Assessing awareness and knowledge of breast and cervical cancer among Appalachian women

Nikki L Lyttle, Kelly Stadelman, Nikki L Lyttle, Kelly Stadelman

Abstract

Introduction: West Virginia is the only state that lies entirely within Appalachia. West Virginians tend to be poorer and more likely to lack health insurance than the general U.S. population. The purpose of this qualitative study was to 1) obtain an understanding of attitudes about breast and cervical cancer screening among women aged 25 to 64 years; 2) determine factors that motivate women to be screened for breast and cervical cancer; and 3) evaluate educational materials about breast and cervical cancer screening for use in this population.

Methods: The West Virginia Breast and Cervical Cancer Screening Program (WVBCCSP) is a comprehensive public health program, funded by the Centers for Disease Control and Prevention, dedicated to removing barriers to breast and cervical cancer screening and providing screenings to underserved women aged 25 to 64 years. The program partnered with RMS Strategies, Inc, to conduct six focus groups in three communities in West Virginia. Women were recruited by telephone based on program eligibility guidelines.

Results: Results indicated that women were concerned about health care costs and lack of health insurance. Cost, fear, and embarrassment were identified as the top barriers to breast and cervical cancer screening. Participants believed that community-based educational campaigns would increase screening and promote use of the WVBCCSP.

Conclusion: Understanding why low-income Appalachian women do not get screened for breast and cervical cancer and determining motivational factors that encourage screening are important to increase screening rates among this population. Breast and cervical cancer efforts that use the words, knowledge, and suggestions of the women they serve are more likely to be effective and have a larger impact.

References

    1. U.S. Census Bureau. Census 2000 demographic profile highlights: West Virginia. Washington (DC): U.S. Census Bureau; [cited 2005 Nov 1]. Available from:
    1. Lengerich EJ, Wyatt SW, Rubio A, Beaulieu JE, Coyne CA, Fleisher L, et al. The Appalachia Cancer Network: cancer control research among a rural, medically underserved population. J Rural Health. 2004;20(2):181–187.
    1. Appalachian Regional Commission. The Appalachian region. Washington (DC): Appalachian Regional Commission; [cited 2005 Nov 1]. Available from: .
    1. Couto RA, Simpson NK, Harris G. Sowing seeds in the mountains: community-based coalitions for cancer prevention and control. National Institutes of Health, National Cancer Institute; Bethesda (MD): 2004.
    1. U.S. Census Bureau. 2004 American Community Survey data profile highlights: West Virginia. Washington (DC): U.S. Census Bureau; [cited 2006 May 1]. Available from:
    1. Hall HI, Uhler RJ, Coughlin SS, Miller DS. Breast and cervical cancer screening among Appalachian women. Cancer Epidemiol Biomarkers Prev. 2002 Jan;11(1):137–142.
    1. American Cancer Society. Breast cancer facts & figures 2005–2006. American Cancer Society; Atlanta (GA): 2005. Available from: .
    1. West Virginia Cancer Registry. Cancer in West Virginia, incidence and mortality, 1993–2002. West Virginia Cancer Registry; Charleston: 2005. Available from: .
    1. Centers for Disease Control and Prevention. The National Breast and Cervical Cancer Early Detection Program 1991–2002 national report. Department of Health and Human Services; Atlanta (GA): 2005. Available from: .
    1. U.S. Preventive Services Task Force (USPSTF). Guide to clinical preventive services. 2nd ed. Washington (DC): U.S. Department of Health and Human Services, Office of Public Health and Science; 1996. pp. 105–117. Available from:
    1. Smith SL, Tessaro IA. Cultural perspectives on diabetes in an Appalachian population. Am J Health Behav. 2005;29(4):291–301.
    1. Willms DG, Best JA, Taylor DW, Gilbert JR, Wilson DMC, Lindsay EA, et al. A systematic approach for using qualitative methods in primary prevention research. Med Anthropol Q 1990;4(4):391–409.
    1. U.S. Department of Health and Human Services. The 2005 HHS poverty guidelines. Washington (DC): U.S. Department of Health and Human Services; Available from: .
    1. The New Mexico Department of Health. The New Mexico Breast and Cervical Cancer Early Detection Program brochure. New Mexico Department of Health; Albuquerque: 2006. Available from: .
    1. Krueger RA, Casey MA. Focus groups: a practical guide for applied research. 3rd ed. SAGE Publications; Thousand Oaks (CA): 2000.
    1. Rodriguez MA, Ward LM, Perez-Stable EJ. Breast and cervical cancer screening: impact of health insurance status, ethnicity, and nativity of Latinas. Ann Fam Med. 2005;3(3):235–241.
    1. Coughlin SS, Thompson TD, Hall HI, Logan P, Uhler RJ. Breast and cervical carcinoma screening practices among women in rural and nonrural areas of the United States, 1998-1999. Cancer. 2002;94(11):2801–2812.

Source: PubMed

3
Subscribe