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The Making of Medicine

A Cancer Screening Disparity Among Rural Women

Women who live in rural areas are more likely to get screened for breast cancer than colorectal cancer, a new study from our Rajesh Balkrishnan, PhD, finds.

Balkrishnan and his colleagues looked at survey responses from 2,897 women, ages 50 to 75, at 11 sites around the country, including here at UVA. They found that about 81% of both urban and rural women were getting breast cancer screenings, but only 78% were up to date on colorectal cancer screening.

Urban women, meanwhile, were significantly more likely to get screened for colorectal cancer than their rural counterparts. The survey found that 82% of urban women were in compliance with colorectal cancer screening guidelines.

So what's behind the disparity? The researchers hypothesize that fewer rural residents may be getting screened for colorectal cancer because they don’t have easy access to testing. Travel times, for example, may be a barrier, and people may find it hard to take time off from work. (They also note that women who have health insurance were two to three times more likely to comply with breast cancer and colorectal cancer screening guidelines than women who don't have insurance.)

The research team is calling for new interventions to help reduce the screening disparities. For example, promoting the availability of at-home testing for colorectal cancer may help boost usage. Those tests can be done by mail, making them an attractive option for people who otherwise have to drive a long way to see a doctor, or who have a hard time taking time off work.

“While the rural health disparities observed in this study present substantial public health challenges, it is possible to improve cancer outcomes through appropriate public health interventions,” said Professor Balkrishnan, of our Department of Public Health Sciences. “Interventions that improve patient navigation and education related to the importance of cancer screenings have a potential to improve access and use of cancer screening in rural areas.”

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