# Cancer screening prevalence and preference among hospitalized women with and without diabetes mellitus

## TL;DR

The study found that women with diabetes are equally nonadherent to breast and colorectal cancer screening guidelines as those without diabetes, but have different risk factors for nonadherence.

## Contribution

The study identifies unique risk factors for cancer screening nonadherence among hospitalized women with diabetes.

## Key findings

- Women with diabetes were more likely to have obesity and comorbidities compared to those without diabetes.
- High risk for CRC was an independent risk factor for nonadherence to BRC screening among women with diabetes.
- Age younger than 60 and smoking were associated with nonadherence to CRC screening among women with diabetes.

## Abstract

To determine the prevalence of nonadherence to breast cancer and colorectal cancer screening, associated risk factors, and screening preference among hospitalized women with and without diabetes aged 50–75 years who were cancer-free at baseline.

A prospective study compared women with and without diabetes who were cancer-free (except for skin cancer) at baseline and between 50 and 75 years of age, admitted to the general medical service at an academic center were approached for study participation from December 1, 2014, to May 31, 2017. The study evaluated breast and colorectal cancer screening nonadherence prevalence, preference for screening locale, sociodemographic and clinical variables associated with nonadherence using multivariable logistic regression model.

Of 510 women, 39% had a prior diagnosis of diabetes mellitus, and 36% were African American. Women with diabetes were more likely to have obesity, reliance on assistive devices for ambulation, inability to work (have a disability), and a greater average number of comorbidities compared to women without diabetes. Women with or without diabetes were equally nonadherent with BRC (28% vs 36%, p = 0.6) and CRC (25% vs 28%, p = 0.51) screening guidelines. After adjustment for sociodemographic and clinical risk factors, only high risk for CRC (OR = 3.20, 95%CI; 1.03–9.91) was an independent risk factor associated with nonadherence to BRC among hospitalized women with diabetes. Whereas after similar adjustment, age younger than 60 years (OR = 2.91, 95%CI; 1.15–7.35) and current or prior smoking (OR = 2.80, 95%CI; 1.14–6.86) were associated with nonadherence to CRC among women with diabetes. 46% of women with diabetes expressed a preference for in-hospital screening for BRC, while 45% expressed a similar preference for CRC.

Hospitalizations may offer additional screening opportunities as almost half of the women with diabetes preferred undergoing breast and colorectal cancer screening during a hospital stay.