A study focused on Texas Medicare beneficiaries shows those who live in rural areas are less likely to undergo a mammogram than urban counterparts. The full results are published in the journal of Geriatric Nursing. [1]
Researchers from the University of Texas at Arlington said that previous studies have found breast cancer screening disparities when looking at factors such as race and age. However, they add there is limited data on how these factors interact with not only each other, but also with the location in which a patient lives.
The research team led by Zhaoli Liu, PhD, examined Texas-based Medicare data representing 114,939 older female Medicare beneficiaries (between the ages of 65 and 74) for their retrospective analysis. When digging into the data, they found women who lived in rural areas were less likely to receive screenings than those covered by Medicare in urban areas. When the data was further broken down, the results showed race also impacted the likelihood of a patient seeking and receiving a mammogram.
Liu and colleagues found that white women in rural areas were more likely than other races to be screened for breast cancer. However, compared to their urban counterparts, white women in rural Texas were screened 4% less often. Hispanic women in urban areas were 33% less likely to receive a mammogram, while non-Hispanic Black women in rural areas were about 22% less likely to undergo routine screening than those in urban areas.
The findings “highlight the importance of addressing rural racial disparities in mammography utilization,” Liu and co-authors wrote, emphasizing that outreach targeted at older women is likely lacking despite its importance.
The researchers broke down the data further, looking at different counties to see what factors contributed to higher rates of imaging. They discovered certain rural areas had additional barriers that reduced overall screening rates, including proximity to medical services. Further, patients with comorbidities, and those who lack a primary care provider, also were less likely to receive screenings, despite their elevated risk for having breast cancer.
“It is worth noting that Texas has the largest rural population and a significant proportion of Hispanic population,” the authors wrote, noting that rural populations in the U.S. are growing and becoming gradually more diverse.
The authors emphasized the need for targeted and effective mammography screening programs to address breast health disparities among minority populations in rural areas, particularly interventions that target older women with minority backgrounds.
To accomplish this, “efforts to reduce rural racial disparities among older women should not only address barriers related to healthcare access and socioeconomic factors but also consider their general health status, comorbidities, and life expectancy,” the authors wrote. They encourage care providers in rural areas to emphasize the importance of routine screenings, especially for those at higher risk for breast cancer.
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