Rural Residents And Cervical Cancer Rates

HOUSTON — Rates of cervical cancer are higher for women living in rural areas than for those living in cities, Vicki Benard, Ph.D., reported at the annual meeting of the American Society of Preventive Oncology.

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Census county codes were used to categorize residents as rural, suburban, or metropolitan. A total of 39,946 cervical cancer cases were reported. Among metropolitan dwellers, the case rate was 11.8 per 100,000 residents; for those in the suburbs, the rate was 13.2 per 100,000; and for rural residents, the rate was 13.8 per 100,000, Dr. Benard reported.

When broken down demographically, black women had the highest rate of cervical cancer at 17.1 per 100,000 residents, followed by 11.4 per 100,000 for white women, 9.9 per 100,000 for Asian/Pacific Islanders, and 7.2 per 100,000 for American Indian/Alaska Natives. Age also factored into cervical cancer rates: Women aged 45 years or younger living in metro areas had a rate of 14.5 per 100,000, compared with 17.2 per 100,000 for rural women.

Dr. Benard and her colleagues speculated that the disparities are due to income, access to care, or quality of health care, but the study did not measure these factors. The study findings are especially timely, as screening and vaccinations against human papillomavirus become available. “Rural areas may need special education and outreach,” Dr. Benard said.

Having worked in both environments--metro and rural--I can tell you that the findings are in line with my clinical experience, as far as cervical dysplasia is concerned. I was quite surprised at the prevalence of high-grade lesions in my rural patient population (mostly white, young, lower middle class/poor). And, at least in that population, access to care and quality of care were not significant issues.