Breast, cervical, and colorectal carcinoma screening in a demographically defined region of the southern U.S.

Steven Scott Coughlin, Trevor D. Thompson, Laura Seeff, Thomas Richards, Fred Stallings

Research output: Contribution to journalArticle

66 Citations (Scopus)

Abstract

BACKGROUND. The "Southern Black Belt," a term used for > 100 years to describe a subregion of the southern U.S., includes counties with high concentrations of African Americans and high levels of poverty and unemployment, and relatively high rates of preventable cancers. METHODS. The authors analyzed data from a state-based telephone survey of adults age ≥ 18 years to compare the cancer screening patterns of African-American and white men and women in nonmetropolitan counties of this region, and to compare those rates with those of persons in other southern counties and elsewhere in the U.S. The primary study groups were comprised of 2165-5888 women and 1198 men in this region interviewed through the Behavioral Risk Factor Surveillance System. The respondents lived in predominantly rural counties in 11 southern states with sizeable African-American populations (≥ 24.5% of county residents). The main outcome measures were recent use of the Papanicolau (Pap) test, mammography, test for fecal occult blood in the stool (FOBT), and flexible sigmoidoscopy or colonoscopy. RESULTS. Between 1998-2000, 66.3% (95% confidence interval [95% CI] ± 2.7%) of 1817 African-American women in the region age ≥ 40 years had received a mammogram within the past 2 years, compared with 69.3% (95% CI ± 1.8%) of 3922 white women (P = 0.066). The proportion of African-American and white women who had received a Pap test within the past 3 years was similar (85.7% [95% CI ± 1.9%] vs. 83.4% [95% CI ± 1.5%]; P = 0.068]. In 1997 and 1999, 29.3% of African-American women in these counties reported ever receiving an FOBT, compared with 36.9% in non-Black Belt counties and 42.5% in the remainder of the U.S. Among white women, 37.7% in Black Belt counties, 44.0% in non-Black Belt counties, and 45.3% in the remainder of the U.S. ever received an FOBT. Overall, similar patterns were noted among both men and women with regard to ever-use of FOBT, flexible sigmoidoscopy, or colonoscopy. Screening rates appeared to vary less by race than by region. CONCLUSIONS. The results of the current study underscore the need for continued efforts to ensure that adults in the nonmetropolitan South receive educational messages, outreach, and provider recommendations concerning the importance of routine cancer screening.

Original languageEnglish (US)
Pages (from-to)2211-2222
Number of pages12
JournalCancer
Volume95
Issue number10
DOIs
StatePublished - Nov 15 2002
Externally publishedYes

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Colorectal Neoplasms
African Americans
Breast Neoplasms
Occult Blood
Confidence Intervals
Sigmoidoscopy
Colonoscopy
Early Detection of Cancer
Behavioral Risk Factor Surveillance System
Unemployment
Mammography
Poverty
Telephone
Outcome Assessment (Health Care)
Population
Neoplasms

Keywords

  • Breast carcinoma
  • Cancer prevention and control
  • Cervical carcinoma
  • Colorectal carcinoma
  • Fecal occult blood testing (FOBT)
  • Flexible sigmoidoscopy
  • Papanicolaou (Pap) tests
  • Screening mammography

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Breast, cervical, and colorectal carcinoma screening in a demographically defined region of the southern U.S. / Coughlin, Steven Scott; Thompson, Trevor D.; Seeff, Laura; Richards, Thomas; Stallings, Fred.

In: Cancer, Vol. 95, No. 10, 15.11.2002, p. 2211-2222.

Research output: Contribution to journalArticle

Coughlin, Steven Scott ; Thompson, Trevor D. ; Seeff, Laura ; Richards, Thomas ; Stallings, Fred. / Breast, cervical, and colorectal carcinoma screening in a demographically defined region of the southern U.S. In: Cancer. 2002 ; Vol. 95, No. 10. pp. 2211-2222.
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T1 - Breast, cervical, and colorectal carcinoma screening in a demographically defined region of the southern U.S.

AU - Coughlin, Steven Scott

AU - Thompson, Trevor D.

AU - Seeff, Laura

AU - Richards, Thomas

AU - Stallings, Fred

PY - 2002/11/15

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N2 - BACKGROUND. The "Southern Black Belt," a term used for > 100 years to describe a subregion of the southern U.S., includes counties with high concentrations of African Americans and high levels of poverty and unemployment, and relatively high rates of preventable cancers. METHODS. The authors analyzed data from a state-based telephone survey of adults age ≥ 18 years to compare the cancer screening patterns of African-American and white men and women in nonmetropolitan counties of this region, and to compare those rates with those of persons in other southern counties and elsewhere in the U.S. The primary study groups were comprised of 2165-5888 women and 1198 men in this region interviewed through the Behavioral Risk Factor Surveillance System. The respondents lived in predominantly rural counties in 11 southern states with sizeable African-American populations (≥ 24.5% of county residents). The main outcome measures were recent use of the Papanicolau (Pap) test, mammography, test for fecal occult blood in the stool (FOBT), and flexible sigmoidoscopy or colonoscopy. RESULTS. Between 1998-2000, 66.3% (95% confidence interval [95% CI] ± 2.7%) of 1817 African-American women in the region age ≥ 40 years had received a mammogram within the past 2 years, compared with 69.3% (95% CI ± 1.8%) of 3922 white women (P = 0.066). The proportion of African-American and white women who had received a Pap test within the past 3 years was similar (85.7% [95% CI ± 1.9%] vs. 83.4% [95% CI ± 1.5%]; P = 0.068]. In 1997 and 1999, 29.3% of African-American women in these counties reported ever receiving an FOBT, compared with 36.9% in non-Black Belt counties and 42.5% in the remainder of the U.S. Among white women, 37.7% in Black Belt counties, 44.0% in non-Black Belt counties, and 45.3% in the remainder of the U.S. ever received an FOBT. Overall, similar patterns were noted among both men and women with regard to ever-use of FOBT, flexible sigmoidoscopy, or colonoscopy. Screening rates appeared to vary less by race than by region. CONCLUSIONS. The results of the current study underscore the need for continued efforts to ensure that adults in the nonmetropolitan South receive educational messages, outreach, and provider recommendations concerning the importance of routine cancer screening.

AB - BACKGROUND. The "Southern Black Belt," a term used for > 100 years to describe a subregion of the southern U.S., includes counties with high concentrations of African Americans and high levels of poverty and unemployment, and relatively high rates of preventable cancers. METHODS. The authors analyzed data from a state-based telephone survey of adults age ≥ 18 years to compare the cancer screening patterns of African-American and white men and women in nonmetropolitan counties of this region, and to compare those rates with those of persons in other southern counties and elsewhere in the U.S. The primary study groups were comprised of 2165-5888 women and 1198 men in this region interviewed through the Behavioral Risk Factor Surveillance System. The respondents lived in predominantly rural counties in 11 southern states with sizeable African-American populations (≥ 24.5% of county residents). The main outcome measures were recent use of the Papanicolau (Pap) test, mammography, test for fecal occult blood in the stool (FOBT), and flexible sigmoidoscopy or colonoscopy. RESULTS. Between 1998-2000, 66.3% (95% confidence interval [95% CI] ± 2.7%) of 1817 African-American women in the region age ≥ 40 years had received a mammogram within the past 2 years, compared with 69.3% (95% CI ± 1.8%) of 3922 white women (P = 0.066). The proportion of African-American and white women who had received a Pap test within the past 3 years was similar (85.7% [95% CI ± 1.9%] vs. 83.4% [95% CI ± 1.5%]; P = 0.068]. In 1997 and 1999, 29.3% of African-American women in these counties reported ever receiving an FOBT, compared with 36.9% in non-Black Belt counties and 42.5% in the remainder of the U.S. Among white women, 37.7% in Black Belt counties, 44.0% in non-Black Belt counties, and 45.3% in the remainder of the U.S. ever received an FOBT. Overall, similar patterns were noted among both men and women with regard to ever-use of FOBT, flexible sigmoidoscopy, or colonoscopy. Screening rates appeared to vary less by race than by region. CONCLUSIONS. The results of the current study underscore the need for continued efforts to ensure that adults in the nonmetropolitan South receive educational messages, outreach, and provider recommendations concerning the importance of routine cancer screening.

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KW - Cancer prevention and control

KW - Cervical carcinoma

KW - Colorectal carcinoma

KW - Fecal occult blood testing (FOBT)

KW - Flexible sigmoidoscopy

KW - Papanicolaou (Pap) tests

KW - Screening mammography

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