Non-Performance of Cancer Screening in Peru: A Comparative Analysis between Regions Exposed and Unexposed to Ozone Layer Mini-Hole
DOI:
https://doi.org/10.30683/1929-2279.2025.14.09Keywords:
Cancer, early diagnosis, ozone layer mini-hole, association measures, exposure, risk, outcomeAbstract
Objective: To determine the prevalence and factors associated with non-performance of cancer screening in Peru based on an analysis between a department exposed to an ozone layer mini-hole versus an unexposed one.
Materials and Methods: Analytical cross-sectional study. The study included individuals aged 15 years and older who responded to questions about cancer screening in the Demographic and Family Health Surveys 2017-2022, comparing a department exposed to an ozone layer mini-hole (Arequipa) with an unexposed one (Lima). Sociodemographic, geographic, health status, and cancer knowledge variables were obtained. Multivariate analysis was performed using Poisson regression with robust standard error.
Results: The study included 10,546 people. The prevalence of non-performance of cancer screening was 75.2%. Multivariate analysis revealed that male sex was a significant risk factor (aPR=1.41; 95% CI: 1.37-1.44), while access to health insurance (aPR=0.91; 95% CI: 0.89-0.93) and the belief that cancer is preventable (aPR=0.92; 95% CI: 0.88-0.95) were protective factors. Education level and wealth index also showed associations with aPR values close to 1. Residence in Arequipa was not a significant factor for non-participation in cancer screening.
Conclusion: The prevalence of non-performance of cancer screening was high. The main factor associated with not undergoing cancer screening was male sex, while having access to health insurance and believing that cancer is preventable were protective factors.
References
Kuwabara Y, Fujii M, Kinjo A, Osaki Y. Abstaining from annual health check-ups is a predictor of advanced cancer diagnosis: a retrospective cohort study. Environ Health Prev Med 2022; 27(0): 1-1. DOI: https://doi.org/10.1265/ehpm.21-00292
Rintala S, Dahlstrom KR, Franco EL, Louvanto K. A synthesis of evidence for cancer-specific screening interventions: A Preventive Medicine Golden Jubilee Review. Preventive Medicine 2023; 167: 107395. DOI: https://doi.org/10.1016/j.ypmed.2022.107395
Stang A, Jöckel K-H. The Impact of Cancer Screening on All-Cause Mortality. Dtsch Arztebl Int 2018; 115(29-30): 481-6. DOI: https://doi.org/10.3238/arztebl.2018.0481
Zielonke N, Gini A, Jansen EEL, Anttila A, Segnan N, Ponti A, et al. Evidence for reducing cancer-specific mortality due to screening for breast cancer in Europe: A systematic review. European Journal of Cancer 2020; 127: 191-206. DOI: https://doi.org/10.1016/j.ejca.2019.12.010
Virgini V, Meindl-Fridez C, Battegay E, Zimmerli L. Check-up examination: recommendations in adults. Swiss Med Wkly 2015; 145: w14075. DOI: https://doi.org/10.4414/smw.2015.14075
Du M, Li P, Tang L, Xu M, Chen X, Long H. Cognition, attitude, practice toward health checkup and associated factors among urban residents in southwest China, Sichuan province, 2022: a community-based study. Z Gesundh Wiss 2023; 1-12. DOI: https://doi.org/10.1007/s10389-023-01883-8
Ramos W, De La Cruz-Vargas JA. Presentación del documento técnico “Análisis de la situación del cáncer en el Perú, 2018”. RFMH 2020; 20(1): 10-1. DOI: https://doi.org/10.25176/RFMH.v20i1.2704
International Agency for Research on Cancer. Cancer Today [Internet]. [citado el 5 de abril de 2025]. Disponible en: https://gco.iarc.who.int/today/
Ramos W, Guerrero N, Medina J, Guerrero P. Análisis de la Situación del Cáncer en el Perú, 2018. Lima: Centro Nacional de Epidemiología, Prevención y Control de Enfermedades; 2022. [Internet]. [citado el 6 de abril de 2025]. Disponible en: https://www.dge.gob.pe/epipublic/uploads/ asis/asis_2020_27_120833.pdf
Ramos W, Gutierrez EL, De La Cruz-Vargas JA, Díaz J, Hurtado J, Ronceros G, et al. Exposure to Atmospheric Ozone Disruption and Altitude Over 3500 m.a.s.l. are Associated with a Higher Prevalence of Photodermatoses in Pediatric Population of High-Altitude in Peru. CCID 2022; Volume 15: 1779-86. DOI: https://doi.org/10.2147/CCID.S374884
Departamento de Epidemiología y Estadística del Cáncer. Registro de Cáncer de Lima Metropolitana. Incidencia y mortalidad 2010-2012. Lima: Instituto Nacional de Enfermedades Neoplásicas; 2016.
Medina Fernández LE, Rodríguez Zea B. Registro de Cáncer Poblacional de Arequipa. Incidencia y Mortalidad 2008-2014. Arequipa: Gerencia Regional de Salud de Arequipa; 2018.
Instituto Nacional de Estadística e Informática. Perú Enfermedades No Transmisibles y Transmisibles, 2022. Lima: INEI; 2023. [Internet]. [citado el 6 de abril de 2025]. Disponible en: https://cdn.www.gob.pe/uploads/document/ file/4570237/Per%C3%BA%3A%20Enfermedades%20No%20Transmisibles%20y%20Transmisibles%2C%202022.pdf?v=1684338910
Ohnishi M, Nakao R, Kawasaki R, Tanaka J, Kosaka S, Umezaki M. Factors associated with failure to undergo health check-ups in Nagasaki Prefecture, Japan. J Rural Med 2023; 18(1): 28-35. DOI: https://doi.org/10.2185/jrm.2022-046
Paek SC, Zhang NJ. Factors associated with the use of annual health checkups in Thailand: evidence from a national cross-sectional health and welfare survey. Front Public Health [Internet] 2024 [citado el 2 de abril de 2025]; 12. DOI: https://doi.org/10.3389/fpubh.2024.1390125
Salinas Cáceres KA. Conocimiento sobre prácticas de fotoprotección solar en conductores de taxis en la ciudad de Arequipa, 2020. Arequipa: Universidad Católica de Santa María; 2020. [Internet]. [citado el 4 de abril de 2025]. Disponible en: https://repositorio.ucsm.edu.pe/server/api/ core/bitstreams/c1d92a20-c587-416a-b99d-ba593d50aa01/content
Choquehuayta Huaman LM. Influencia de la radiación solar en el estilo de vida de los pobladores del distrito de Cayma-Arequipa 2019. Arequipa: Universidad Continental; 2019. [Internet]. [citado el 4 de abril de 2025]. Disponible en: https://repositorio.continental.edu.pe/bitstream/20.500.12394/6117/2/IV_FIN_108_TI_Choquehuayta_Huaman_2019.pdf
Nuñez Vásquez JL. Nivel de prácticas fotoprotectoras frente a la exposición solar en adolescentes en el cercado de Arequipa, 2015. Arequipa; Universidad Católica de Santa María; 2015. [Internet]. [citado el 4 de abril de 2025]. Disponible en: https://repositorio.ucsm.edu.pe/server/api/ core/bitstreams/5f9231c1-4ea2-46ce-8989-f189032d5e84/content
Noguchi R, Shen J. Factors affecting participation in health checkups: Evidence from Japanese survey data. Health Policy 2019; 123(4): 360-6. DOI: https://doi.org/10.1016/j.healthpol.2018.10.013
Baccolini V, Isonne C, Salerno C, Giffi M, Migliara G, Mazzalai E, et al. The association between adherence to cancer screening programs and health literacy: A systematic review and meta-analysis. Preventive Medicine 2022; 155: 106927. DOI: https://doi.org/10.1016/j.ypmed.2021.106927
Ito N, Sugimori H, Odajima T, Yoshimura N, Muto S, Hirao M, et al. Factors Associated with Refraining from Health Checkups during the COVID-19 Pandemic in Japan. Healthcare 2023; 11(17): 2385. DOI: https://doi.org/10.3390/healthcare11172385
Full Text PDF [Internet]. [citado el 18 de abril de 2025]. Disponible en: https://journals.plos.org/plosone/article/ file?id=10.1371/journal.pone.0251264&type=printable
Papageorge MV, Woods AP, de Geus SWL, Ng SC, McAneny D, Tseng JF, et al. The Persistence of Poverty and its Impact on Cancer Diagnosis, Treatment and Survival. Annals of Surgery 2023; 277(6): 995. DOI: https://doi.org/10.1097/SLA.0000000000005455
Full Text PDF [Internet]. [citado el 18 de abril de 2025]. Disponible en: https://onlinelibrary.wiley.com/doi/pdfdirect/ 10.1002/ijc.34932
Williams F, Thompson E. Disparities in Breast Cancer Stage at Diagnosis I. Journal of Health Disparities Research and Practice Journal of Health Disparities Research and Practice 2017; 10(3). Available at: https://digitalscholarship.unlv.edu/ jhdrp/vol10/iss3/4 [citado el 18 de abril de 2025]. Disponible en: https://digitalscholarship.unlv.edu/cgi/viewcontent.cgi? article=1504&context=jhdrp
Nevin PE, Garcia PJ, Blas MM, Rao D, Molina Y. Inequities in cervical cancer care in indigenous Peruvian women. The Lancet Global Health 2019; 7(5): e556-7. DOI: https://doi.org/10.1016/S2214-109X(19)30044-0
Araujo JM, Gómez AC, Jongh WZ-D, Ausejo J, Córdova I, Schwarz LJ, et al. A nationwide pilot study on breast cancer screening in Peru [Internet] 2023 [citado el 18 de abril de 2025]. DOI: https://doi.org/10.3332/ecancer.2023.1494
Vasudevan L, Stinnett S, Mizelle C, Melgar K, Makarushka C, Pieters M, et al. Barriers to the uptake of cervical cancer services and attitudes towards adopting new interventions in Peru. Preventive Medicine Reports 2020; 20: 101212. DOI: https://doi.org/10.1016/j.pmedr.2020.101212
Yabroff KR, Reeder-Hayes K, Zhao J, Halpern MT, Lopez AM, Bernal-Mizrachi L, et al. Health Insurance Coverage Disruptions and Cancer Care and Outcomes: Systematic Review of Published Research. J Natl Cancer Inst 2020; 112(7): 671-87. DOI: https://doi.org/10.1093/jnci/djaa048
Yirga GK, Bantie B, Hiruy EG, Baye AA, Kerebeh G, Shiferaw K, et al. Health checkup practice and its associated factors among adults in South Gondar zone Ethiopia. Sci Rep 2024; 14(1): 21237. DOI: https://doi.org/10.1038/s41598-024-69921-3
Tungu M, Luoga P, Anaeli A, Nyamhanga T. Correlates associated with health insurance on cervical cancer screening in Tanzania: a comparison between the insured and uninsured women using demographic and health survey 2022. BMC Health Services Research 2024; 24(1): 1512. DOI: https://doi.org/10.1186/s12913-024-11989-8
Zhao J, Han X, Nogueira L, Fedewa SA, Jemal A, Halpern MT, et al. Health insurance status and cancer stage at diagnosis and survival in the United States. CA: A Cancer Journal for Clinicians 2022; 72(6): 542-60. DOI: https://doi.org/10.3322/caac.21732
Hsia J, Kemper E, Kiefe C, Zapka J, Sofaer S, Pettinger M, et al. The Importance of Health Insurance as a Determinant of Cancer Screening: Evidence from the Women’s Health Initiative. Preventive Medicine 2000; 31(3): 261-70. DOI: https://doi.org/10.1006/pmed.2000.0697
Zhao G, Okoro CA, Li J, Town M. Health Insurance Status and Clinical Cancer Screenings Among U.S. Adults. American Journal of Preventive Medicine 2018; 54(1): e11-9. DOI: https://doi.org/10.1016/j.amepre.2017.08.024
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