The study also found that Appalachian women who never or rarely get mammograms, which screen for breast cancer, usually don’t get pap-smears, which screen for cervical cancer, either, Allison Perry reports for UKNow.
Appalachian Kentucky has a 17 percent higher overall cancer death rate than the rest of the country, with a 67 percent higher incidence of invasive cervical cancer and a 33 percent higher death rate of invasive cervical cancer. Breast cancer is the 3rd leading cause of cancer in Kentucky.
Researchers talked to 222 women in six rural counties in Appalachian Kentucky to assess whether they followed cancer screening guidelines. The study, published in the journal Women & Health, found that 33 percent of the women had recently been screened for both breast and ovarian cancers and 48 percent were rarely or had never been screened for both.
The study also found four common reasons that would increase the odds that these women would never or rarely get screenings for breast and cervical cancer: embarrassment to get the test, a belief that not having insurance makes it difficult to get a Pap test, belief that a mammogram is only necessary if you have symptoms and lack of advice to get a mammogram from their doctor in the prior 12 months, Perry reports.
The belief that breast cancer screening is only necessary if a woman has symptoms is of particular concern to the researchers, Perry reports. Often, by the time a woman has symptoms or has a lump, the cancer has advanced. Women 40 and older should get a mammogram every one to two years. If all did, that could reduce the mortality rates by 20 to 25 percent over a decade, Perry reports.
“Our study findings reinforce the challenges to screening faced by many vulnerable and underserved women,” said Nancy Schoenberg, lead author on the paper and professor of behavioral science at the UK College of Medicine, told Perry. “Whether they experience inadequate knowledge, as shown in this research, or inadequate resources, as shown in other studies, many women find it difficult to obtain optimal preventive health care. Facilitating optimal prevention will reduce the huge toll cancer takes on women, their families and their communities.”
In an earlier paper, in Medical Anthropology Quarterly, Schoenberg and Elaine Drew of the Medical College of Wisconsin challenged the longstanding notion that fatalism (the belief in a lack of personal power or
control over destiny or fate) discourages Appalachians from modifying their health behaviors. Their studies of rural Appalachian women’s health
decisions surrounding cancer treatments “suggested that for
these women, numerous and complex factors—including inadequate access to health
services, a legacy of self-reliance, insufficient privacy, combined with a culturally
acceptable idiom of fatalism—foster the use of, but not necessarily a rigid conviction
in, the notion of fatalism,” the study report says.