Article
Life Stressors Are an Important Reason for Women Discontinuing Follow-up Care for Cervical Neoplasia
Cancer Epidemiology, Biomarkers & Prevention
(2006)
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
Disciplines
Publication Date
February, 2006
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/
http://cebp.aacrjournals.org/content/15/2/321.full.pdf+html.