Carole Bullock

HOUSTON — Rates of cervical cancer are higher for women living in rural areas than for those living in cities, Vicki Benard, Ph.D., reported at the annual meeting of the American Society of Preventive Oncology.

Dr. Benard of the Division of Cancer Prevention and Control at the Centers for Disease Control and Prevention reported cervical cancer rates among women in the United States, using the CDC's National Program of Cancer Registries, the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program, and the 2000 U.S. census.

Census county codes were used to categorize residents as rural, suburban, or metropolitan. A total of 39,946 cervical cancer cases were reported. Among metropolitan dwellers, the case rate was 11.8 per 100,000 residents; for those in the suburbs, the rate was 13.2 per 100,000; and for rural residents, the rate was 13.8 per 100,000, Dr. Benard reported.

When broken down demographically, black women had the highest rate of cervical cancer at 17.1 per 100,000 residents, followed by 11.4 per 100,000 for white women, 9.9 per 100,000 for Asian/Pacific Islanders, and 7.2 per 100,000 for American Indian/Alaska Natives. Age also factored into cervical cancer rates: Women aged 45 years or younger living in metro areas had a rate of 14.5 per 100,000, compared with 17.2 per 100,000 for rural women.

Dr. Benard and her colleagues speculated that the disparities are due to income, access to care, or quality of health care, but the study did not measure these factors. The study findings are especially timely, as screening and vaccinations against human papillomavirus become available. “Rural areas may need special education and outreach,” Dr. Benard said.

HOUSTON — Rates of cervical cancer are higher for women living in rural areas than for those living in cities, Vicki Benard, Ph.D., reported at the annual meeting of the American Society of Preventive Oncology.

Dr. Benard of the Division of Cancer Prevention and Control at the Centers for Disease Control and Prevention reported cervical cancer rates among women in the United States, using the CDC's National Program of Cancer Registries, the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program, and the 2000 U.S. census.

Census county codes were used to categorize residents as rural, suburban, or metropolitan. A total of 39,946 cervical cancer cases were reported. Among metropolitan dwellers, the case rate was 11.8 per 100,000 residents; for those in the suburbs, the rate was 13.2 per 100,000; and for rural residents, the rate was 13.8 per 100,000, Dr. Benard reported.

When broken down demographically, black women had the highest rate of cervical cancer at 17.1 per 100,000 residents, followed by 11.4 per 100,000 for white women, 9.9 per 100,000 for Asian/Pacific Islanders, and 7.2 per 100,000 for American Indian/Alaska Natives. Age also factored into cervical cancer rates: Women aged 45 years or younger living in metro areas had a rate of 14.5 per 100,000, compared with 17.2 per 100,000 for rural women.

Dr. Benard and her colleagues speculated that the disparities are due to income, access to care, or quality of health care, but the study did not measure these factors. The study findings are especially timely, as screening and vaccinations against human papillomavirus become available. “Rural areas may need special education and outreach,” Dr. Benard said.

HOUSTON — Rates of cervical cancer are higher for women living in rural areas than for those living in cities, Vicki Benard, Ph.D., reported at the annual meeting of the American Society of Preventive Oncology.

Dr. Benard of the Division of Cancer Prevention and Control at the Centers for Disease Control and Prevention reported cervical cancer rates among women in the United States, using the CDC's National Program of Cancer Registries, the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program, and the 2000 U.S. census.

Census county codes were used to categorize residents as rural, suburban, or metropolitan. A total of 39,946 cervical cancer cases were reported. Among metropolitan dwellers, the case rate was 11.8 per 100,000 residents; for those in the suburbs, the rate was 13.2 per 100,000; and for rural residents, the rate was 13.8 per 100,000, Dr. Benard reported.

When broken down demographically, black women had the highest rate of cervical cancer at 17.1 per 100,000 residents, followed by 11.4 per 100,000 for white women, 9.9 per 100,000 for Asian/Pacific Islanders, and 7.2 per 100,000 for American Indian/Alaska Natives. Age also factored into cervical cancer rates: Women aged 45 years or younger living in metro areas had a rate of 14.5 per 100,000, compared with 17.2 per 100,000 for rural women.

Dr. Benard and her colleagues speculated that the disparities are due to income, access to care, or quality of health care, but the study did not measure these factors. The study findings are especially timely, as screening and vaccinations against human papillomavirus become available. “Rural areas may need special education and outreach,” Dr. Benard said.

HOUSTON — Barriers to early detection of colorectal cancer among underserved patients include limited access to care and fatalistic beliefs about a cancer diagnosis, Aimee James, Ph.D., reported at the annual meeting of the American Society of Preventive Oncology.

“Fatalist views and myths were prevalent” in a focus-group study of 18 underserved patients. Such misconceptions included “the risk of 'going under the knife,' and dangers of exposing cancer to air,” said Dr. James, of the department of preventive medicine and public health, University of Kansas, Kansas City.

She and her associates interviewed patients at a federally funded community health center who volunteered to participate in focus group sessions. Most were unemployed, and 71% were uninsured. The study was funded by the American Cancer Society.

“Many said they knew nothing about colorectal cancer or expressed confusion about GI anatomy or what the tests might entail,” Dr. James said in an interview.

In regard to access to care, the main issues were not being able afford follow-up, not knowing where to go, or not having confidence in the care they would receive. Other barriers to early detection were negative attitudes about survival. “Some told us that surgery can cause cancer to spread, and they do believe that. The health care provider needs to address these belief systems,” Dr. James said.

Participants said that early detection improved outcomes, yet many doubted the effectiveness of treatment. As one patient put it, “When it's time for you to go, I don't care how many surgeries they do, how many pap smears you get, or how many times they scrape you clean, it's time to go.”

'Fatalist views and myths were prevalent' in a focus-group study of 18 underserved patients. DR. JAMES

HOUSTON — Barriers to early detection of colorectal cancer among underserved patients include limited access to care and fatalistic beliefs about a cancer diagnosis, Aimee James, Ph.D., reported at the annual meeting of the American Society of Preventive Oncology.

“Fatalist views and myths were prevalent” in a focus-group study of 18 underserved patients. Such misconceptions included “the risk of 'going under the knife,' and dangers of exposing cancer to air,” said Dr. James, of the department of preventive medicine and public health, University of Kansas, Kansas City.

She and her associates interviewed patients at a federally funded community health center who volunteered to participate in focus group sessions. Most were unemployed, and 71% were uninsured. The study was funded by the American Cancer Society.

“Many said they knew nothing about colorectal cancer or expressed confusion about GI anatomy or what the tests might entail,” Dr. James said in an interview.

In regard to access to care, the main issues were not being able afford follow-up, not knowing where to go, or not having confidence in the care they would receive. Other barriers to early detection were negative attitudes about survival. “Some told us that surgery can cause cancer to spread, and they do believe that. The health care provider needs to address these belief systems,” Dr. James said.

Participants said that early detection improved outcomes, yet many doubted the effectiveness of treatment. As one patient put it, “When it's time for you to go, I don't care how many surgeries they do, how many pap smears you get, or how many times they scrape you clean, it's time to go.”

'Fatalist views and myths were prevalent' in a focus-group study of 18 underserved patients. DR. JAMES

HOUSTON — Barriers to early detection of colorectal cancer among underserved patients include limited access to care and fatalistic beliefs about a cancer diagnosis, Aimee James, Ph.D., reported at the annual meeting of the American Society of Preventive Oncology.

“Fatalist views and myths were prevalent” in a focus-group study of 18 underserved patients. Such misconceptions included “the risk of 'going under the knife,' and dangers of exposing cancer to air,” said Dr. James, of the department of preventive medicine and public health, University of Kansas, Kansas City.

She and her associates interviewed patients at a federally funded community health center who volunteered to participate in focus group sessions. Most were unemployed, and 71% were uninsured. The study was funded by the American Cancer Society.

“Many said they knew nothing about colorectal cancer or expressed confusion about GI anatomy or what the tests might entail,” Dr. James said in an interview.

In regard to access to care, the main issues were not being able afford follow-up, not knowing where to go, or not having confidence in the care they would receive. Other barriers to early detection were negative attitudes about survival. “Some told us that surgery can cause cancer to spread, and they do believe that. The health care provider needs to address these belief systems,” Dr. James said.

Participants said that early detection improved outcomes, yet many doubted the effectiveness of treatment. As one patient put it, “When it's time for you to go, I don't care how many surgeries they do, how many pap smears you get, or how many times they scrape you clean, it's time to go.”

'Fatalist views and myths were prevalent' in a focus-group study of 18 underserved patients. DR. JAMES