Rural Cancer Disparities: Understanding Implications for Breast and Cervical Cancer Diagnoses

Carnahan, Leslie R.; Abdelrahim, Randa; Ferrans, Carol Estwing; Rizzo, Genevieve R; Molina, Yamilé; Handler, Arden

doi:10.1188/21.cjon.s1.10-16

Cited by 4 publications

(4 citation statements)

References 32 publications

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“…Accessibility has undoubtedly improved over time, but long-standing barriers to cervical cancer screening may remain for many rural females. A 2021 qualitative study of public health nurses in rural areas found that common barriers to cervical cancer screening include insufficient access to health care practitioners because of health care facility closures or consolidations; clinician shortages; lack of available appointments; and financial burdens, such as lack of insurance and underinsurance, inability to afford copayments, and/or inability to afford or access transportation to appointments . Other research suggests that the supply of primary care professionals serves as a mediator of the association between rural residence and cervical cancer .…”

Section: Discussionmentioning

confidence: 99%

“…A 2021 qualitative study of public health nurses in rural areas found that common barriers to cervical cancer screening include insufficient access to health care practitioners because of health care facility closures or consolidations; clinician shortages; lack of available appointments; and financial burdens, such as lack of insurance and underinsurance, inability to afford copayments, and/or inability to afford or access transportation to appointments. 22 Other research suggests that the supply of primary care professionals serves as a mediator of the association between rural residence and cervical cancer. 23 To facilitate an increase in Papanicolaou testing among rural residents, clinics may need to implement systems to remind clinicians and patients of their screening histories, increase the availability of clinic appointments, and accommodate residents’ schedules by offering screenings during evening or weekend hours or through mobile clinics.…”

Section: Discussionmentioning

confidence: 99%

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Cervical Cancer Screening Rates Among Rural and Urban Females, From 2019 to 2022

Borders,

Thaxton Wiggins

2024

JAMA Netw Open

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ImportanceLittle nationally representative research has examined Papanicolaou testing rates from before the pandemic in 2019 through the COVID-19 pandemic in 2022. Papanicolaou testing rates among rural females are a concern as they have historically had lower screening rates than their urban counterparts.ObjectiveTo examine the receipt of a Papanicolaou test in the past year among US females overall and females residing in rural and urban areas in 2019, 2020, and 2022.Design, Setting, and ParticipantsThis repeated cross-sectional study used data from 3 years of the Health Information National Trends Survey (HINTS), a nationally representative survey that asks respondents about cancer screenings, sources of health information, and health and health care technologies. Study participants were females aged 21 to 65 years. Individuals who received a Papanicolaou test more than 1 to 3 years prior to a HINTS interview were excluded as they were likely not due for a Papanicolaou test.ExposuresSurvey year (2019, 2020, and 2022) and rural or urban residence were the main exposure variables.Main Outcomes and MeasuresSelf-reported receipt of a Papanicolaou test within the past year.ResultsAmong the 188 243 531 (weighted; 3706 unweighted) females included in the analysis, 12.5% lived in rural areas and 87.5% in urban areas. Participants had a mean (SE) age of 43.7 (0.27) years and were of Hispanic (18.8%), non-Hispanic Asian (5.2%), non-Hispanic Black (12.2%), non-Hispanic White (59.6%), or non-Hispanic other (4.1%) race and ethnicity. In 2022, unadjusted past-year Papanicolaou testing rates were significantly lower among rural vs urban residents (48.6% [95% CI, 39.2%-58.1%] vs 64.0% [95% CI, 60.0%-68.0%]; P &lt; .001). Adjusted odds of past-year Papanicolaou testing were lower in 2022 than 2019 (odds ratio, 0.70; 95% CI, 0.52-0.95; P = .02).Conclusions and RelevanceThis repeated cross-sectional study found that past-year Papanicolaou testing rates were lower in 2022 than 2019, pointing to a need to increase access to screenings to prevent an uptick in cervical cancer incidence. Rural-vs-urban differences in 2022 indicate a need to specifically target rural females.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cervical Cancer Screening Rates Among Rural and Urban Females, From 2019 to 2022

Borders,

Thaxton Wiggins

2024

JAMA Netw Open

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“…In 2020, the World Health Organisation (WHO) reported that cervical cancer is the fourth most frequently diagnosed cancer in females. However, health inequalities contribute to significant disparities in cervical cancer diagnosis rates between rural and urban areas 1 . Socioeconomic factors and limited available healthcare resources reduce rural populations' access to diagnostic and therapeutic services 2–5 .…”

Section: Introductionmentioning

confidence: 99%

“…However, health inequalities contribute to significant disparities in cervical cancer diagnosis rates between rural and urban areas. 1 Socioeconomic factors and limited available healthcare resources reduce rural populations' access to diagnostic and therapeutic services. 2 , 3 , 4 , 5 Studies have demonstrated that cervical cancer incidence and mortality were higher among rural‐dwelling females than their urban counterparts.…”

Section: Introductionmentioning

confidence: 99%

Exploring the sources of cervical cancer screening self‐efficacy among rural females: A qualitative study

Zhang,

Sit,

Wang

et al. 2023

Health Expectations

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AimEvidence showed self‐efficacy was relevant to rural females' cervical cancer screening behaviour. However, little is known about sources of self‐efficacy in cervical cancer screening among rural females. This study aimed to explore sources of self‐efficacy in cervical cancer screening among rural females.DesignA qualitative descriptive study was conducted. Both users and providers of cervical cancer screening services in rural areas of China were recruited through maximum variation sampling.MethodsIndividual semi‐structured interviews through telephone calls were conducted. Data were analysed via six main stages of the framework method, with the social cognitive theory as a reference.ResultsFour main sources were identified, including personal screening experience, hearing about other women's screening experiences, professional health education and consultation, and emotional status. Personal screening experience included enactive mastery of completing the screening behaviour and cognitive mastery of internalisation of the screening. Only the experience of completing cervical cancer screening behaviour was not strong enough to improve self‐efficacy. Cognitive mastery showed more critical influence.ConclusionThese four sources of rural females' cervical cancer screening self‐efficacy matched with the major sources of self‐efficacy of the social cognitive theory. Cognition was critical to influencing the screening self‐efficacy. Intervention strategies aimed at enhancing rural females' cervical cancer screening self‐efficacy can be developed from these four major sources.Public ContributionA registered nurse with rich experience in cervical cancer‐related research and qualitative study was the interviewer of this study. Rural females and cervical cancer screening services providers (healthcare professionals and village staff) were recruited as interviewees. The interview guides were developed by the research team and evaluated by an expert panel including two nurse leaders of gynaecological cancer, one doctor specialised in cervical cancer, and one medical director in a local rural hospital.

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Opportunities, Challenges, and Priorities for Achieving Equity in Cancer Outcomes

Carpten,

Stern

2023

Cancer Health Disparities

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Rural Cancer Disparities: Understanding Implications for Breast and Cervical Cancer Diagnoses

Cited by 4 publications

References 32 publications

Cervical Cancer Screening Rates Among Rural and Urban Females, From 2019 to 2022

Cervical Cancer Screening Rates Among Rural and Urban Females, From 2019 to 2022

Exploring the sources of cervical cancer screening self‐efficacy among rural females: A qualitative study

Opportunities, Challenges, and Priorities for Achieving Equity in Cancer Outcomes

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