US FARM WOMENS PARTICIPATION IN BREAST-CANCER SCREENING PRACTICES

Background. Surveys of women in the general population indicate that women are being screened for breast cancer at a much lower rate than recommended. There has been a concern that women living in rural areas may be screened for breast cancer even less often than women in urban or suburban areas because of reduced access to health practitioners. Methods. A random sample of farm women age 40 years or older from 4 rural counties in Michigan was surveyed on knowledge, attitudes, and use of breast cancer screening. Results. Six hundred eighty farm women completed a questionnaire. This was a response rate of 63.8%. The percentages of farm women who reported ever having had a mammogram, having had a mammogram in the past 3 years, and having had a mammogram in the last year were 80.6, 73.7, and 51.9%, respectively. The frequency of clinical breast examinations parallelled mammography usage at slightly higher percentages. Mammogram usage increased with higher education, income, and insurance coverage. Usage decreased in women age 75 years or older (ever 63.1%, in the last 3 years 58.2%, and in the last year 40.4%). Farm women were generally knowledgeable about symptoms and signs of breast cancer and understood the benefit of screening. There was, however, a range of answers on when to start or stop having a mammogram. Among farm women who reported not having a mammogram recently, the most important reasons were: haven't had any problems (29.4%), wasn't recommended by a doctor (14.3%), and procrastinated (11.3%). Conclusions. Farm women in this survey reported having had breast cancer screening at rates similar to or above those in the general population. Because of a limited response rate (63.5%) and the relative affluence of the farming community in the 4 counties surveyed, these results are probably not generalizable to all populations of farm or rural women.