Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10019, USA
Joseph J Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA
Rural Remote Health. 2022 Sep;22(3):7339. doi: 10.22605/RRH7339. Epub 2022 Sep 11.
Prior research has revealed rural populations have lower rates of breast and colorectal cancer screening compared to their urban counterparts in the USA. An increasing number of rural hospitals have closed, with rural residents reporting skipping diagnosing imaging and preventative care due to a lack of access. Considering increasing rural hospital closures, this study investigated disparities in breast and colorectal cancer screening between urban and rural women in the USA.
This cross-sectional study analyzed the Behavioral Risk Factor Surveillance System (BRFSS) data 2014-2019. Focusing on women aged 50-74 years, this study evaluated the prevalence of breast cancer and colorectal cancer (CRC) screening overall and by urban-rural location using multivariable logistic regressions.
During the study period, the adjusted prevalences of breast cancer screening were 80.0% and 77.1% (p<0.001) in urban and rural settings, respectively. The adjusted CRC screening prevalences were 72.8% and 68.4% (p<0.001) in urban and rural settings, respectively. By year, this study found that by 2019 there was no significant difference between urban and rural screening: 80.8% versus 79.6% in breast cancer and 78.9% versus 76.6% in CRC screening in urban and rural groups, respectively. Screening disparities existed between different racial groups.
Breast cancer and CRC screening disparities between urban and rural women have narrowed; however, they continue to exist within these groups. The implementation of screening initiatives targeting underscreened rural regions and racial groups continues to be necessary.
先前的研究表明，与美国的城市居民相比，农村居民的乳腺癌和结直肠癌筛查率较低。随着越来越多的农村医院关闭，农村居民报告由于缺乏获得途径而跳过诊断性影像学检查和预防性护理。考虑到农村医院的关闭数量不断增加，本研究调查了美国城乡女性在乳腺癌和结直肠癌筛查方面的差异。
本横断面研究分析了 2014 年至 2019 年期间的行为风险因素监测系统（BRFSS）数据。本研究重点关注年龄在 50-74 岁的女性，使用多变量逻辑回归评估了乳腺癌和结直肠癌（CRC）筛查的总体流行率以及城乡地区的流行率。
在研究期间，城市和农村地区调整后的乳腺癌筛查率分别为 80.0%和 77.1%（p<0.001）。城市和农村地区调整后的 CRC 筛查率分别为 72.8%和 68.4%（p<0.001）。按年份来看，本研究发现到 2019 年，城乡之间的筛查率没有显著差异：乳腺癌分别为 80.8%和 79.6%，CRC 分别为 78.9%和 76.6%。不同种族群体之间存在筛查差异。
城乡女性之间的乳腺癌和结直肠癌筛查差距已经缩小；然而，这些群体内部仍然存在差距。继续针对筛查不足的农村地区和种族群体实施筛查计划仍然是必要的。
