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    Breast and Cervical Cancer Screening Patterns among Rural Hispanic and American Indian Women in Arizona

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    Author
    Nuño, Thomas
    Issue Date
    2011
    Keywords
    Health disparities
    Hispanic
    Rural health
    Women's health
    Epidemiology
    American Indian
    Cancer screening
    Advisor
    Harris, Robin
    
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    Show full item record
    Publisher
    The University of Arizona.
    Rights
    Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
    Abstract
    Breast and cervical cancer disparities among Hispanic and American Indian women are a significant public health problem. Breast cancer is the most common neoplasm among Hispanic women. Cervical cancer has a higher incidence and mortality among Hispanic women compared to non-Hispanic White women. Breast cancer detection often comes late for American Indian women and breast cancer survival for this population is relatively poor. Hispanic and American Indian women who reside in rural areas of Arizona are especially at-risk of non-participation in breast and cervical cancer screening programs. This dissertation utilized data from two sources: a health-education intervention trial designed to increase mammography screening among women living in a rural area along the U.S.-Mexico border of Arizona and survey data from multiple years of the Arizona Behavioral Risk Factor Survey (BRFS) focusing on breast and cervical cancer screening self-reported behaviors. The purpose of the dissertation research was to identify factors associated with cancer screening behaviors among Hispanic and American Indian women that reside in rural Arizona settings. Hispanic women who participated in the promotora-based educational intervention program were more likely to report receiving a mammogram at the followup compared to women who did not participate in the program. Results from both the baseline community survey and the BRFS showed that Hispanic women who received prior recommendations from a clinician to get both mammography and Pap smear were more likely to report they received a mammogram within the past year and a Pap smear within the past three years. Rural Hispanic and American Indian women reported lower rates of ever having had breast and cervical cancer screening compared to their urban counterparts. Breast and cervical cancer screening use in these populations can potentially be increased with at least two strategies. First, clinician recommendation of both mammograms and Pap smears and opportunistic screening during regular clinic visits may increase breast and cervical cancer screening coverage. Secondly, culturallyappropriate interventions that utilize promotoras or lay health advisors could increase screening rates. In conclusion, Hispanic and American Indian women that reside in rural areas of Arizona, whether throughout the State or along the U.S.-Mexico border, are two underserved populations in Arizona with low rates of breast and cervical cancer screening that need to be addressed in order to reduce the burden of cancer in these populations.
    Type
    text
    Electronic Dissertation
    Degree Name
    Ph.D.
    Degree Level
    doctoral
    Degree Program
    Graduate College
    Epidemiology
    Degree Grantor
    University of Arizona
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