Comparison of breast and cervical cancer screening utilization among rural and urban Hispanic and American Indian women in the Southwestern United States
Rural Hispanic and American Indian (AI) women are at risk of non-participation in cancer screening programs. The objective of this study was to compare breast and cervical cancer screening utilization among Hispanic and AI women that reside in rural areas of the Southwestern United States to their urban counterparts and to assess characteristics that influence cancer screening.
This study utilizes Behavioral Risk Factor Surveillance System (BRFSS) data from 2006 to 2008 for Arizona and New Mexico. The BRFSS is a federally funded telephone survey to collect data on risk factors contributing to the leading causes of death and chronic diseases.
Rural Hispanic and AI populations reported some differences in screening rates compared with their urban counterparts. Among Hispanic women, 58 % of rural residents reported having had a mammogram within the past year, compared with 66 % of urban residents. Among AI women, 81 % of rural residents had ever had a mammogram, compared with 89 % of urban residents. Rural AI women were less likely to have ever had a mammogram (OR = 0.5; 95 % CI = 0.3–0.9) compared with urban AI women. Rural Hispanic women were less likely to have had a mammogram within 1 year (OR = 0.7; 95 % CI = 0.5–0.9) compared with urban Hispanic women. Results suggest that rural Hispanic women were less likely to have had a Pap smear within 3 years (OR = 0.7; 95 % CI = 0.4–1.3) compared with urban Hispanic women.
Our results provide some evidence that Hispanic and AI women that reside in rural areas of the Southwestern United States have lower rates of breast and cervical cancer screening use compared with their urban counterparts. Special efforts are needed to identify ways to overcome barriers to breast and cervical cancer screening for rural Hispanic and AI women.
KeywordsHispanic American Indian Cancer screening Rural health Women’s health Health disparities
The authors would like to acknowledge Richard Porter, Chief of the Bureau of Public Health Statistics for the Arizona Department of Health Services and Wayne A. Honey, Survey Epidemiologist for the New Mexico Department of Health for their assistance with the use of BRFSS data. We also would like to acknowledge Gary Hart, Bonnie Lafleur, Jenny Chong, Joe Tabor, and Howard Eng at the University of Arizona Mel and Enid Zuckerman College of Public Health for assistance with rural/urban data analysis. Lastly, we acknowledge William P. Bartoli from the Centers for Disease Control and Prevention for assistance with complex data analysis. Funding for the preparation and completion of this manuscript was provided by the Racial and Ethnic Approaches to Community Health (REACH) program at the Mel and Enid Zuckerman College of Public Health Center of Excellence in Women’s Health and by the Arizona Area Health Education Center (AzAHEC) Clinical Outcomes and Comparative Effectiveness Research (COCER) Fellowship program.
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