Background: Minority women residing in rural geographic communities bear a disproportionate burden of mortality due to invasive breast cancer compared to other racial/ethnic majority groups. Despite this heightened rate of mortality, preventative screening in African American (AA) and Hispanic (H) women is significantly lower than that of Non-Hispanic White (NHW) women. The purpose of this study is to identify and validate the barriers associated with non-compliance to recommended breast cancer screening guidelines in AA and H women in rural geographic regions.

Methods: A prior observational analysis conducted by RHEAI using data from the Texas Cancer Registry (TCR), U.S. Census Bureau, and Survey Epidemiology and End Results (SEER) Database identified Cherokee County, Texas as having significant disparity in breast cancer screening and mortality rates when comparing AA, H, and NHW women. To gauge this disparity, we collected opinions about breast cancer screening and mortality incidence by surveying 13 local stakeholders (including breast cancer survivors, religious leaders, community leaders, local hospital employees and educators) within the minority community. Based on stakeholder survey results and health disparity literature reviews, a relevant and culturally sensitive survey was developed using the 5-point Likert scale to identify the perceived barriers to breast cancer screening in the general minority community. A total of 115 surveys of AA and H women were planned. The sample size was calculated based on the percentage of AA and H women residing in Cherokee County with a 95% level of confidence and a +5% margin of error.

Results: 115 surveys were completed online via Facebook Survey (n=62) and in printed form (n=53) between 06/2012 and 05/2013. Median age of participants was 49 years (range 28-64), 73% were AA women and 27% were H women residing in rural Cherokee County. Lack of breast cancer educational/awareness programs, limited transportation access, and lack of mammography facilities were identified as barriers associated with decreased adherence to breast cancer screening guidelines. Identified barriers varied based on participant age, familial breast cancer history, and education level.

Conclusions: The results of this study demonstrate that minority women in rural areas are willing to comply with recommended screening guidelines if they have access to appropriate educational tools and screening facilities. RHEAI is currently working with community stakeholders to design and initiate a region-wide culturally relevant breast cancer screening and prevention educational/awareness program.

Citation Format: Monique J. Carter. Identifying barriers to breast cancer screening guideline adherence among minority women residing in rural geographical regions: Final analysis. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr A31. doi:10.1158/1538-7755.DISP13-A31

©2014 American Association for Cancer Research.
2014