Service Agencies May Be Key to Increased Rural Cancer Screenings
Hershey, Pa. - Cancer prevention strategies aimed at medically underserved populations may be most successful when they engage trusted community organizations and service providers. A recent Penn State College of Medicine study found that educating women about breast cancer and available screening options at food pantries in rural Indiana County increased the number of free screenings provided to underserved county residents by 28 percent in one year.
For the study, researchers analyzed data from an initiative of the Indiana County Cancer Coalition to determine whether local adaptation of a nationally recognized cancer screening awareness program would improve rates of screening among rural women. The results were published recently in Journal of Rural Health.
Of 302 age-eligible (at least 40 years old) women, 158 had not had a mammogram in the previous year or had not followed up for a subsequent mammogram after an initial finding. The program provided 138 of these women with a mammogram, and for 13 of them, it was their first. Three women were diagnosed with early-stage breast cancer, and all three received treatment.
"The finding that this program could increase screening mammography is particularly exciting because the regular use of screening mammography in the United States has been decreasing in recent years, despite the overwhelming evidence that mammography saves lives," said senior author Eugene J. Lengerich, Department of Public Health Sciences and Penn State Hershey Cancer Institute. "The medical community is eager to find new ways to overcome this disturbing national trend. Our collaborative approach provides a potential blueprint for other communities or national organizations, since many of the study partners have national affiliations, to consider as they try to overcome barriers to access of this life-saving procedure."
In addition to reserchers from the College of Medicine, the study was authored by representatives of Penn State Cooperative Extension, the American Cancer Society, Adagio Health and the Indiana Regional Medical Center.
The Indiana County Cancer Coalition - a partnership between local agencies and organizations to address the cancer control needs of medically underserved families in Indiana County - formed a new partnership in 2005 with the Indiana County Community Action Program, which provides low-cost foods to low-income county residents through a network of 18 food pantries. The team adapted the American Cancer Society's Tell a Friend program, which relies on one-on-one contact to encourage friends and family to get a regular mammogram. The goal was to see whether such an evidence-based intervention would be successful for cancer prevention and control in a rural community setting.
National health organizations recommend that women older than 40 years of age have an annual screening mammogram. Women who are poor, are less educated, lack a usual source of care or reside in rural areas are less likely to receive screenings. Indiana County is part of Appalachia, a mostly rural region stretching from southern New York to Mississippi. Women in Appalachia are screened less often than other women in the United States, and breast cancer is more often diagnosed at late stages in this region than elsewhere in the country.
During the study, posters and fliers at pantry sites provided information about breast cancer and mammograms and let women know of an upcoming opportunity to enroll for a no-cost screening. During the following month, volunteers interviewed women visiting the food pantry to determine their screening eligibility. Women in need of a screening mammogram were referred for appointments as necessary. A media awareness campaign was included in the study enrollment period. Volunteers also helped assure a high rate of participation by phoning women to remind them of their appointment and to help overcome any transportation barriers.
The study was funded in part by the National Cancer Institute.
This press release courtesy of Penn State's Department of Public Information
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