Preventive medicine最新文献

{"title":"Potentially preventable hospitalizations among American Indian and Alaska Native adults, 2016–2021","authors":"Bionca M. Davis ,&nbsp;Sara Bressler ,&nbsp;Andria Apostolou ,&nbsp;Dana Bruden ,&nbsp;Michael G. Bruce ,&nbsp;Marc Fischer","doi":"10.1016/j.ypmed.2025.108281","DOIUrl":"10.1016/j.ypmed.2025.108281","url":null,"abstract":"<div><h3>Objective</h3><div>Potentially preventable hospitalizations are inpatient admissions for a standard set of selected acute illnesses and chronic conditions that might have been avoided with preventive care or outpatient management. During 2010–2012, Alaska Native adults had higher rates of potentially preventable hospitalizations compared to other adults in Alaska. We evaluated potentially preventable hospitalizations among American Indian/Alaska Native (AI/AN) adults in the United States during 2016–2021.</div></div><div><h3>Methods</h3><div>We used hospital discharge data from the Indian Health Service National Patient Information Reporting System (NPIRS) to calculate and compare average annual age-adjusted rates of potentially preventable hospitalizations per 1000 AI/AN adults for two acute conditions (community-acquired pneumonia and urinary tract infection) and four chronic conditions (diabetes, heart failure, asthma/chronic obstructive pulmonary disease, and hypertension).</div></div><div><h3>Results</h3><div>Of 310,889 hospitalizations among AI/AN adults, 40,400 (13 %) were defined as potentially preventable for an annual rate of 7.6 per 1000 persons. Rates were stable during 2016–2019 (8.7 per 1000) but declined during 2020–2021 (5.9 per 1000), likely related to the COVID-19 pandemic. Older adults and rural residents had significantly higher rates of potentially preventable hospitalizations across all six conditions assessed, with community-acquired pneumonia having the highest hospitalization rate among adults aged ≥65 years (5.2 per 1000).</div></div><div><h3>Conclusions</h3><div>Targeted preventive care and appropriate outpatient management for AI/AN elders living in rural areas might help improve health and reduce medical costs through decreased hospitalizations. Vaccination against respiratory infections could have the greatest impact in reducing preventable hospitalizations among AI/AN adults.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"195 ","pages":"Article 108281"},"PeriodicalIF":4.3,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143817363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with human papillomavirus (HPV) patient-clinician communication and HPV vaccine uptake among adults in the United States","authors":"Heather N. Owens ,&nbsp;Naomi C. Brownstein ,&nbsp;Junmin Whiting ,&nbsp;Mariana Arevalo ,&nbsp;Monica L. Kasting ,&nbsp;Susan T. Vadaparampil ,&nbsp;Katharine J. Head ,&nbsp;Shannon M. Christy","doi":"10.1016/j.ypmed.2025.108280","DOIUrl":"10.1016/j.ypmed.2025.108280","url":null,"abstract":"<div><h3>Objective</h3><div>Human papillomavirus (HPV) vaccine is approved for those aged 9–45 years. However, HPV vaccine uptake remains suboptimal in the United States (U.S.), particularly among young and mid-age adults. This paper describes HPV vaccine patient-clinician communication, clinician recommendation receipt, and HPV vaccine uptake among U.S. adults who were eligible for the HPV vaccine as adults.</div></div><div><h3>Methods</h3><div>U.S. adults up to age 45 and who were aged 18+ when the HPV vaccine was approved were recruited for an online survey (<em>n</em> = 1107) between February–March 2021. Multivariable logistic regression analyses were used to assess: (1) clinician-patient HPV vaccination discussions; (2) ever having received an HPV vaccine recommendation from a clinician; and (3) HPV vaccine uptake.</div></div><div><h3>Results</h3><div>Thirty-four percent of participants reported having prior HPV vaccine discussions with a clinician, 31.1 % reporting ever having received a clinician recommendation for the vaccine, and only 23.8 % reported receiving the vaccine. Receiving the HPV vaccine was positively associated with prior HPV vaccine discussions (aOR: 2.93; 95 % CI: 1.98–4.35) and ever receiving an HPV vaccine recommendation from a clinician (aOR: 10.64; 95 % CI: 7.14–15.88). Additional factors consistently associated with all three models (discussing, receiving a clinician recommendation, and vaccine uptake) include higher HPV vaccine knowledge and higher HPV vaccine embarrassment.</div></div><div><h3>Conclusions</h3><div>Unvaccinated age-eligible adults represent a missed opportunity for HPV-related cancer prevention. Interventions to support clinicians providing care to young and mid-age adults are needed to increase clinician discussions and recommendations of the HPV vaccine and patient uptake of the HPV vaccine.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"195 ","pages":"Article 108280"},"PeriodicalIF":4.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of urinary incontinence, physical activity and cardiovascular disease risk among women in the United States","authors":"Lisa L. VanWiel ,&nbsp;Lucas J. Carr ,&nbsp;Dale S. Bond ,&nbsp;Yin Wu ,&nbsp;Elena Tunitsky-Bitton ,&nbsp;Paul Tulikangas ,&nbsp;Adam C. Steinberg ,&nbsp;Kara M. Whitaker","doi":"10.1016/j.ypmed.2025.108277","DOIUrl":"10.1016/j.ypmed.2025.108277","url":null,"abstract":"<div><h3>Objective</h3><div>Urinary incontinence (incontinence) is a common condition among women which may contribute to low moderate-to-vigorous physical activity (MVPA). Thus, women with incontinence may have increased risk for inactivity and related cardiovascular disease (CVD). The objective of this study was to determine the associations of incontinence with MVPA and CVD risk.</div></div><div><h3>Methods</h3><div>This retrospective observational study used electronic medical records to capture data on incontinence diagnosis, self-reported MVPA using the Exercise Vital Sign, CVD risk factors and diagnosis using ICD-10 codes, and demographic information from July 2022–June 2024 in Connecticut. Multinomial logistic regression assessed the association of incontinence and MVPA classification (inactive: 0 min/week, insufficiently active: 1–149 min/week, and active ≥150 min/week). Logistic regression models assessed associations of incontinence with CVD risk calculator components and diagnosed CVD. All models adjusted for age, race, body mass index, and tobacco use.</div></div><div><h3>Results</h3><div>Of 20,155 women who were included in analysis (mean age 50.36 ± 16.42 years), 5.4 % had an incontinence diagnosis. Compared to those without incontinence, those with incontinence did not differ in MVPA classification, but had greater odds of type two diabetes (aOR 1.25, 95 % CI: 1.06–1.48), dyslipidemia (aOR 1.37, 95 % CI: 1.19–1.58), stroke (aOR 1.55, 95 % CI: 1.06–2.25), and coronary artery bypass grafts (aOR 3.17, 95 % CI: 1.45–6.95) after adjustment.</div></div><div><h3>Conclusions</h3><div>Incontinence was not associated with MVPA classification but was associated with inactivity related CVD risk factors and cardiometabolic comorbid conditions. Future studies should investigate potential mechanisms of this association including incontinence severity, activity intensity, and chronic inflammation.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"194 ","pages":"Article 108277"},"PeriodicalIF":4.3,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in the food environment surrounding schools in four New Jersey school districts between school years 2012–13 and 2019–20","authors":"Francesco Acciai ,&nbsp;Montserrat Ganderats-Fuentes ,&nbsp;Punam Ohri-Vachaspati","doi":"10.1016/j.ypmed.2025.108278","DOIUrl":"10.1016/j.ypmed.2025.108278","url":null,"abstract":"<div><h3>Objectives</h3><div>While public health policies have mostly targeted the food environment within schools, recent research shows that the food environment surrounding schools is also related to children's diet and health outcomes. The goal of this paper was to examine the changes in the food environment around schools from school year 2012–13 to 2019–20 in four New Jersey school districts.</div></div><div><h3>Methods</h3><div>We analyzed data from 152 kindergarten – 12th grade public schools in Camden, Newark, New Brunswick, and Trenton for 2012–13 to 2019–20. Food outlets within 0.25-mile buffers around schools were classified into convenience stores, limited-service restaurants, small grocery stores, and upgraded convenience stores. Multivariable Poisson and negative binomial regression models were used to evaluate trends in food outlet prevalence over the study period.</div></div><div><h3>Results</h3><div>The number of convenience stores decreased by 6 % annually (exp(<em>βi</em>) = 0.94, 95 % CI: 0.91; 0.96), while the number of upgraded convenience stores (carrying a selection of healthier items) increased by 30 % annually (exp(<em>βi</em>) = 1.30, 95 % CI: 1.17; 1.44). Other outlet types, such as small grocery stores and limited-service restaurants, remained stable.</div></div><div><h3>Conclusions</h3><div>Although unhealthy outlets remained the most prevalent, there were improvements in the food environment around schools over the study period. Notably, these changes coincided with local policy initiatives aimed at improving healthy food offerings in convenience stores. Local policies can improve the food environment around schools by increasing access to healthier options. Policies aimed at improving the food environment around schools are crucial for supporting children's health and enhancing the effectiveness of school nutrition programs.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"194 ","pages":"Article 108278"},"PeriodicalIF":4.3,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of the leisure-time physical activity environment on odds of glycemic control among a nationwide cohort of United States veterans with a new type-2 diabetes diagnosis","authors":"Stephanie L. Orstad ,&nbsp;Priscilla M. D'antico ,&nbsp;Samrachana Adhikari ,&nbsp;Rania Kanchi ,&nbsp;David C. Lee ,&nbsp;Mark D. Schwartz ,&nbsp;Sanja Avramovic ,&nbsp;Farrokh Alemi ,&nbsp;Brian Elbel ,&nbsp;Lorna E. Thorpe","doi":"10.1016/j.ypmed.2025.108274","DOIUrl":"10.1016/j.ypmed.2025.108274","url":null,"abstract":"<div><div><strong>Objective.</strong> This study examined associations between access to leisure-time physical activity (LTPA) facilities and parks and repeated measures of glycated hemoglobin (A1C) over time, using follow-up tests among United States Veterans with newly diagnosed type-2 diabetes (T2D). <strong>Methods.</strong> Data were analyzed from 274,463 patients in the Veterans Administration Diabetes Risk cohort who were newly diagnosed with T2D between 2008 and 2018 and followed through 2023. Generalized estimating equations with a logit link function and binomial logistic regression were used to examine associations. <strong>Results.</strong> Patients were on average 60.5 years of age, predominantly male (95.0 %) and white (66.9 %), and had an average of 11.7 A1C tests during the study follow-up period. In high- and low-density urban communities, a one-unit higher LTPA facility density score was associated with 1 % and 3 % greater likelihood of in-range A1C tests during follow-up, respectively, but no association was observed among patients living in suburban/small town and rural communities. Across community types, closer park distance was not associated with subsequent greater odds of in-range A1C tests. Unexpectedly, in low-density urban areas, the likelihood of in-range A1C tests was 1 % lower at farther park distances. <strong>Conclusions.</strong> These results suggest that broader access to LTPA facilities, but not park proximity, may contribute in small ways to maintaining glycemic control after T2D diagnosis in urban communities. Tailored interventions may be needed to promote patients' effective use of LTPA facilities and parks.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"194 ","pages":"Article 108274"},"PeriodicalIF":4.3,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the predictive performance of different data sources to forecast overdose deaths at the neighborhood level with machine learning in Rhode Island","authors":"John C. Halifax ,&nbsp;Bennett Allen ,&nbsp;Claire Pratty ,&nbsp;Victoria Jent ,&nbsp;Alexandra Skinner ,&nbsp;Magdalena Cerdá ,&nbsp;Brandon D.L. Marshall ,&nbsp;Daniel B. Neill ,&nbsp;Jennifer Ahern","doi":"10.1016/j.ypmed.2025.108276","DOIUrl":"10.1016/j.ypmed.2025.108276","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the predictive performance of different data sources to forecast fatal overdose in Rhode Island neighborhoods, with the goal of providing a template for other jurisdictions interested in predictive analytics to direct overdose prevention resources.</div></div><div><h3>Methods</h3><div>We evaluated seven combinations of data from six administrative data sources (American Community Survey (ACS) five-year estimates, built environment, emergency medical services non-fatal overdose response, prescription drug monitoring program, carceral release, and historical fatal overdose data). Fatal overdoses in Rhode Island census block groups (CBGs) were predicted using two machine learning approaches: linear regressions and random forests embedded in a nested cross-validation design. We evaluated performance using mean squared error and the percentage of statewide overdoses captured by CBGs forecast to be in top percentiles from 2019 to 2021.</div></div><div><h3>Results</h3><div>Linear models trained on ACS data combined with one other data source performed well, and comparably to models trained on all available data. Those including emergency medical service, prescription drug monitoring program, or carceral release data with ACS data achieved a priori goals for percentage of statewide overdoses captured by CBGs prioritized by models on average.</div></div><div><h3>Conclusions</h3><div>Prioritizing neighborhoods for overdose prevention with forecasting is feasible using a simple-to-implement model trained on publicly available ACS data combined with only one other administrative data source in Rhode Island, offering a starting point for other jurisdictions.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"194 ","pages":"Article 108276"},"PeriodicalIF":4.3,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The associations of long working hours and unhealthy diet on cardiometabolic outcomes and mortality in US workers.","authors":"Xiang Li, Jian Li, Xuyuehe Ren, Tong Xia, Onyebuchi A Arah, Liwei Chen","doi":"10.1016/j.ypmed.2025.108275","DOIUrl":"https://doi.org/10.1016/j.ypmed.2025.108275","url":null,"abstract":"<p><strong>Objectives: </strong>To examine independent and joint associations of long working hours (LWH) and EAT-Lancet diet on cardiometabolic outcomes and mortality in US workers.</p><p><strong>Methods: </strong>This prospective cohort included US workers from the National Health and Nutrition Examination Survey, with cross-sectional baseline data from 1999 to March 2020. A subsample of participants from 1999 to 2018 was linked to the National Death Index, with mortality follow-up through December 2019. The independent and joint associations of LWH (≥ 55 vs. < 55 h/week) and EAT-Lancet diet scores (low vs. high) on cardiometabolic outcomes and mortality were estimated using multivariable logistic and Cox proportional hazards models, respectively.</p><p><strong>Results: </strong>LWH was associated with higher odds of obesity (OR = 1.20; 95 % CI = 1.07, 1.34) among all workers and higher CVD mortality among workers with high CVD risk at baseline (HR = 1.64, 95 %CI = 0.79, 3.12). Low diet scores were associated with higher odds of obesity (OR = 1.34, 95 %CI = 1.21, 1.42) and diabetes (OR = 1.33, 95 %CI = 1.01, 1.76) among all workers. Working hours and diet scores were jointly associated with obesity and CVD mortality, indicating by the relative excess risk due to interaction greater than zero among all workers.</p><p><strong>Conclusions: </strong>LWH and unhealthy diet are independent risk factors and may interact to exacerbate adverse cardiometabolic health outcomes.</p>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":" ","pages":"108275"},"PeriodicalIF":4.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the mediating role of Charlson comorbidity index in the association between body mass index and depression in U.S. adults: NHANES 2007–2020","authors":"Xianling Liu ,&nbsp;Wei Zheng ,&nbsp;Yan Sun ,&nbsp;Yansong Li ,&nbsp;Yiting Pan ,&nbsp;Kai Wang ,&nbsp;Miao Lu ,&nbsp;Di Xu","doi":"10.1016/j.ypmed.2025.108273","DOIUrl":"10.1016/j.ypmed.2025.108273","url":null,"abstract":"<div><h3>Objective</h3><div>The relationship among body mass index (BMI), Charlson comorbidity index (CCI), and depression forms a complex interplay that affects both physical and mental health. However, whether CCI mediates the association between BMI and depression remains unclear. In this study, we aimed to elucidate the mediating role of CCI in the relationship between BMI and depression.</div></div><div><h3>Methods</h3><div>This study used data from the National Health and Nutrition Examination Survey, a program of the National Center for Health Statistics in the United States, including 23,639 participants from 2007 to 2020. Wilcoxon rank-sum and Rao-Scott adjusted chi-square tests were employed to compare characteristics between adults with and without depression. Weighted logistic regression and restricted cubic spline models were applied to investigate the pairwise associations among BMI, CCI, and depression. Mediation analysis was performed to assess whether CCI mediated the relationship between BMI and depression.</div></div><div><h3>Results</h3><div>Of the 23,639 participants, 2128 (9.0 %) had depression. Significant associations were observed between BMI and CCI; CCI and depression; and BMI and depression (<em>P</em> &lt; 0.001). A U-shaped relationship between BMI and depression odds was identified, with the lowest odds at a BMI of 23 kg/m². Mediation analysis revealed that CCI partially mediated the BMI-depression relationship, accounting for 19.5 % of the total effect.</div></div><div><h3>Conclusions</h3><div>The results suggest that CCI plays a mediating role in the association between BMI and depression, and that improved chronic disease management may be associated with lower odds of depression in high BMI populations.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"194 ","pages":"Article 108273"},"PeriodicalIF":4.3,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143706281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial factors and associations with preventive cardiovascular screening among U.S adults: Findings from the National Health Interview Survey, 2023","authors":"Osayande Agbonlahor,&nbsp;Abigail Gamble,&nbsp;Caroline Compretta,&nbsp;Joshua R. Mann,&nbsp;Fazlay Faruque","doi":"10.1016/j.ypmed.2025.108272","DOIUrl":"10.1016/j.ypmed.2025.108272","url":null,"abstract":"<div><h3>Objective</h3><div>Structural and COVID-related factors have been linked with the decline in preventive health screenings among adults. However, associations between psychosocial factors and undergoing preventive cardiovascular screening are not fully known. The current study examined associations between psychosocial factors and preventive cardiovascular screening among U.S. adults.</div></div><div><h3>Methods</h3><div>We used data from the 2023 National Health Interview Survey (<em>N</em> = 23,428). Data were collected from January to December from adults living in U.S. Preventive cardiovascular (CV) screening (i.e., blood pressure, cholesterol, or blood sugar level) was defined as no screening, and undergoing screening for any CV risk within the past year. Psychosocial factors were defined as discrimination, life satisfaction, and depression. Multivariable logistic regression models examined the associations between psychosocial factors and preventive cardiovascular screening, adjusted for sociodemographic characteristics.</div></div><div><h3>Results</h3><div>Adults with diagnosis of depression (OR: 1.93, 95 % CI: 1.65–2.25) had higher odds of undergoing screening for any CV risk. Adults who experienced discrimination had lower odds of undergoing screening for cholesterol (OR: 0.77, 95 % CI: 0.71–0.84) and blood sugar level specifically (OR: 0.78, 95 % CI: 0.72–0.85), while life dissatisfaction was associated with lower odds of screening for blood pressure (OR: 0.76, 95 % CI: 0.58–0.99) and blood sugar level specifically (OR: 0.80, 95 % CI: 0.65–0.97).</div></div><div><h3>Conclusions</h3><div>Discrimination and life dissatisfaction were associated with decreased odds of undergoing specific preventive cardiovascular screening, and depression is associated with increased odds of undergoing any preventive cardiovascular screening. Equitable health care policies focused on addressing psychosocial factors are needed to increase preventive cardiovascular screening among U.S. adults.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"194 ","pages":"Article 108272"},"PeriodicalIF":4.3,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical cancer screening and risk factor prevalence by sexual identity: A comparison across three national surveys in the United States","authors":"Jennifer C. Spencer ,&nbsp;Hanwen Zhang ,&nbsp;Brittany M. Charlton ,&nbsp;Phillip W. Schnarrs ,&nbsp;Felicitas Kuehne ,&nbsp;Uwe Siebert ,&nbsp;Amy Trentham-Dietz ,&nbsp;Navkiran K. Shokar ,&nbsp;Jane J. Kim ,&nbsp;Michael P. Pignone","doi":"10.1016/j.ypmed.2025.108262","DOIUrl":"10.1016/j.ypmed.2025.108262","url":null,"abstract":"<div><h3>Objectives</h3><div>Women identifying as lesbian, gay, bisexual, or queer (LGBQ) have lower cervical cancer screening use and differences in care access. Less known about how differences vary by data sources and within LGBQ subgroups. We evaluated LGBQ disparities in cervical cancer screening use and risk factors across three national surveys in the United States.</div></div><div><h3>Methods</h3><div>Data were from the 2019 and 2021 National Health Interview Survey, the 2018 and 2020 Behavioral Risk Factor Surveillance Survey, and the 2017–2019 National Survey of Family Growth. We meta-analyzed self-reported cervical cancer screening to estimate pooled relative risks (pRR), comparing those identifying as LGBQ to those identifying as straight/heterosexual. We also evaluated differences in care access and behavioral risk factors by sexual identity.</div></div><div><h3>Results</h3><div>Despite demographic differences across surveys, all three surveys demonstrated a small reduction in up-to-date cervical cancer screening for LGBQ vs. straight/heterosexual women (pRR = 0.91 [CI 0.89–0.93]). The screening gap was larger for gay/lesbian (pRR: 0.90 [0.85–0.94]) than bisexual women (pRR: 0.94 [0.92–0.97]) and largest at younger ages (pRR age 21–29: 0.89 [CI 0.85–0.93]). LGBQ women reported consistently lower access to care across multiple measures. Risk factors were mixed, including higher smoking rates and higher HPV vaccination coverage for LGBQ women vs. straight.</div></div><div><h3>Discussion</h3><div>LGBQ women are less likely to be screened for cervical cancer. Closing disparities in care access and identifying feasible and acceptable screening interventions will help reduce these disparities. We must also ensure high-quality data collection to monitor disparities across and within key subgroups.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"194 ","pages":"Article 108262"},"PeriodicalIF":4.3,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}