Rectifying cancer disparities in rural Appalachia
Methods: BRFSS data for Kentucky were analyzed. Weighted percentages of screening rates were calculated and logistic regression analyses were performed. Subsequently, data from an intervention study being conducted in rural Appalachian Kentucky and pilot data from a study of FIT testing were analyzed.
Results: Overall, Pap testing in Kentucky has declined in the past 10 years. However, women in urban areas were 35% (P<.001) more likely to have a Pap test in the past three years compared to rural women. Similarly, women in non-Appalachia areas had a 48% (P<.001) increase compared to Appalachian. Also, people 50 or older in urban or non-Appalachia had a 41% increase in the odds of having ever having a sigmoidoscopy/colonoscopy compared to those in rural and/or Appalachia areas. Our Prevention Research Center conducted non-clinic based screening for HPV among rural Appalachian women overdue for Pap tests and found that about one-third tested positive for at least one oncogenic HPV strain; related navigation services were effective. Our PRC is also planning an acceptability trial of FIT testing for the early detection of colorectal cancers in this population.
Conclusion: Rural populations residing in Appalachian Kentucky have a disproportionate risk of cervical and colorectal cancer, requiring innovative outreach and screening methods.
Learning Areas:Administer health education strategies, interventions and programs
Advocacy for health and health education
Assessment of individual and community needs for health education
Chronic disease management and prevention
Communication and informatics
Conduct evaluation related to programs, research, and other areas of practice
Demonstrate rural disparities in screening for cervical and colorectal cancers Identify examples of potential interventions to rectify each disparity
Keyword(s): Rural Health, Cancer Screening
Qualified on the content I am responsible for because: I am the current director of the UK rural cancer prevention center and have served as PI on several research projects focusing on cancer prevention through uptake of appropriate screening.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.