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Article
Life Stressors Are an Important Reason for Women Discontinuing Follow-up Care for Cervical Neoplasia
Cancer Epidemiology, Biomarkers & Prevention (2006)
  • Ann L. Coker, University of Texas Health Science Center at Houston
  • Sharon Bond, Medical University of South Carolina
  • Lucia Pirisi, University of South Carolina - Columbia
Abstract
Although studies have addressed psychosocial factors associated with obtaining follow-up care for an abnormal Pap test, none have explored the effect of stressful life events in predicting the receipt of follow-up care for an abnormal Pap test. Data from a program (1995-2001) that provided free follow-up care for women with low-grade cervical lesions (n = 601) was used to determine whether life stressors increased risk of study discontinuation. Women were interviewed at baseline and offered follow-up at 4- to 6-month intervals for up to 24 months. Of the 556 women recruited and interviewed (92% response rate), 53 were referred out because they had high-grade cervical lesions and 33 had a health condition precluding follow-up. Among 470 women who began follow-up, 175 (37.2%) discontinued before completing three visits. Women who discontinued were significantly more likely to report more stressful life events in the past year [age-adjusted relative risk (aRR), 1.19; 95% confidence interval (95% CI), 1.08-1.30; 17-item scale]. Events most strongly associated with discontinuation included having a problem with a boss (aRR, 1.9; 95% CI, 1.5-2.4), severe physical partner violence (aRR, 1.7; 95% CI, 1.3-2.2), being homeless (aRR, 2.1; 95% CI, 1.6-2.8), and having an unplanned pregnancy (aRR, 1.5, 95% CI, 1.2-2.1). Life stressors may be important predictors of discontinuation of free follow-up care among women in need of immediate follow-up care to prevent lesion progression.
Keywords
  • Gynecologic cancers: cervical,
  • Risk Assessment,
  • Prevention,
  • Psychosocial aspects
Publication Date
February, 2006
Publisher Statement
UK faculty may access full text of the manuscript through this repository. Non UK faculty may access the article by linking to the publisher at

http://cebp.aacrjournals.org/content/15/2/321.full.pdf+html.

Citation Information
Ann L. Coker, Sharon Bond and Lucia Pirisi. "Life Stressors Are an Important Reason for Women Discontinuing Follow-up Care for Cervical Neoplasia" Cancer Epidemiology, Biomarkers & Prevention Vol. 15 Iss. 2 (2006)
Available at: http://works.bepress.com/anncoker/49/