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Cancer screening rates lower among women with diabetes

A review of studies carried out across two decades has shown that women with diabetes are less likely to attend key cancer screening appointments than women without diabetes.

The researchers suggest that the demands of managing diabetes may have an impact on women with diabetes and/or their healthcare providers.

37 studies were included in the analysis. The researchers did not narrow down the participants by type of diabetes.

Speaking to Reuters Health, senior researcher Dr Lorraine Lipscombe, associate professor of medicine at the University of Toronto, said: “We know people with diabetes have a small, but significantly increased risk for certain kinds of cancer.

“We wanted to find out if lower cancer screening is contributing to these differences. And, if there is a higher risk of cancer, we wanted to make sure we’re at least catching the cancers early.”

The results showed that women with diabetes were 24% less likely to undergo a smear test (Papanicolaou test), which tests for cervical cancer when compared with women without diabetes. Attendance for mammogram tests, carried out to screen for breast cancer, were also lower by 17% for women with diabetes.

There was a 14% lower likelihood of women with diabetes attending colorectal cancer screening. By comparison, men with diabetes had similar rates of colorectal cancer screening when compared to men without diabetes.

The review of studies did not directly look into why cancer screening rates were lower, so researchers can only speculate. People with diabetes are screened for a number of different complications each year and this may impact the offer of or take-up of cancer screening tests.

Dr Lipscombe added: “The complexity and time taken to manage diabetes could mean routine preventive services such as cancer screening may be forgotten or neglected, by both patients and providers.

“We know the more chronic diseases a person has, the less likely they are to see their primary care provider, but the latter must stay part of the team.”

In contemplating the differences between rates of colorectal cancer screening between men and women with diabetes, Dr Lipscombe put forward that, “We wonder if there is a perception that colorectal cancer is more common in men than women.”

The study is published in the Diabetologia journal.

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