BACKGROUND: Depression has been associated with lower cancer screening rates in some studies. We examined whether a higher depressive symptom burden presented a barrier to subsequent mammography and Papanicolaou (Pap) smear testing. METHODS: Study of Women's Health Across the Nation (SWAN) is a cohort study of 3302 community-dwelling women. At baseline, participants were 42-52 years old, had no surgical removal of the uterus or both ovaries, no current use of hormones that affect the ovaries, and at least one menses in the previous 3 months. SWAN data spanned 4 years. Repeated measures logistic models determined odds of mammography and of Pap screening in the year following depressive symptom burden, as determined by Center for Epidemiological Studies Depression score (CES-D). The models controlled for age, race/ethnicity, health insurance, medical history and use, smoking, obesity, and socioeconomic status. RESULTS: At baseline, 75.6% (2493 of 3297) had a low depressive symptom burden (CES-D score < 16, referent), 9.5% (312 of 3297) had a moderate burden (CES-D 16-20), and 14.9% (492/3297) had a high burden (CES-D > or = 21). Women with a high depressive symptom burden had, in the subsequent year, significantly lower odds of mammography (OR 0.84, 95% CI 0.73-0.97) but not Pap smear (OR 0.88, 95% CI 0.76-1.03). There was not a significant dose-response relationship between depressive symptom burden and screening. CONCLUSIONS: The presence of a high depressive symptom burden is a modest independent risk factor for lack of subsequent mammography. Ensuring that depressed patients receive regular cancer screening services is important.
BACKGROUND:Depression has been associated with lower cancer screening rates in some studies. We examined whether a higher depressive symptom burden presented a barrier to subsequent mammography and Papanicolaou (Pap) smear testing. METHODS: Study of Women's Health Across the Nation (SWAN) is a cohort study of 3302 community-dwelling women. At baseline, participants were 42-52 years old, had no surgical removal of the uterus or both ovaries, no current use of hormones that affect the ovaries, and at least one menses in the previous 3 months. SWAN data spanned 4 years. Repeated measures logistic models determined odds of mammography and of Pap screening in the year following depressive symptom burden, as determined by Center for Epidemiological Studies Depression score (CES-D). The models controlled for age, race/ethnicity, health insurance, medical history and use, smoking, obesity, and socioeconomic status. RESULTS: At baseline, 75.6% (2493 of 3297) had a low depressive symptom burden (CES-D score < 16, referent), 9.5% (312 of 3297) had a moderate burden (CES-D 16-20), and 14.9% (492/3297) had a high burden (CES-D > or = 21). Women with a high depressive symptom burden had, in the subsequent year, significantly lower odds of mammography (OR 0.84, 95% CI 0.73-0.97) but not Pap smear (OR 0.88, 95% CI 0.76-1.03). There was not a significant dose-response relationship between depressive symptom burden and screening. CONCLUSIONS: The presence of a high depressive symptom burden is a modest independent risk factor for lack of subsequent mammography. Ensuring that depressedpatients receive regular cancer screening services is important.
Authors: Joseph L Riley; Elizabeth A Pomery; Virginia J Dodd; Keith E Muller; Yi Guo; Henrietta L Logan Journal: J Rural Health Date: 2013-02-22 Impact factor: 4.333
Authors: Chenshu Zhang; Judith S Brook; Carl G Leukefeld; Mario De La Rosa; David W Brook Journal: Subst Use Misuse Date: 2017-04-14 Impact factor: 2.164
Authors: Julie C Weitlauf; Surai Jones; Xiangyan Xu; John W Finney; Rudolf H Moos; George F Sawaya; Susan M Frayne Journal: Womens Health Issues Date: 2013 May-Jun