PubMed Health⌕ Search

Biomedical subjects

Steven S Coughlin

Publications and source records attributed to Steven S Coughlin.

33 records · Page 2Linked to original sources
PubMed2003

Nonadherence to breast and cervical cancer screening: what are the linkages to chronic disease risk?

BACKGROUND: Several preventive practices that reduce chronic disease risk have been associated with breast and cervical cancer screening, including maintenance of normal weight and avoidance of cigarette smoking. A history of certain chronic illnesses such as diabetes and cardiovascular disease has also been related to cancer screening. Nevertheless, studies that have attempted to identify women who are less likely to have had a recent breast or cervical cancer screening test have infrequently examined the associations of breast and cervical cancer screening with multiple health factors that influence chronic disease risk. METHODS: To clarify relationships between cancer screening and health behaviors and other factors that influence chronic disease risk, we examined the self-reported breast and cervical cancer screening practices of women in the United States by using data from the 1999 Behavioral Risk Factor Surveillance System. The women were described according to their recent use of mammography and the Papanicolaou test, physician visits within the past year, health insurance coverage, and preventive practices that reduce chronic disease risk. RESULTS: Overall, 74.5% (95% CI, 73.9%-75.1%) of the women in this sample aged 40 years or older (n = 56,528) had received a mammogram within the past 2 years. The percentage of women who had been screened for breast cancer, however, varied widely by factors associated with reducing the risk of chronic disease (e.g., cholesterol check in the past 2 years, blood pressure check in the past 2 years, normal weight, avoidance of cigarette smoking) and having access to health care (e.g., health insurance coverage, recent physician visit). Similarly, 84.4% (95% CI, 83.9%-84.9%) of all women aged 18 years or older who had not undergone a hysterectomy (n = 69,113) had received a Papanicolaou test in the past 3 years, and factors associated with reduced chronic disease risk and health care access were related to having had a recent Papanicolaou test. CONCLUSION: The results of this study suggest that underscreened women who are at risk for breast and cervical cancer are likely to benefit from programs that identify and address coexisting prevention needs. The identification of coexisting prevention needs might assist in developing interventions that address multiple risks for chronic disease among women and might subsequently help improve the efficiency and effectiveness of prevention programs.

Adolescent↗
PubMed2002

Breast, cervical, and colorectal carcinoma screening in a demographically defined region of the southern U.S.

BACKGROUND: The "Southern Black Belt," a term used for > 100 years to describe a subregion of the southern U.S., includes counties with high concentrations of African Americans and high levels of poverty and unemployment, and relatively high rates of preventable cancers. METHODS: The authors analyzed data from a state-based telephone survey of adults age >or= 18 years to compare the cancer screening patterns of African-American and white men and women in nonmetropolitan counties of this region, and to compare those rates with those of persons in other southern counties and elsewhere in the U.S. The primary study groups were comprised of 2165-5888 women and 1198 men in this region interviewed through the Behavioral Risk Factor Surveillance System. The respondents lived in predominantly rural counties in 11 southern states with sizeable African-American populations (>or= 24.5% of county residents). The main outcome measures were recent use of the Papanicolau (Pap) test, mammography, test for fecal occult blood in the stool (FOBT), and flexible sigmoidoscopy or colonoscopy. RESULTS: Between 1998-2000, 66.3% (95% confidence interval [95% CI] +/- 2.7%) of 1817 African-American women in the region age >or= 40 years had received a mammogram within the past 2 years, compared with 69.3% (95% CI +/- 1.8%) of 3922 white women (P = 0.066). The proportion of African-American and white women who had received a Pap test within the past 3 years was similar (85.7% [95% CI +/- 1.9%] vs. 83.4% [95% CI +/- 1.5%]; P = 0.068]. In 1997 and 1999, 29.3% of African-American women in these counties reported ever receiving an FOBT, compared with 36.9% in non-Black Belt counties and 42.5% in the remainder of the U.S. Among white women, 37.7% in Black Belt counties, 44.0% in non-Black Belt counties, and 45.3% in the remainder of the U.S. ever received an FOBT. Overall, similar patterns were noted among both men and women with regard to ever-use of FOBT, flexible sigmoidoscopy, or colonoscopy. Screening rates appeared to vary less by race than by region. CONCLUSIONS: The results of the current study underscore the need for continued efforts to ensure that adults in the nonmetropolitan South receive educational messages, outreach, and provider recommendations concerning the importance of routine cancer screening.

Black or African American↗
PubMed2002

Breast and cervical carcinoma screening practices among women in rural and nonrural areas of the United States, 1998-1999.

BACKGROUND: Prior studies have suggested that women living in rural areas may be less likely than women living in urban areas to have had a recent mammogram and Papanicolau (Pap) test and that rural women may face substantial barriers to receiving preventive health care services. METHODS: The authors examined both breast and cervical carcinoma screening practices of women living in rural and nonrural areas of the United States from 1998 through 1999 using data from the Behavioral Risk Factor Surveillance System. The authors limited their analyses of screening mammography and clinical breast examination to women aged 40 years or older (n = 108,326). In addition, they limited their analyses of Pap testing to women aged 18 years or older who did not have a history of hysterectomy (n = 131,813). They divided the geographic areas of residence into rural areas and small towns, suburban areas and smaller metropolitan areas, and larger metropolitan areas. RESULTS: Approximately 66.7% (95% confidence interval [CI] = 65.8% to 67.6%) of women aged 40 years or older who resided in rural areas had received a mammogram in the past 2 years, compared with 75.4% of women living in larger metropolitan areas (95% CI = 74.9% to 75.9%). About 73.0% (95% CI = 72.2% to 73.9%) of women aged 40 years or older who resided in rural areas had received a clinical breast examination in the past 2 years, compared with 78.2% of women living in larger metropolitan areas (95% CI = 77.8% to 78.7%). About 81.3% (95% CI = 80.6% to 82.0%) of 131,813 rural women aged 18 years or older who had not undergone a hysterectomy had received a Pap test in the past 3 years, compared with 84.5% of women living in larger metropolitan areas (95% CI = 84.1% to 84.9%). The differences in screening across rural and nonrural areas persisted in multivariate analysis (P < 0.001). CONCLUSIONS: These results underscore the need for continued efforts to provide breast and cervical carcinoma screening to women living in rural areas of the United States.

Adolescent↗
PubMed2002

Breast and cervical cancer screening practices among Hispanic women in the United States and Puerto Rico, 1998-1999.

BACKGROUND: Results from recent studies suggest that Hispanic women in the United States may underuse cancer screening tests and face important barriers to screening. METHODS: We examined the breast and cervical cancer screening practices of Hispanic women in 50 states, the District of Columbia, and Puerto Rico from 1998 through 1999 by using data from the Behavioral Risk Factor Surveillance System. RESULTS: About 68.2% (95% confidence interval [CI] = 66.3 to 70.1%) of 7,253 women in this sample aged 40 years or older had received a mammogram in the past 2 years. About 81.4% (95% CI = 80.3 to 82.5%) of 12,350 women aged 18 years or older who had not undergone a hysterectomy had received a Papanicolaou test in the past 3 years. Women with lower incomes and those with less education were less likely to be screened. Women who had seen a physician in the past year and those with health insurance coverage were much more likely to have been screened. For example, among those Hispanic women aged 40 years or older who had any health insurance coverage (n = 6,063), 72.7% (95% CI 70.7-74.6%) had had a mammogram in the past 2 years compared with only 54.8% (95% CI 48.7-61.0%) of women without health insurance coverage (n = 1,184). CONCLUSIONS: These results underscore the need for continued efforts to ensure that Hispanic women who are medically underserved have access to cancer screening services.

Adolescent↗
PubMed2002

Breast and cervical cancer screening among migrant and seasonal farmworkers: a review.

Women constitute about one in five hired farmworkers in the US. Their health may be affected by exposure to unhealthy living and working conditions, by increased exposure to health hazards, by poverty, and by poor utilization of health care and preventive services. About 69% of migrant and seasonal farmworkers were born outside the US, mostly in Mexico and central America, and many speak little English. The health concerns of women who are migrant and seasonal farmworkers include breast and cervical cancer, which can be prevented or controlled through routine screening, but cancer incidence and mortality data for migrant workers are sparse. We reviewed published studies that examined breast and cervical cancer screening in this population. These studies include cross-sectional surveys, health needs assessments, and randomized and non-randomized intervention trials. A review of published studies of cancer screening among women who are migrant and seasonal farmworkers indicates that underutilization of mammograms and Papanicolau (Pap) tests among this population may stem from their limited awareness of the importance of cancer screening and cultural beliefs. Other barriers include cost, lack of health insurance, lack of transportation and child care difficulties. The extent to which results obtained in selected localities are generalizable to other settings is uncertain, but results to date provide important information about possible approaches for increasing cancer screening among women migrant farmworkers.

Agriculture↗
PubMed2002

An empirical study of the use of living versus deceased study subjects: associations with liver cancer in the selected cancers study.

PURPOSE: In case-control studies, the issue of whether living or deceased controls should be used for deceased cases has been controversial. METHODS: Using data from a study of cancer among men that selected both live (n = 1910) and deceased controls (n = 596) for cases of liver cancer (109 deceased, 59 living), we examined the effects of using information from proxy respondents (cases and controls) and from live cases and controls on associations between liver cancer and known risk factors. Cases diagnosed between 1984 and 1988 were selected from eight population-based cancer registries. Live controls were recruited by random digit dialing, deceased controls from death certificate files. Controls were matched to cases on geographic area, year-of-birth, and race. RESULTS: Adjusted odds ratios (OR) calculated for deceased cases and controls, when compared to odds ratios for live cases and controls, were attenuated towards the null value for history of hepatitis (4.7 vs. 14.9), blood transfusions (1.1 vs. 7.8), and cirrhosis (9.3 vs. 51.1). When all cases and living controls were used, odds ratios did not differ substantially from those for living cases and controls except for cirrhosis (OR = 154.2). For smoking, the odds ratios were similar in all analyses. Adjustment for type of interview (self, proxy) did not eliminate differences between results for living and deceased subjects; significant interactions were found between type of interview and hepatitis, cirrhosis, and blood transfusions. CONCLUSIONS: Selection of live controls for deceased cases is recommended to decrease misclassification in measures of exposure.

Adult↗
PubMed2002

A review of genetic polymorphisms and prostate cancer risk.

In this study, we review a variety of genetic polymorphisms that may have an etiologic role in prostate cancer. We include associations identified in molecular epidemiology studies and the consistency of findings reported to date. Suggestions for further research are also offered. For the purposes of this review, we identified relevant articles through a MEDLINE search for the period of January 1987 through March 2001. The searches were limited to articles published in English. Medical subject headings were used to scan titles, abstracts, and subject headings in the databases using the keywords "prostate neoplasms," "genetics," and "polymorphisms."

Genetic Linkage↗
PubMed2002

Breast and cervical cancer screening among Appalachian women.

Medical service shortages, rural residence, and socioeconomic and cultural factors may pose barriers to breast and cervical cancer screening among women living in the Appalachian region of the United States. This study determined the rates of breast and cervical cancer screening in Appalachia and identified factors associated with screening. Data from the Behavioral Risk Factor Surveillance System, 1996 to 1998, for the Appalachian region were analyzed to determine the percentage of women > or =40 years of age who had had a mammogram or clinical breast examination (CBE) within the past 2 years and the percentage of women > or =18 years of age who had had a Pap test within the past 3 years. Screening rates were compared with those for women living elsewhere in the United States. Screening rates were further assessed according to demographic, socioeconomic, and physical and behavioral health factors. Multiple logistic regression analyses were conducted to examine the predictors of screening. Overall, 14,520 Appalachian women > or =18 years of age reported on Pap tests; 13,223 women > or =40 years of age reported on mammogram screening, and 13,124 women reported on CBE screening. Among Appalachian women, 68.8% [95% confidence interval (CI), 67.8-69.9] had a mammogram, 75.1% (95% CI, 74.1-76.1) had a CBE in the past 2 years, and 82.4% (95% CI, 81.5-83.3) had a Pap test in the past 3 years. These rates were at most approximately 3% lower than those for women living elsewhere in the United States, but these differences were statistically significant. Older women and women with less education or income were screened less commonly. Women who had visited a doctor within the past year were more likely to have been screened. Additional interventions are needed to increase breast and cervical cancer screening rates for Appalachian women to meet the goals of Healthy People 2010, targeting in particular population groups found to have lower screening rates.

Adult↗
PubMed2002

Cervical cancer screening in the workplace. Research review and evaluation.

1. The workplace has become an increasingly important site for disseminating health information and implementing health promotion activities, including cancer screening. 2. Few studies have focused on the benefits and effectiveness of worksite programs for Pap tests. 3. It is unclear from studies conducted to date if cervical cancer screening in the workplace is more likely to prevent cervical cancer than alternative approaches outside the workplace. 4. The occupational and environmental health nurse has an important role to play in worksite cancer screening programs.

Female↗
PubMedDate not supplied

Breast and cervical cancer screening practices among Hispanic and non-Hispanic women residing near the United States-Mexico border, 1999-2000.

This study examined the breast and cervical cancer screening practices of Hispanic and non-Hispanic women (n = 3,568) in counties that approximate the US southern border region. According to the Health Resources Services Administration (HRSA), border counties are those in which any part of the county is within 100 kilometers (62.14 miles) of the border. The study used data from Behavioral Risk Factor Surveillance System (BRFSS) surveys of adults aged > or = 18 years conducted in 1999 and 2000. The study looked at recent use of mammography and the Papanicolaou (Pap) test. Hispanic women were less likely to have had a recent mammogram or Pap test as compared with non-Hispanic women in border counties, and as compared with Hispanic and non-Hispanic women in nonborder counties of Texas, New Mexico, Arizona, and California combined, and with other women in the United States. Results underscore the need for continued efforts to ensure that medically underserved women who live in the border region have access to cancer screening services.

Adolescent↗
PubMedDate not supplied

Glutathione S-transferase polymorphisms and risk of ovarian cancer: a HuGE review.

Glutathione S-transferases (GSTs) catalyze the conjugation of glutathione to numerous potentially genotoxic compounds. The GSTM1 gene codes for the enzyme glutathione S-transferase-mu, the GSTT1 gene codes for the enzyme glutathione S-transferase-theta, and the GSTP1 gene codes for the enzyme glutathione S-transferase-pi. GSTM1 is polymorphically expressed, and three alleles have been identified (GSTM1-0, GSTM1a, and GSTM1b). Two functionally different genotypes at the GSTT1 locus have been described. Individuals with homozygous deletions of GSTM or GSTT have reduced or no glutathione S-transferase activity and therefore may be unable to eliminate electrophilic carcinogens as efficiently. However, results of epidemiologic studies do not confirm associations between GSTM1, GSTT1, and GSTP1 and epithelial ovarian cancer.

Epidemiologic Studies↗