Comparing Rural and Urban Cervical and Breast Cancer Screening Rates in a Privately Insured Population

Abstract

Low preventive screening varies by region and contributes to poor outcomes for breast and cervical cancer. Previous comparative urban and rural research on preventive screening has focused on government programs. This study quantified and compared rural and urban preventive cancer screening rates for women who were privately insured. National Quality Forum measures were used to calculate rates for women within rural and urban parts of the same Hospital Referral Region (HRR) using claims data. Mammography screening rates for women age 24 to 69 years were 77.1% in 2011 and 76.1% in 2008. Compared to urban women, mammography screening rates for women visiting rural physicians were lower in 42%, higher in 2% and identical in 56% of HRRs. Cervical cancer screening rates for women age 21 to 64 years were 82.9% in 2011 and 83.5% in 2008. Cervical cancer screening rates among women who saw rural physicians were lower in 55%, higher in 4%, and identical in 42% of HRRs. HRRs where rural areas underperformed urban areas increased between 2008 and 2011 for both screenings. Moderate but notable differences in women's preventive screening rates between rural and urban physicians highlight the need for practical solutions that increase use of screening services and reduce barriers to services in rural areas.

Breast, Cervical, and Colorectal Cancer Screening: Patterns Among Women With Medicaid and Commercial Insurance

“…34 Another recent claims-based study of breast and cervical cancer screening, from the commercially insured population, found rural residence as an important predictor of screening status. 35 These findings suggest that despite addressing the economic disparities in access to care through expanded insurance coverage and the elimination of out-of-pocket costs for these preventive cancer screenings, a complex matrix of logistic and sociocultural barriers to care persist. Increasing contact with primary care remains the critical first step to improving coordination of care.…”

Rural‐Urban Differences in Human Papillomavirus‐associated Cancer Trends and Rates

“…Given the delay between exposure and outcome, a more immediate strategy would be to increase cancer screening (eg, cervical) availability and utilization among rural residents. Studies have reported that rural residents are less likely to receive cancer screening than their urban peers . Further, rural residents are more likely to state cost as a factor in not receiving screening, have less access to specialty cancer care, not receive physician recommendations for screening, and experience higher rates of screening‐preventable cancers and higher cancer mortality .…”

Screening Results of Non-Communicable Diseases in Adult and Elderly People Living in the Rural Area; Cross-sectional Descriptive Study

“…In a study conducted with individuals working in agriculture, it was 7% (9). In a study conducted in the United States, the rate of individuals undergoing FOBT in rural areas was 22% (30). According to the results of our study, there is a substantial need of raising awareness regarding colorectal cancer screening in Turkey.…”