Women With Diabetes Forego Certain Cancer Screenings

Diabetes patients have a greater risk of developing cancer and experiencing cancer-related mortality. A new meta-analysis analyzed the correlation between diabetes and undergoing breast, cervical, and colorectal cancer screening. The study authors queried MEDLINE, EMBASE, and CINAHL for relevant studies published between Jan. 1, 1997, and July 18, 2018, and also performed hand searches of reference lists of the included studies and known literature reviews. Inclusion criteria included studies performed in the general population; diabetes was a predictor compared against a non-diabetes control group; and the study’s outcomes included breast (mammography), cervical (Papanicolaou smear), or colorectal (fecal and endoscopic) cancer screening uptake. Final analysis included 37 studies, of which 25 were cross-sectional and 12 were cohort studies; 27 studies focused on breast, 19 on cervical, and 18 on colorectal cancer screening. Patients with diabetes, compared to non-diabetes controls, were significantly less likely to undergo breast (adjusted odds ratio [OR]=0.83; 95% CI, 0.77 to 0.90) and cervical (OR=0.76, 95% CI, 0.71 to 0.81) cancer screening. Having diabetes did not significantly impact the likelihood of undergoing colorectal cancer screening overall (OR=0.95; 95% CI, 0.86 to 1.06), but among women, those with diabetes, compared to those without, were less likely to undergo colorectal cancer screening (OR=0.86, 95% CI, 0.77 to 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,” wrote the researchers.