Women With Diabetes Less Likely to Undergo Cancer Screening

Women with diabetes have suboptimal breast, cervical, and colorectal cancer screening rates compared with women without diabetes, according to a study published in Diabetologia.

Researchers conducted a literature review of Medline, Embase, and CINAHL for studies published between January 1, 1997, and July 18, 2018. Eligible studies were those conducted in the general population; with diabetes included as a predictor versus a comparison group without diabetes; and with breast (mammography), cervical (Papanicolaou smear), or colorectal (fecal and endoscopic tests) cancer screening uptake included as an outcome.

A total of 37 studies were included, including 25 cross-sectional studies and 12 cohort studies. Of these studies, 27 assessed breast cancer screening, 19 assessed cervical cancer screening, and 18 assessed colorectal cancer (CRC) screening.

Across the studies, mean sample diabetes prevalence was 15.1% for breast cancer, 9.7% for cervical cancer, and 12.4% for CRC.

Screenings lacking in women with diabetes

Women with diabetes had a significantly lower likelihood of undergoing screening for breast (adjusted odds ratio [OR] = 0.83; 95% CI, 0.77-0.90) and cervical (OR=0.76; 95% CI, 0.71-0.81) cancer. CRC screening was comparable among women with and without diabetes (OR=0.95; 95% CI, 0.86-1.06); however, women with diabetes were less likely to receive a CRC screening test than women without diabetes (OR=0.86; 95% CI, 0.77-0.97).

“Given the increased risk of cancer in this population, higher quality prospective evidence is necessary to evaluate the contribution of diabetes to cancer screening disparities in relation to other patient-, provider-, and system-level factors,” the researchers concluded.