Comparison of breast and cervical cancer screening utilization among rural and urban Hispanic and American Indian women in the Southwestern United States

Nuño, Tomas; Gerald, Joe K.; Harris, Robin B.; Martı́nez, Marı́a Elena; Estrada, Antonio; García, Francisco

doi:10.1007/s10552-012-0012-0

Cited by 34 publications

(28 citation statements)

References 39 publications

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“…24 Research has shown an inverse association between educational attainment and cancer mortality. 25 Several studies also report decreased access to cancer screening and worse outcomes for women in rural areas, 26, 27 although one Chicago study showed an urban disadvantage. 28 …”

Section: Discussionmentioning

confidence: 99%

Paths to health equity: Local area variation in progress toward eliminating breast cancer mortality disparities, 1990‐2009

Rust

Zhang

Malhotra

et al. 2015

Cancer

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Background U.S. breast cancer deaths have been declining since 1989, but African American women are still more likely than white women to die of breast cancer. Black-white disparities in breast cancer mortality rate-ratios have actually been increasing. Methods Across 762 U.S. counties with enough deaths to generate reliable rates, we examined county-level age-adjusted breast cancer mortality rates for women aged 35–74 during the period 1989–2010. Twenty-two years of mortality data generated 20 three-year rolling average data points, each centered on a specific year from 1990 – 2009. We used mixed linear models to group each county into one of four mutually exclusive trend patterns. We also categorized the most recent three-year average black breast cancer mortality rate for each county as being worse than or not worse than the breast cancer mortality rate for the total U.S. population. Results More than half of counties (54%) showed persistent, unchanging disparities. Roughly one in four (24%) had a divergent pattern of worsening black-white disparities. However, 10.5% of counties sustained racial equality over the 20-year period, and 11.7% of counties actually showed a converging pattern from high disparities to greater equality. Twenty-three counties had 2008–2010 black mortality rates better than the U.S. average mortality rate. Conclusion Disparities are not inevitable. Four U.S. counties have sustained both optimal and equitable black outcomes, as measured by both absolute (better than US average) and relative (equality in local black-white rate-ratio) benchmarks for decades, while six counties have shown a path from disparities to health equity.

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Section: Discussionmentioning

confidence: 99%

Paths to health equity: Local area variation in progress toward eliminating breast cancer mortality disparities, 1990‐2009

Rust

Zhang

Malhotra

et al. 2015

Cancer

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“…In a study conducted in Spain, cervical cancer screening coverage and the prevalence of abnormal cervical cytology was examined in Catalonia by immigration status in over 1 million women. The study showed that immigrants had higher screening rates than Spanish-born women, but were more likely to have abnormal cervical cytology (2.9 vs. 4.5%), highlighting an increased risk for cervical disease in immigrant populations [77,78]. …”

Section: Health Literacy and Immigration Statusmentioning

confidence: 99%

Racial/Ethnic Disparities in Cervical Cancer Screening and Outcomes

et al. 2016

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Invasive cervical cancer disproportionately affects women without sufficient access to care, with higher rates among minority groups in higher-income countries and women in low-resource regions of the world. Many elements contribute to racial/ethnic disparities in the cervical cancer continuum - from screening and diagnosis to treatment and outcome. Sociodemographic factors, access to healthcare, income and education level, and disease stage at diagnosis are closely linked to such inequities. Despite the identification of such elements, racial/ethnic disparities persist, and are widening in several minority subgroups, particularly in older women, who are ineligible for human papillomavirus (HPV) vaccination and are underscreened. Recent studies suggest that racial/ethnic differences in HPV infection exist and may also have a role in observed differences in cervical cancer. In this review, we provide an overview of the current literature on racial disparities in cervical cancer screening, incidence, treatment and outcome to inform future strategies to reduce persistent inequities.

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“…Most screening studies intended to increase cancer screening rates focus on specific vulnerable and marginalized populations known to have low cancer screening rates [2-10], such as: immigrants [11-17], ethnic minorities [2,11,15,18,19], underserved populations [20,21], uninsured [11,18,20], individuals with mental health issues [22-24], indigenous populations [4,15,25,26] and rural residents [15,27,28]. These vulnerable and marginalized populations tend to be localized geographically, resulting in community or neighbourhood level studies designed to inform changes at the local level and to be generalizable to other vulnerable and marginalized populations in other geographic locations.…”

Section: Introductionmentioning

confidence: 99%

Who are the under- and never- screened for cancer in Ontario: a qualitative investigation

et al. 2014

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BackgroundObserved breast, cervical and colon cancer screening rates are below provincial targets for the province of Ontario, Canada. The populations who are under- or never-screened for these cancers have not been described at the Ontario provincial level. Our objective was to use qualitative methods of inquiry to explore who are the never- or under-screened populations of Ontario.MethodsQualitative data were collected from two rounds of focus group discussions conducted in four communities selected using maps of screening rates by dissemination area. The communities selected were archetypical of the Ontario context: urban, suburban, small city and rural. The first phase of focus groups was with health service providers. The second phase of focus groups was with community members from the under- and never- screened population. Guided by a grounded theory methodology, data were collected and analyzed simultaneously to enable the core and related concepts about the under- and never-screened to emerge.ResultsThe core concept that emerged from the data is that the under- and never-screened populations of Ontario are characterized by diversity. Group level characteristics of the under- and never- screened included: 1) the uninsured (e.g., Old Order Mennonites and illegal immigrants); 2) sexual abuse survivors; 3) people in crisis; 4) immigrants; 5) men; and 6) individuals accessing traditional, alternative and complementary medicine for health and wellness. Under- and never-screened could have one or multiple group characteristics.ConclusionThe under- and never-screened in Ontario comprise a diversity of groups. Heterogeneity within and intersectionality among under- and never-screened groups adds complexity to cancer screening participation and program planning.

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Comparison of breast and cervical cancer screening utilization among rural and urban Hispanic and American Indian women in the Southwestern United States

Cited by 34 publications

References 39 publications

Paths to health equity: Local area variation in progress toward eliminating breast cancer mortality disparities, 1990‐2009

Paths to health equity: Local area variation in progress toward eliminating breast cancer mortality disparities, 1990‐2009

Racial/Ethnic Disparities in Cervical Cancer Screening and Outcomes

Who are the under- and never- screened for cancer in Ontario: a qualitative investigation

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