Rural–urban differences in breast and colorectal cancer screening among US women, 2014–2019

Introduction: Prior research has revealed rural populations have lower rates of breast and colorectal cancer screening compared to their urban counterparts in the United States. 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 investigates disparities in breast and colorectal cancer screening between urban and rural women in the United States.
Methods: This cross-sectional study analyzed the Behavioral Risk Factor Surveillance System (BRFSS) data 2014-2019. Focusing on women aged 50-74, this study evaluates the prevalence of breast cancer and colorectal cancer (CRC) screening overall and by urban-rural locations using multivariable logistic regressions.
Results: During the study period, the adjusted prevalence of breast cancer screening was 80.0% vs. 77.1%(p<0.001) in urban vs rural settings. The adjusted CRC screening prevalence was 72.8% vs. 68.4%(p<0.001) in urban vs rural settings, respectively. By year, this study found that by 2019 there was no significant difference in urban vs rural screening; 80.8% vs. 79.6% in breast cancer and 78.9% vs. 76.6% in CRC screening in urban vs rural groups, respectively. Screening disparities existed between different racial groups.
Conclusions: Breast cancer and CRC screening disparities between urban and rural women have narrowed however continue to exist within these groups. The implementation of screening initiatives targeting under screened rural regions and racial groups continues to be necessary.