Department of Community and Preventive Medicine, University of Rochester, Rochester, New York, USA.
J Rural Health. 2012 Summer;28(3):312-9. doi: 10.1111/j.1748-0361.2012.00405.x. Epub 2012 Apr 4.
We examined the rural-urban disparity of screening for breast cancer and colorectal cancer (CRC) among the elder Medicare beneficiaries and assessed rurality's independent impact on receipt of screening.
Using 2005 Medicare Current Beneficiary Survey, we applied weighted logistic regression to estimate the overall rural-urban disparity and rurality's independent impact on cancer screening, controlling for patient, and area factors.
From urban, large rural, small rural, and isolated rural areas, the rates for mammogram last year were 53%, 52%, 45%, and 44%, respectively. They were 56%, 50%, 48%, and 43% for CRC screening, respectively. After controlling for patient and area level characteristics, rurality is significantly associated with CRC screening, but not mammogram.
We found rural-urban disparities for both mammogram and CRC screenings. Patient and area factors totally eliminated the rural-urban disparity for mammogram but not CRC screening. Health promotions to improve cancer screening should focus more on small and isolated rural areas.
我们考察了老年医疗保险受益人中乳腺癌和结直肠癌（CRC）筛查的城乡差异，并评估了农村地区对接受筛查的独立影响。
我们使用 2005 年 Medicare 现行受益人调查，应用加权逻辑回归来估计癌症筛查的总体城乡差异和农村地区的独立影响，同时控制患者和地区因素。
来自城市、大农村、小农村和偏远农村地区的人去年进行乳房 X 光检查的比例分别为 53%、52%、45%和 44%。进行 CRC 筛查的比例分别为 56%、50%、48%和 43%。在控制患者和地区特征后，农村地区与 CRC 筛查显著相关，但与乳房 X 光检查无关。
我们发现了乳腺癌和 CRC 筛查的城乡差异。患者和地区因素完全消除了乳房 X 光检查的城乡差异，但没有消除 CRC 筛查的城乡差异。改善癌症筛查的健康促进措施应更多地关注小农村和偏远农村地区。
