Louisiana Via Research Day Book 2026

Community / Public Health

Community / Public Health

117 ENDOMETRIOSIS AND DEPRESSION AND ANXIETY: AN ANALYSIS OF THE ALL OF US RESEARCH PROGRAM

116 DISPARITIES IN BREAST AND CERVICAL CANCER SCREENING IN THE UNITED STATES

Matthew Overturf, PhD; Hannah Shankle Walden, OMS-III VCOM-Louisiana

Viktoriya Salgalova, OMS-III; Mallory Barlow, OMS-III; Savannah Newell, PhD VCOM-Louisiana

Context: Disparities in breast and cervical cancer screening rates remain a public health concern in the United States. Although cancer screenings are well-established preventive measures, participation rates continue to be suboptimal. Social determinants of health have consistently been shown to influence healthcare adherence and outcomes. Objective: This study aimed to identify the most statistically significant lifestyle barrier to receiving appropriate cancer screening recommendations. Methods: We conducted a cross-sectional analysis using data from the All of Us Research program, which includes de-identified health information from individuals across the country. Separate cohorts were created for breast and cervical cancer screening. The breast cancer screening cohort included 62,774 individuals assigned female at birth, aged 40-74 years old, excluding those with a documented bilateral mastectomy. The cervical cancer screening cohort included 57,362 individuals aged 21-65, excluding those with a history of hysterectomy. Screening completion was

determined by the presence of a mammogram or Pap smear, respectively. Descriptive statistics and chi-squared analysis were used to evaluate screening completion across demographic and socioeconomic variables, including race, income, education level, insurance status, and access to healthcare. In the breast cancer screening cohort, Native Hawaiian or Other Pacific Islander individuals had the lowest screening rate (28.6%) compared to White individuals (42%). Screening completion increased linearly with income, ranging from 33.7% in the lowest income group to 42.8% in the highest. Education level also influenced rates, with 25.9% of individuals without a high school diploma screened, compared to 41.6% of those with a college degree or higher. Insurance status showed a marked difference (17.9% among uninsured versus 41.2% among insured), as did geographic location (29.2% in rural versus 41.2% in non-rural areas). Findings in the cervical cancer screening cohort were consistent. White participants had a 21.3% screening rate, while Native Hawaiian or Other Pacific Islanders had 8.5%. Income was again a key factor, with 16.9% screening in the less

than $35,000 group compared to 23.1% in the greater than $75,000 group. Screening completion ranged from 15.4% among those without a high school diploma to 22.3% among those with a college or advanced degree. Insurance status showed smaller differences (19.5% among uninsured versus 20.9% among insured), and rural residence was associated with lower screening rates (15.3% versus 21.1%). All differences in both cohorts were statistically significant (P < 0.001), except for insurance status in the cervical screening cohort. Chi-squared analysis revealed that income level had the strongest association with screening completion across both cohorts. Conclusion: Suboptimal screening rates were observed among all individuals, even those with higher income and education levels. These findings suggest that, beyond socioeconomic barriers, other factors such as misinformation, cultural beliefs, and lack of trust in the healthcare system may universally influence screening behaviors.

Background: Endometriosis is a gynecological condition that is frequently associated with chronic pelvic pain, decreased quality of life, and delayed diagnosis. Many previous studies have reported increased rates of depression and anxiety among individuals that have been diagnosed with endometriosis. Current evidence is limited by small sample sizes and inconsistent findings regarding whether mental health outcomes are driven by endometriosis or by associated chronic pain. Objective: To evaluate the association between endometriosis and mental health conditions, specifically depression and anxiety, using data from the National Institutes of Health All of Us Research Program. Based on previous literature, we hypothesize a positive association between endometriosis and depression and anxiety. Methods: We will perform a retrospective observational study using the All of Us electronic health record and survey data. Adult females with a documented diagnosis of endometriosis will be compared to those without endometriosis. Primary outcomes include diagnoses of depressive and anxiety disorders.

Binomial modeling and odds ratios will be used to assess associations while adjusting for demographic characteristics, socioeconomic factors, and comorbid chronic pain conditions. Results: Individuals with endometriosis are expected to demonstrate a higher prevalence of mental health conditions compared to controls, even after adjustment for relevant confounders. The study is currently in progress, and results will be added when data analysis is complete. Conclusion: By utilizing a database from diverse regions across the United States, this study seeks to clarify the relationship between endometriosis and mental health conditions beyond smaller populations, such as those in clinical and regional studies. Findings may help identify the roles of chronic pain and disease burden in mental health outcomes and highlight the importance of multidisciplinary approaches that address both the physical and psychological dimensions of endometriosis. Improved recognition of these associations may support earlier intervention and more comprehensive care for women with chronic pelvic pain.

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2026 Research Recognition Day