TY - JOUR
T1 - Examining the roles of travel distance, medical mistrust, and cancer fatalism in the uptake of clinical cancer prevention among women in rural and urban US communities
T2 - A secondary data analysis
AU - Aruma, Jane Frances
AU - Hearn, Madison
AU - Bernacchi, Veronica
AU - Moss, Jennifer L.
N1 - Publisher Copyright:
© 2024 The Authors
PY - 2024/2
Y1 - 2024/2
N2 - Introduction: Rural adults are less likely to receive cancer screening than urban adults, likely due to systematic differences in community- and individual-level factors. The purpose of this study was to analyze the relative contributions of rurality, travel time, medical mistrust, and cancer fatalism in explaining uptake of clinical cancer prevention services. Methods: We conducted a secondary data analysis of 2019–2020 survey data from women, ages 45–65, in rural and urban counties in central Pennsylvania, examining rurality, travel time to a primary care provider, medical mistrust, and cancer fatalism, as well as uptake of guideline-recommended colorectal cancer screening, cervical cancer screening, and preventive check-up. Final models used multivariable logistic regression to assess the relationships among study variables, controlling for participant demographics. Results: Among 474 participants, 48.9 % resided in rural counties. Most participants had received clinical cancer prevention services (colorectal cancer screening: 55.4 %; cervical cancer screening: 82.8 %; preventive check-up in the last year: 75.4 %). Uptake of services was less common among participants with higher medical mistrust (colorectal cancer screening: adjusted odds ratio [aOR] = 0.87, 95 % confidence interval [CI] = 0.76–1.00; cervical cancer screening: aOR = 0.79, 95 % CI = 0.63–1.00; last-year check-up: aOR = 0.74, 95 % CI = 0.63–0.88). Conclusions: Patient attitudes, particularly medical mistrust, may contribute to rural/urban disparities in clinical cancer prevention among women. Community- and individual-level interventions are needed to improve cancer outcomes in rural areas.
AB - Introduction: Rural adults are less likely to receive cancer screening than urban adults, likely due to systematic differences in community- and individual-level factors. The purpose of this study was to analyze the relative contributions of rurality, travel time, medical mistrust, and cancer fatalism in explaining uptake of clinical cancer prevention services. Methods: We conducted a secondary data analysis of 2019–2020 survey data from women, ages 45–65, in rural and urban counties in central Pennsylvania, examining rurality, travel time to a primary care provider, medical mistrust, and cancer fatalism, as well as uptake of guideline-recommended colorectal cancer screening, cervical cancer screening, and preventive check-up. Final models used multivariable logistic regression to assess the relationships among study variables, controlling for participant demographics. Results: Among 474 participants, 48.9 % resided in rural counties. Most participants had received clinical cancer prevention services (colorectal cancer screening: 55.4 %; cervical cancer screening: 82.8 %; preventive check-up in the last year: 75.4 %). Uptake of services was less common among participants with higher medical mistrust (colorectal cancer screening: adjusted odds ratio [aOR] = 0.87, 95 % confidence interval [CI] = 0.76–1.00; cervical cancer screening: aOR = 0.79, 95 % CI = 0.63–1.00; last-year check-up: aOR = 0.74, 95 % CI = 0.63–0.88). Conclusions: Patient attitudes, particularly medical mistrust, may contribute to rural/urban disparities in clinical cancer prevention among women. Community- and individual-level interventions are needed to improve cancer outcomes in rural areas.
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U2 - 10.1016/j.pmedr.2024.102611
DO - 10.1016/j.pmedr.2024.102611
M3 - Article
C2 - 38375162
AN - SCOPUS:85183648913
SN - 2211-3355
VL - 38
JO - Preventive Medicine Reports
JF - Preventive Medicine Reports
M1 - 102611
ER -