Racial differences in knowledge, attitudes, and cancer screening practices among a triracial rural population

Authors

  • Electra D. Paskett Ph.D.,

    Corresponding author
    1. Division of Epidemiology and Biometrics, School of Public Health, The Ohio State University, Columbus, Ohio
    2. Center for Population Health and Health Disparities, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio
    • Center for Population Health and Health Disparities, The Ohio State University Comprehensive Cancer Center, 320 West 10th Avenue, Starling Loving Hall A356, Columbus, OH 43210-1240
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    • Fax: (614) 293-5611

  • Cathy Tatum M.A.,

    1. Center for Population Health and Health Disparities, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio
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  • Julia Rushing M.S.,

    1. Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina
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  • Robert Michielutte Ph.D.,

    1. Department of Family and Community Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina
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  • Ronny Bell Ph.D.,

    1. Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina
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  • Kristie Long Foley Ph.D.,

    1. Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina
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  • Marisa Bittoni M.S.,

    1. Center for Population Health and Health Disparities, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio
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  • Stephanie Dickinson M.A.S.

    1. Center for Population Health and Health Disparities, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio
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  • The views expressed herein do not necessarily reflect the opinions of the National Cancer Institute or the U.S. Government.

Abstract

BACKGROUND

Low-income, minority, and rural women face a greater burden with regard to cancer-related morbidity and mortality and are usually underrepresented in cancer control research. The Robeson County Outreach, Screening and Education Project sought to increase mammography use among low-income, minority, and rural women age > 40 years. The current article reports on racial disparities and barriers to screening, especially those related to knowledge, attitudes, and behaviors.

METHODS

A baseline survey was administered to 897 women age > 40 years who lived in rural Robeson County in North Carolina. The sample consisted of three principal racial groups: whites, African Americans, and Native Americans. Survey comparisons were made among racial groups with respect to knowledge, attitudes, and behaviors regarding breast and cervical carcinoma screening.

RESULTS

Overall, Native American and African-American women had lower levels of knowledge, more inaccurate beliefs, and more barriers to screening compared with white women. Among the notable findings were that 43% of the patient population did not mention mammograms and 53% did not mention Pap smears as breast and cervical carcinoma screening tests, respectively; furthermore, compared with white women, significantly fewer African-American and Native American women mentioned these tests (P < 0.001). Sixty-seven percent of all women reported that a physician had never encouraged them to receive a mammogram, although 75% reported having received a regular checkup in the preceding year.

CONCLUSIONS

Although all low-income rural women experienced significant barriers to receiving cancer screening tests, these barriers were more common for minority women compared with white women. More research is needed to identify ways to overcome such barriers, especially among Native American women. The results of the current study have important implications with respect to the designing of interventions aimed at improving cancer screening for all women. Cancer 2004. © 2004 American Cancer Society.

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