventive services to women with DM. Differences exist in the provision of recommended preventive health services between women with and without DM, and there are also research gaps regarding well-woman preventive care in women with DM. Open Science Framework- https://doi.org/10.17605/OSF.IO/3MV6Q.