Screening Rates Research Articles

Utilizing Quality Improvement Methodology to Address Disparities in Colorectal Cancer Screening Between Faculty and Resident Physicians.

Health system data from a large academic medical center revealed a 14% lower rate of colorectal cancer (CRC) screening in resident patient panels compared to faculty patient panels. This resident-led quality improvement (QI) work identified causes for disparities in CRC screening and implemented an innovative panel management intervention to reduce CRC screening disparities. Analysis was conducted across two academic primary care clinics at a single institution. Residents engaged key stakeholders in the CRC screening process to identify causes for disparities and potential solutions in the CRC screening process. A novel interprofessional panel management protocol was implemented to guide residents on how to perform population health strategies to increase CRC screening and to streamline the navigation process. The effectiveness of each intervention in improving CRC screening was analyzed. After four months of protocol implementation, CRC screening for resident patient panels improved from 62 to 68% based on analysis done on a run chart. The difference in CRC screening between faculty and resident patient panels decreased from 14 to 10%, reducing the disparity by 29%. This interprofessional panel management protocol significantly increased the CRC screening rates among patients receiving primary care from resident physicians. This further highlights the importance of multipronged interventions to improve disparities in CRC screening and to improve overall screening rates.

Leveraging Patient Advocacy and Faith-Based Partnerships to Educate, Activate, and Prepare Black Communities to be Screened for Lung Cancer.

Lung cancer is the second most common and the deadliest cancer for men and women in the U.S. Historical and current-day injustices, implicit and explicit bias, stigma, social determinants, and disparities contribute to inequitable lung cancer-related health outcomes for Black and African Americans comparatively. Despite being a preventive health recommendation for over a decade, the percentage of eligible individuals screened remains low. Burgeoning lung cancer screening programs have established capacity and opened access across the country, but screening rates remain exceedingly poor, especially among people of color. More intentional efforts must be made, and socially conscious and population-specific methods must be undertaken to ensure all eligible individuals realize the benefits of screening. Partnerships between lung cancer patient advocacy and faith-based organizations are a natural leverage point to educate, prepare, and empower Black health ministries to disseminate lung cancer-related health information to their faith communities. This How I Do It shares an approach to community outreach and engagement in Black churches in the South, informed by established principles and best practices and the perspectives and skills only lived experiences can offer.

Post-Stroke Osteoporosis Screening: A Scoping Review.

There are no specific screening recommendations for post-stroke osteoporosis despite evidence that people post-stroke are at heightened risk of fragility fractures. Our objective was to explore the extent of evidence and map the current literature available for osteoporosis screening in the post-stroke population. This scoping review searched for articles in Medline, Embase, and CINAHL databases published in English before May 2024, involving osteoporosis screening for adults after stroke. Title and abstract screening as well as full text review and data extraction was performed by two reviewers. Analysis of the studies is descriptive and narrative. Eight articles met inclusion criteria: five published articles and three peer-reviewed conference abstracts. Three study designs were utilized: four cross-sectional studies, three cohort studies, and one survey. Four studies investigated post-stroke osteoporosis screening rates, two looked at screening pathways for post-stroke osteoporosis, and two assessed novel osteoporosis screening tools. No post-stroke osteoporosis screening guidelines were found. Across all included studies, reported screening rates for post-stroke osteoporosis were less than 10%. This scoping review emphasizes the need for osteoporosis screening guidelines and risk assessment tools specific to the post-stroke population.

Shoulder Arthroplasty Patients Are Underscreened for Osteoporosis.

Osteoporosis screening and subsequent treatment has been shown to be efficacious in decreasing the rates of fragility fractures and periprosthetic fractures (PPF). However, current screening and treatment rates are low. This study aims to determine (1) the prevalence of total shoulder arthroplasty (TSA) patients who meet criteria for osteoporosis screening, (2) the prevalence of those screened, and (3) the 5-year cumulative incidence of fragility fracture (FF) and periprosthetic fractures (PPF). The PearlDiver database was used to identify all patients older than 50 years who underwent TSA. Guidelines from the American Association of Clinical Endocrinologists were used to stratify patients into "high risk" and "low risk" of osteoporosis cohorts using International Classification of Disease codes for various risk factors. The prevalence of osteoporosis screening using dual-energy x-ray absorptiometry (DXA) scan was analyzed, and the 5-year cumulative incidence of FF and PPF was calculated between the "low-risk" and "high-risk" groups using Kaplan-Meier analysis. In total, 66,140 (65.5%) who underwent TSA were considered "high risk" for osteoporosis. Of the "high-risk" patients, 11.7% patients received routine osteoporosis screening preoperatively. Within 5 years, "high-risk" TSA patients had markedly higher cumulative incidence for PPF (HR: 1.4; 95% CI: 1.0-1.9; P = 0.037) and FF (HR: 2.42; 95% CI: 2.1-2.8; P < 0.001) when compared with those at "low risk". There is a high prevalence of osteoporosis among patients undergoing TSA but a low rate of routine osteoporosis screening in this cohort. Patients with osteoporosis who are categorized as "high risk" have an increased rate of fragility fractures and PPF. Therefore, there is an opportunity to increase appropriate osteoporosis screening and management in this cohort, which may affect future risk of FF and periprosthetic fracture. III.

Optimal ordering for Product-as-a-Service models with circular economy practices

The Product-as-a-Service (PaaS) model offers the opportunity to implement circular actions such as repairing, reusing, collecting end-of-life products, and recycling. However, adopting circular practices causes more complexities in managing the inventory flow due to repetitive product subscriptions. Accordingly, this paper aims to optimise a PaaS model's order quantity and profit, considering circular economy practices and various quality levels for subscription products. In the proposed model, the subscription firm defines a quality check and repair procedure at the end of each quality period before sending the product to another subscriber. Moreover, the firm recycles end-of-life products and sells the recycled material to the supplier. This study aims to compare a closed-loop PaaS model with the traditional economic order quantity model in terms of operational costs, revenue, and inventory flow. The results show that factors such as the difference between the demand rates of the consecutive periods, the relationship between the recycling capacity and the final collection rate, and the difference between the screening and demand rates have essential roles in alleviating the extra inventory costs related to circular economy actions like reusing, repairing, and recycling.

A pilot randomized clinical trial of a smartphone-based application to support at-home PSA screening and culturally tailored prostate cancer education for African American men: A study protocol

BackgroundProstate cancer is the most diagnosed cancer in Black/African American men (AA) and the second‑leading cause of cancer-related deaths. A prostate-specific antigen (PSA) blood test is an early detection screening tool for prostate cancer, but uptake of PSA screening remains low among AA men. Greater PSA screening rates among AA men, coupled with earlier treatment, may reduce disparities in prostate cancer outcomes, including mortality. The current pilot study will test the first-of-its-kind mobile health (mHealth) app to improve prostate cancer knowledge and increase PSA screening uptake among AA men using home-based screening methods. MethodsAA men aged 55 to 69 and are not up to date with PSA screening will be randomly assigned 1:1 to receive a prostate cancer screening app: Prevention Taskforce App (Taskforce App; control condition) or the Prostate Cancer Genius App (Genius App; intervention condition), which was developed specifically for AA men. ResultsWe will evaluate the preliminary efficacy of the apps via post-intervention group differences on the validated 18-item Prostate Cancer Knowledge Scale (primary outcome). We will also explore post-intervention group differences in perceived engagement, accessibility, and acceptability between the apps. Finally, we will derive preliminary estimates of PSA screening rates between study conditions and identify mechanisms of screening adherence. DiscussionmHealth apps offer promise to improve prostate cancer knowledge and screening rates among AA men. Demonstrating the preliminary efficacy of the Genius App will support future fully-powered mHealth interventions to address health disparities.

Individual and Catchment Area Factors Associated With Breast and Cervical Cancer Screening Within the Military Health System.

Breast and cervical cancer screening is critical to identifying cases at earlier stages in order to begin treatment earlier and improve survival. Screening rates have been shown to vary within the Military Health System (MHS). The goal is to estimate drivers of variation in screening rates within the MHS. We used 2007-2019 MHS Data Repository Data to examine individual-level and catchment area-level factors associated with 1- and 2-year breast and cervical cancer screening rates. Specifically, we estimated univariate and multivariate association between 1- and 2-year probability of breast and cervical cancer screening rates and age group, marital status, rank, service branch, beneficiary type (service member vs. dependent), race/ethnicity of service members, catchment area fraction of overall care through purchased care and average per capita spending. The project was approved by both the Penn State Institutional Review Board (IRB) and the Defense Health Agency's electronic IRB. Overall, we observed a 45.6% 1 year and a 65.7% 2-year mammography screening rate and a 30.5% 1 year and a 51.9% 2-year Pap testing rate. For breast cancer screening, we found higher screening rates for older (ages 50-64 years), married, service members, more senior ranked women or those married to more senior ranked members, and non-Hispanic Black women in both unadjusted and multivariate analyses. Conversely, we found higher rates of cervical cancer screening for younger, unmarried, more junior ranked women as well as for non-Hispanic Black women. We also found higher rates for both breast and cervical cancer screening in catchment areas with a greater fraction of care delivered through the private sector. Our finding of higher screening in catchment areas with higher rates of purchased care warrants additional study to understand what factors may drive this result. The differential findings of the association between individual characteristics and breast and cervical cancer screening suggest important differences in these 2 types of screening with potentially different policies required to encourage and enhance breast vs. cervical cancer screening. Finally, our results showing higher screening among non-Hispanic Black women suggests important features of the MHS, such as universal, low-cost sharing coverage may help to reduce racial and ethnic disparities in breast and cervical cancer screening.

Estimating the Impact of Asthma and COPD on Lung Cancer Screening in the USA.

Examine the association of asthma, COPD, and Asthma-COPD overlap (ACO) on rates of lung cancer screening. 2022 Behavior and Risk Factors Surveillance Survey was used for cross-sectional analysis of self-reported lung cancer screening prevalence in those with COPD, asthma, and ACO, with stratification by smoking status. Multivariate logistic regression was performed to assess the relationship between asthma, COPD, ACO and lung cancer screening status. 17.9% of eligible adults were up-to-date on lung cancer screening. Those with COPD and ACO had higher rates of ever undergoing lung cancer screening (50.8% and 47.5%) than those with asthma (26.4%) or neither condition (23%). Adults with COPD (adjusted odds ratios (aOR): 2.86, 95% CI 2.49-3.28) and ACO (aOR: 2.85, 95% CI 2.49-3.28) had increased odds of ever having lung cancer screening compared with those without either condition. Stratification by smoking status shows that individuals who formerly smoked had slightly higher odds of ever undergoing screening than individuals currently smoking. Lung cancer screening rates have increased; however, it remains low. Adults with COPD and ACO are more likely to undergo lung cancer screening.

Glaucoma Screening and Referral Risk Factors in a High-Risk Population: Follow-up Study of the Manhattan Vision Screening Study (NYC-SIGHT)

Précis: Community-based eye health screenings that incorporated fundus photography and optometric exams in a high-risk NYC population effectively identified a higher than average number of participants that required an in-office glaucoma evaluation. Purpose: To report glaucoma screening rates and risk factors associated with referral for in-office glaucoma evaluation in the Manhattan Vision Screening and Follow-up Study (NYC-SIGHT). Methods: In this 5-year, cluster-randomized clinical trial, eligible individuals aged 40 and older were recruited from affordable housing developments and senior centers. Visual acuity with correction, intraocular pressure (IOP) measurements, and non-mydriatic fundus photography were conducted. Images were graded by a glaucoma specialist; those with an abnormal image were referred; those who failed the screening or had an unreadable fundus image were examined by the study optometrist. Chi-squared tests and stepwise multivariate logistic regression analyses were conducted to determine factors associated with glaucoma referral. Results: 708 participants were screened; 189 (26.6%) were referred for an in-office glaucoma evaluation due to an abnormal optic disc image (n=138) or abnormal optometric exam (n=51). Those referred had a mean age 68.5 ±11.7 years and were 60% female, 57% Black, and 37% Hispanic. Stepwise multivariate logistic regression showed participants with self-reported glaucoma (OR 8.096, 95% CI 4.706–13.928, P=0.000), IOP&gt;23 mmHg at the screening (OR 3.944, 95% CI 1.704–9.128, P=0.001), or wore prescription eyeglasses (OR 1.601, 95% CI 1.034–2.48, P=0.035) had higher odds of being referred for an in-office glaucoma evaluation. Of those referred, 106 (56%) attended, 36 participants (34%) were diagnosed with glaucoma and 38 participants (35.8%) as glaucoma suspects. Conclusion: Our findings support public health approaches that focus community-based eye health screenings on high-risk populations and prioritize underserved communities.

21. THE PREVALENCE OF CERVICAL CANCER SCREENING IN LOW AND MIDDLE-INCOME COUNTRIES: A LITERATURE REVIEW

Objectives: to determine the prevalence of cervical cancer screening in low and middle-income countries. Method: This literature review was conducted in accordance with the Cochrane Collaboration guidance for literature reviews and reported following the PRISMA statement. We conducted searches of electronic bibliographic databases including Pubmed, Embase, MEDLINE, Cochrane Systematic Reviews and Cochrane CENTRAL. Results: Our searches of the listed electronic databases generated 7,845 records. 23 studies met the inclusion criteria. The total sample size of female participants was 213,199. The definition of screening definitions were relatively similar among studies. Screening rates varied between studies (from 4% to 43%). The Pap smear test was the most common screening modality, next was Visual Inspection Acetic Acid (VIA). The overall prevalence of cervical cancer screening was still remarkably low 21.85% (95%CI: 20.56 - 22.32, I2 = 40%, p &lt;0.001). Conclusions: Despite global efforts to make screening approaches affordable and accessible, most women in low- and middle-income countries are not screened for cervical cancer.

Participation and relative cost of attendance by direct-mail compared to opt-in invitation strategy for HPV self-sampling targeting cervical screening non-attenders: A large-scale, randomized, pragmatic study.

Broad accessibility to cervical cancer screening and high participation rate is essential to reduce cervical cancer incidence. HPV self-sampling is an alternative to clinician collected cervical samples to increase accessibility and screening coverage. To inform on deployment strategies of HPV self-sampling, this large-scale, randomized, pragmatic study compared two invitation modalities; direct-mail and opt-in. The study included screening non-attenders from the Capital Region of Denmark randomly allocated (1:4) to a direct-mail or opt-in invitation for cervical screening by HPV self-sampling. Primary endpoint was screening participation; secondary endpoints were HPV prevalence and histology outcome. Adherence to follow-up and cost were also evaluated. After exclusion of hysterectomized/non-accessible women, 49,393 women were invited: 9639 by direct-mail, and 39,754 by the opt-in offer. A direct-mail invitation for HPV self-sampling yielded a significant higher participation than an opt-in invitation. HPV self-sample participation for direct-mail was 25.2% (n = 2426), opt-in participation was 20.2% (n = 8047), adjusted OR = 1.27, 95% CI 1.20-1.34. Participation increased with age (p < .0001) for both strategies and decreased with screening history of non-attendance (p < .0001). Interaction between invitation strategy and age/screening history was found; more women below 50 years of age participated by direct-mail compared to opt-in (p < .0001) and higher participation by direct-mail group was found in women with a short history of non-attendance (p < .0001). Participation of long-term unscreened women was similar between arms. The relative cost was ≈14 HPV self-sample kits distributed per additional participant by direct-mail over opt-in. HPV prevalence, adherence to follow-up, and detection of high-grade cervical intraepithelial neoplasia was similar between invitation strategies.

Prospective multicenter cohort study on breast cancer screening using an automated breast ultrasound with remote reading

Objective: To construct a remote screening network for breast cancer based on automated breast ultrasound (ABUS) and explore the value of ABUS with remote reading for breast cancer screening. Methods: We constructed a remote breast cancer screening network including one remote reading center and 48 image-acquisition centers. We recruited women to participate in breast cancer screening at one of these image-acquisition centers from January 2021 to January 2023. The technicians collected the whole breast images using the ABUS. The images were then sent to the reading center through the PVBUS System and interpreted independently by two radiologists using the Breast Imaging Reporting and Data System (BI-RADS). BI-RADS categories 1 and 2 indicate negative screening results, and women diagnosed with these categories were recommended for annual breast ultrasound screening. BI-RADS categories 3, 4, and 5 indicate positive results. Women with BI-RADS category 3 lesions were recommended for follow-up examinations every 6 months using ABUS or handheld ultrasound, while those with BI-RADS 4 and 5 lesions were suggested to undergo pathological examinations. Results: In our study, we enrolled 10 344 women who completed the ABUS screening and were followed up for more than 12 months. After remote reading, 6 164 women were diagnosed with BI-RADS category 1 and 2 626 woman were within BI-RADS category 2. In contrast, 1 404 women were within BI-RADS category 3, a total of 135 women were within BI-RADS category 4, and 15 women were within BI-RADS category 5. The positive screening rate of ABUS was 15.0% (1 554/10 344). The ABUS with remote reading had a detection rate of 3.7/1 000 (38/10 344) for breast cancer screening, with a sensitivity of 97.4% (38/39) and a specificity of 85.3% (8 789/10 305). Among the 38 breast cancer cases detected, 92.1% (35/38) were invasive carcinomas, and 63.2% (24/38) were stage 0 or Ⅰ breast cancers. Conclusions: Breast cancer screening based on ABUS with remote reading provided an efficient and feasible solution to the problem of unevenly distributed medical resources and medical staff levels in various regions of China, enabling the decentralization of high-quality medical resources and improving the accessibility of high-quality screening services. It has provided an alternative for breast cancer screening in China.

Longer travel times to acute hospitals are associated with lower likelihood of cancer screening receipt among rural-dwelling adults in the U.S. South.

Given rural hospitals' role in providing outpatient services, we examined the association between travel burdens and receipt of cancer screening among rural-dwelling adults in the U.S. South region. First, we estimated network travel times and distances to access the nearest and second nearest acute care hospital from each rural census tract in the U.S. South. After appending the Centers for Disease Control's PLACES dataset, we fitted generalized linear mixed models. Longer distances to the second nearest hospital are negatively associated with breast, colorectal, and cervical cancer screening receipt among eligible rural-dwelling adults. Rural-dwelling women in counties with 1 closure had reduced likelihood of breast cancer screening. Residence in a partial- or whole-county Health Professional Shortage Area (HPSA) was negatively associated with cancer screening receipt. Specialist (OB/GYN and gastroenterologist) supply was positively associated with receipt of cancer screening. Uninsurance was positively associated with cervical and breast cancer screening receipt. Medicaid expansion was associated with increased breast and cervical cancer screening. Rural residents in partial-county primary care HPSAs had the lowest rates of breast, cervical, and colorectal cancer screening, compared with whole-county HPSAs and non-shortage areas. These residents also faced the greatest distances to their nearest and second nearest hospital. This is notable because rural residents in the South face greater travel burdens for cancer care compared with residents in other regions. Finally, the positive association between uninsurance and breast and cervical cancer screening may reflect the CDC's National Breast and Cervical Cancer Early Detection Program's effectiveness.

Awareness of breast cancer and perceived barriers to breast screening methods: a community based cross-sectional study among women in Yemen

BackgroundIn Yemen, effective early detection and a comprehensive grasp of breast cancer symptoms and risk factors are vital in preventing its potentially deadly spread. However, challenges arise in combating breast cancer in Yemen due to the lack of patient registries, national strategies, and structured cancer treatment plans.ObjectiveThis research sought to evaluate the awareness levels of breast cancer and the perceived obstacles to breast cancer screening among adult Yemeni women.MethodsA community-based cross-sectional questionnaire study was conducted from September 2023 to January 2024 from two teaching and largest hospitals in the capital municipality, Sana’a, Yemen, where 533 women (≥ 18 years old) were conveniently selected in this study. Data were analyzed using SPSS software (version 23).. The Chi-square test was used to test associations. The factors associated with breast cancer awareness and barriers to breast cancer screening were analyzed separately, using multivariable logistic regression.ResultsThe study revealed that 88.6% of women were familiar with breast cancer, and 61.9% being knowledgeable about screening methods such as clinical breast examination (CBE) or mammography. The primary hindrance to screening (84.1%, n = 53) was the absence of symptoms or pain. The second most common reason for not undergoing screening was a lack of understanding about breast cancer and its treatment (61.9%, n = 39).ConclusionTo enhance breast cancer screening rates among Yemeni women consistently, targeted educational programs emphasizing the benefits of early detection and dispelling misconceptions and barriers related to the disease are essential.

Preventative care in student-run free clinics: a narrative review on feasibility, ethics, and recommendations

BackgroundStudent-run free clinics are critical for medical education and medical care of underserved populations. This paper explores the feasibility of establishing ethical preventative health services at student-run free clinics such as the Rochester Education and Advocacy for Community Health (REACH) Clinic, affiliated with the Mayo Clinic Alix School of Medicine. Our analysis discusses the challenges and ethical considerations of providing preventative healthcare in student-run clinics. This paper also provides recommendations for implementing preventative care at REACH and other student-run clinics.MethodsA literature search was conducted by an experienced librarian across four databases using keywords “student-run clinics” and “preventative healthcare.” Additionally, contributing authors identified and gathered data about community service organizations that provide preventative healthcare services to residents of Rochester, MN and surrounding areas.ResultsThe literature search yielded 50 articles, 20 of which were included in the narrative review. Vaccinations and cancer screenings were the two preventative care initiatives most commonly undertaken by student-run clinics. The benefits of student-run clinic initiatives for both patients and students were an emerging theme. Clinics often achieved high vaccination and screening rates, and integration of preventative care topics into medical curricula was valued by students. However, the limitations of student-run clinics also emerged as a theme, particularly limitations to resources and comprehensive follow-up. 15 community health organizations in/around Rochester, MN were identified; of these, five provide preventative healthcare services.ConclusionStudent-run clinics like REACH play a key role in delivering preventative care to underserved populations, bridging critical gaps in our healthcare system, and benefiting patients and students alike. However, the ethical principles of beneficence and non-maleficence should be considered when student-run clinics decide what services to offer. Preventative care has been successfully implemented at other student-run clinics but requires careful arrangement of adequate follow-up care, especially when it comes to cancer screening. Vaccinations are a low-cost, high-impact initiative that can be feasibly implemented at most student-run clinics.

Trends and Disparities in Lung Cancer Screening Rates in Southeast Michigan

Trends and Disparities in Lung Cancer Screening Rates in Southeast Michigan

Socioeconomic Inequalities in Participation in Colorectal Cancer Screening in Ontario, Canada: A decomposition analysis.

The relationship between socioeconomic status and colorectal cancer (CRC) screening in Canada remains poorly understood. This study aims to measure and explain the extent of socioeconomic inequalities in CRC screening participation in Ontario, Canada. This study assesses socioeconomic inequalities in CRC screening uptake in Ontario among adults aged 50 to 74 years (n=12,039) utilizing cross-sectional data from the 2017-2018 Canadian Community Health Survey (CCHS). The Wagstaff Index (WI) and the Erreygers Index (EI) were used to quantify and decompose income-related inequality in CRC screening participation. The results revealed an overall CRC screening rate of 71.7%, with higher rates among females (78.4%) compared to males (69.4%). The positive values of the WI (0.193; 95% confidence interval [CI]: 0.170 to 0.215) and the EI (0.156; 95% CI: 0.138 to 0.174) indicated a pro-rich inequality in CRC screening participation in Ontario (i.e., screening is more concentrated among wealthier individuals). The decomposition analysis identified income (71.61%), education (8.61%), and language barriers with healthcare providers (5.76%) as the primary factors contributing to the observed income-related inequality in CRC screening participation. Income is the primary driver of socioeconomic inequality, requiring targeted strategies to boost screening rates among low-income residents. Addressing education and language barriers through awareness initiatives and language support can reduce socioeconomic inequalities in cancer screening uptake in Ontario. Our study reveals significant socioeconomic inequality in colorectal cancer screening in Ontario, driven by income, education, and language barriers, underscoring the need for targeted interventions to promote equitable access.

“It’s a Low-key Thing of Eugenics”: Barriers to Cervical Cancer Screening and Disability Reproductive Justice for People with Disabilities During the COVID-19 Pandemic

Breast and cervical cancer screening is essential to the sexual and reproductive health of women and transgender people, resulting in reduced cancer incidence, improved outcomes, and lower mortality risk. However, previous studies have found lower rates of cancer screening among people with disabilities compared to those without disabilities, and increased rates of adverse associated outcomes, including later-stage cancer diagnosis and lower survival rates (Cuypers et al., 2022; Hughes et al., 2022). As such, this paper aims to mobilize the disability reproductive justice framework as a relevant lens for examining disparities in breast and cervical cancer screening that have a detrimental impact on people with disabilities. A mixed deductive and inductive approach was used to analyze 32 interviews with people who self-identified as having a physical, sensory, psychiatric, intellectual and/or developmental disability. This study was grounded in community- based research and was guided by peer researchers with lived experiences of disability and community partners. Our findings revealed that disparities in breast and cervical cancer screening for disabled women are present and ongoing. Themes that emerged included intersectional injustices, inaccessible spaces and systems, barriers to the right to reproductive health care, lack of autonomy and self-determination, and recommendations from people with disabilities. We conclude that this inaccessibility to cancer screening is a form of modern-day eugenics. The lack of accommodation for people with disabilities and recognition of them as sexual beings has contributed to these evident health inequities. While cancer screening services were delayed and disrupted for the entire population during COVID-19, there needs to be a consideration for the heightened vulnerability of this group, as well as the existing marginalization that creates barriers to access in the first place.

An umbrella review of socioeconomic status and cancer

Extensive evidence underscores the pivotal role of socioeconomic status (SES) in shaping cancer-related outcomes. However, synthesizing definitive and actionable insights from the expansive body of literature remains a significant challenge. To elucidate the associations between SES, cancer outcomes, and the overall cancer burden, we conducted a comprehensive burden estimation coupled with an umbrella review of relevant meta-analyses. Our findings reveal that robust or highly suggestive meta-analytic evidence supports only a limited number of these associations. Individuals with lower SES, compared to those with higher SES, are disproportionately disadvantaged by reduced access to immunotherapy, KRAS testing for colorectal cancer, targeted cancer therapies, and precision treatments for melanoma. Additionally, they exhibit lower rates of breast cancer screening and higher incidence rates of lung cancer. Furthermore, countries with a higher Human Development Index demonstrate a substantially greater burden related cancer incidence, with this disparity being more pronounced among men than women.

Risk factors for deep vein thrombosis and pulmonary embolism: a comparative study between acute hospital care and mental health inpatient settings for older people

Purpose This study aims to establish if risk factors for venous thromboembolism (VTE) in older hospitalized psychiatric patients differ from geriatric inpatients and if the current risk assessment tools being used are suitable. Design/methodology/approach The authors undertook a single centre retrospective review of 75 records for presence of predetermined risk factors. In total, 55 discharged patients with thrombotic events within geriatric settings were compared with 20 from mental health settings. Differences in risk factors were determined using t-test and Fisher’s exact test. Findings VTE patients in geriatric units were older and had reduced mobility. Psychiatric patients were more likely to be dehydrated and treated with psychotropics. Whilst rates of VTE screening were comparable in both settings, geriatric inpatients were more frequently prescribed thromboprophylaxis. Research limitations/implications Older psychiatric inpatients differ from those in medical/surgical settings in their profiles and risk factors for VTE. Approaches for VTE risk management also differed. Practical implications The study suggests the need for VTE screening tools and treatment protocols specific to older psychiatric settings. Social implications Targeted approaches may improve outcomes specific to each group. Originality/value To the best of the authors’ knowledge, this is the first attempt in comparing VTE risk factors across acute physical health care and mental health settings.