ASPO Abstracts
Identifying associations with cancer screening among women in rural, segregated communities
Category: Early Detection & Risk Prediction
Conference Year: 2021
Abstract Body:
Cancer incidence and mortality are higher among rural and racially-segregated communities; however, this
burden can be decreased through routine cancer screening. Thus, it is important to identify barriers and
facilitators to cancer screening among this vulnerable population to best address these disparities. This
mixed-methods study aimed to assess multilevel factors related to cancer screening among women from
14 rural, segregated counties in Pennsylvania. We recruited 100 participants (women ages 50-65) to
complete a quantitative survey. Then, we invited 16 of these participants to take part in qualitative focus
groups. The participants discussed attitudes and barriers surrounding colorectal and cervical cancer
screening tests. We used a concurrent mixed methods approach, using logistic regression to assess
quantitative relationships between multilevel factors and cancer screening, and content analysis to identify
themes related to cancer screening. In quantitative analysis, 89% and 65% of participants up-to-date with
cervical and colorectal cancer screening, respectively. Participants' travel time from their home to
provider's office moderated the relationship between cancer fatalism and screening. In qualitative analysis,
we identified three themes about multilevel barriers to cancer screening in this population: concerns about
privacy, medical mistrust, and logistical barriers (including travel time to providers, burden on family
members, and lack of local high-quality facilities). Therefore, compounding multilevel barriers may
decrease the likelihood to be screened for cancer. Many of the barriers to cancer screening identified in
this mixed methods study can be linked to the inadequate quality and continuity of care provided by local
health systems in rural and segregated communities. Future research should focus on ways to address the
multilevel barriers to cancer screening through primary care interventions to facilitate increased screening
rates with limited resources.
Keywords: Cancer Screening, Rural Health, Women's Health