Welch, C., Miller, C. W., & James, N. T. (2008). Journal of Obstetric, Gynecologic and Neonatal Nursing, 37, 51-57.
Although there have been substantial reductions in cancer-related deaths, disproportionately high mortality rates remain among certain age, racial or ethnic, geographic, and socioeconomic status groups. Specific goals, articulated in Healthy People 2010, include target reduction in overall cancer death rates. This study aimed to identify sociodemographic and health-related determinants of breast and cervical cancer screening behaviors, and evaluates the progress toward Healthy People 2010 cancer-related objectives by analyzing questionnaires from 24,757 women who were a part of the Behavioral Risk Factor Surveillance System in 11 states in the United States. They found that there were nine independently significant predictors: current healthcare coverage, nonsmoking, age 40 to 64 years, over 65 years of age, no activity limitations, black, non-Hispanic race, income of $35,000 or more, current exercise performance, and not at risk for high cholesterol. There seems to be a negative economy of scale with respect to age, because as age increases, screening declines and morbidity or mortality increases. Given this disparity, related Healthy People objectives 2010 goals, as of 2005, remain largely unrealized. It is critical that nurses not only understand the complex sequelae that result from a delayed diagnosis of breast and cervical cancer but also be able to recognize and plan interventions to capture those women who are at the highest risks of a delayed diagnosis.
Maaly Kamal Gumei