Background: Rural counties in Virginia have significantly higher overall cancer mortality compared to the state. Virginia is one of a few states that has both breast and colorectal cancer hotspots, driven primarily by mortality rates among African Americans. The Virginia Living Well Research and Registry (VALW), a community registry, was developed in collaboration with community partners to collect critical patient reported outcomes, including cancer protective and risk behaviors that can be tracked longitudinally. We assessed participation in cancer screening and five cancer protective behaviors, with comparison by geographical residence and race. Method: In-person and electronic recruitment by community-based staff enrolled adults (18+ years) living in Virginia, focusing on predominantly rural counties.
Surveys were completed in-person, by phone or online. Questions included cancer screening (breast, cervical, colorectal), five cancer protective behaviors (physical activity, sleep, alcohol, BMI, smoking status) and demographics. Rural residence was defined using RUCC codes and calculated from mailing addresses. Results: To date, 586 participants are enrolled; 74% are rural (RUCC 4-9), 47% are Black/African American and 70% identify as female. Rural residents reported significantly lower household income (Χ2=25:p< .000), greater use of Medicare (Χ2=4.5:p=.034) and lower (pre-COVID) unemployment (Χ2=7.1:p=.008) compared to urban participants. White participants reported significantly more alcohol use (Χ2=5.6:p=.003), greater sleep disturbance (Χ2=5.6:p=.018) and lower BMI(Χ2=33.4:p<.000) compared to Black participants. Screening rates among those eligible were 82% biennial mammography, 72.3% pap (every 3yr.), 11% annual FIT tests and 77% colonoscopy. 18% reported current tobacco use. No differences in cancer screening, smoking or physical activity were identified by race or rural residence. Only 26% engaged in 4/5 or 5/5 of the assessed cancer protective behaviors. Conclusion: In this geographically and racially diverse sample, engagement in cancer screening was high with no identified racial or geographical disparities, reflecting in part, our long-term community engagement and strong community partnerships. Overall engagement in multiple cancer protective behaviors was low, while tobacco use was higher than the national rate. In addition to screening promotion, cancer prevention efforts in rural communities could leverage successful approaches used to promote screening to also address modifiable lifestyle factors. Finally, the geographical and racial diversity of this sample is strength.
Citation Format: Maria D. Thomson, A. Williams, M.A. Preston, A.L. Sutton, V.B. Sheppard. The Virginia Living Well Research and Registry: A community registry to assess cancer screening and lifestyle behaviors among rural Virginia residents [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-023.