Geographic disparities in cancer screening and fatalism among a nationally representative sample of US adults

2019 ◽  
Vol 73 (12) ◽  
pp. 1128-1135
Author(s):  
Jennifer L Moss ◽  
Rebecca Ehrenkranz ◽  
Lilian G Perez ◽  
Brionna Y Hair ◽  
Anne K Julian
Keyword(s):  
Breast Cancer ◽  
Colorectal Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Rural Areas ◽  
Representative Sample ◽  
Racial Segregation ◽  
Cancer Fatalism ◽  
Nationally Representative

BackgroundCancer screening in the USA is suboptimal, particularly for individuals living in vulnerable communities. This study aimed to understand how rurality and racial segregation are independently and interactively associated with cancer screening and cancer fatalism.MethodsWe used data from a nationally representative sample of adults (n=17 736) from National Cancer Institute’s Health Information National Trends Survey, 2011–2017, including cancer screening (colorectal, breast, cervical, prostate) among eligible participants and cancer fatalism. These data were linked to county-level metropolitan status/rurality (US Department of Agriculture) and racial segregation (US Census). We conducted multivariable analyses of associations of geographic variables with screening and fatalism.ResultsBreast cancer screening was lower in rural (92%, SE=1.5%) than urban counties (96%, SE=0.5%) (adjusted OR (aOR)=0.52, 95% CI 0.31 to 0.87). Colorectal cancer screening was higher in highly segregated (70%, SE=1.0%) than less segregated counties (65%, SE=1.7%) (aOR=1.28, 95% CI 1.04 to 1.58). Remaining outcomes did not vary by rurality or segregation, and these variables did not interact in their associations with screening or fatalism.ConclusionSimilar to previous studies, breast cancer screening was less common in rural areas. Contrary to expectations, colorectal cancer screening was higher in highly segregated counties. More research is needed on the influence of geography on cancer screening and beliefs, and how access to facilities or information may mediate these relationships.

Impact of organization of colorectal cancer screening: Results of EDIFICE study

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6078-6078
Author(s):  
Y. Coscas ◽  
D. Serin ◽  
L. Cals ◽  
F. Eisinger ◽  
J. Blay ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Representative Sample ◽  
Consensus Conference ◽  
Demographic Characteristics ◽  
Self Report ◽  
Nationwide Observational Study ◽  
Colorectal Screening ◽  
Second Wave

6078 Background: The EDIFICE study aimed to allow better understanding of population’s adhesion to the tests available for the 4 most frequent cancers: breast, colorectal, prostate and lung. In 1998 the French National Consensus Conference advocated for mass cancer screening (CS) using Hemoccult II. The departments are divided according to the existence or not of an organized program: this screening was organized in 22 departments (3 “scout” started in 1998, 9 “first wave” in 2003 and 12 “second wave” in 2004). Results are reported hereunder. Methods: This first nationwide observational study was carried out in France from January 18th to February 2nd, 2005 among a representative sample of 1504 subjects aged between 40 and 75 years and a representative sample of 600 general practitioners (GPs). Information about participating subjects included socio-demographic characteristics, attitude towards CS, and about GPs’ medical practice regarding CS. Results: Only 25% of the 970 subjects aged between 50 and 74 years had undergone a colorectal screening test. In the organized departments (OD), the rate of persons who self-report any colorectal cancer screening was 34% vs 20% in unorganized departments (UD) (OR=1.99, CI95% 1.47- 2.69, p<0.001). The rate of recent screening within a range of 2 years was 24% for OD vs 8% for UD (OR=3.35, CI95% 1.91- 5.88, p<0.01). The rate of “fear of the test and/or its results” was higher in OD: 11% versus 6% (OR=1.97, CI95% 1.11–3.49). The rate of GPs who advocated systematically for screening was 40%, 29%, 26% and 13% for scout, first wave, second wave OD and baseline UD respectively. Organization reduced the rate of screening based on colonoscopy alone from 69% persons in UD to 35% in the OD. Conclusions: The main result of this survey comparing data in the same frame of time, in the same country, is that organized programs for colorectal cancer impact of health outcomes. No significant financial relationships to disclose.

National survey of breast cancer screening in rural America.

2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 13-13 ◽  
Author(s):  
Jeffrey M. Peppercorn ◽  
Kevin Houck ◽  
Adane Fekadu Wogu ◽  
Victor Villagra ◽  
Gary H. Lyman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Rural Women ◽  
Rural Areas ◽  
Univariate Analysis ◽  
College Education ◽  
Screening Mammography ◽  
Screening Methods ◽  
Annual Screening

13 Background: Screening mammography leads to early detection of breast cancer and improved survival. We conducted a survey of predominantly rural U.S. women who receive health insurance through the National Rural Electric Cooperative Association (NRECA) to evaluate the prevalence of annual and biennial screening and to identify potential disparities and barriers to breast cancer screening. Methods: We conducted a national cross-sectional survey of women between ages 40 and 65 who are insured by the NRECA regarding their utilization of mammography screening and barriers to screening. A study specific survey was mailed to 2,000 randomly selected eligible women without prior diagnosis of breast cancer. We assessed demographics and receipt of mammography within past 12 months (all women) and number of screening mammograms within the past 4 years (among women age 44 and older) to identify consistent annual screening and biennial screening patterns. Results: 1,204 women responded to the survey (response rate 60.2%). 74% live in rural areas, 18% suburban, 8% urban. 73% report less than 4 years college education and 19% have family incomes < $50,000/year. Overall, 72% reported screening mammography within 12 months, 59% reported consistent annual screening and 84% reported at least biennial screening. Rural women were less likely to undergo consistent annual (56% vs. 66%, p = 0.003) or biennial screening (82% vs. 89%, p = 0.01) compared to women in non-rural areas. Women under 50 were less likely to report screening within 12 months (67% vs. 77%, p = 0.0002), consistent annual (49% vs. 63%, p < 0.0001) or biennial screening (79% vs. 86%, p = 0.002). Significantly more rural women cited cost and distance as barriers, while busy schedule, fear of diagnosis, and fear of discomfort were important barriers among all demographic groups. Fear of the test was a greater barrier among younger vs. older women (p < 0.02). In univariate analysis; household income did not correlate with screening, and education was only a factor among younger women. Conclusions: A substantial percentage of rural U.S. women fail to undergo screening mammography. Potentially modifiable barriers include out of pocket expenses, convenience of screening, and fear of diagnosis and the test itself.

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