Increasing Breast and Cervical Cancer Screening in Rural Populations: A Systematic Literature Review

Authors:

Joelle Atere-Roberts (Presenter)
Centers for Disease Control and Prevention

Ingrid J. Hall, Centers for Disease Control and Prevention
Judith Smith, Centers for Disease Control and Prevention

Public Health Statement: Despite widespread promotion of breast and cervical cancer (BCC) screening, uptake remains low in rural communities. Barriers to healthcare, which often result in poorer health outcomes, differentially impact residents of rural communities. Effective interventions addressing the unique needs of rural women are necessary to target these barriers and increase BCC screening participation.

Purpose: To review and assess the published literature on interventions to increase BCC screening in rural communities.

Methods/Approach: A systematic literature search of PubMed/Medline was performed to identify BCC screening interventions conducted in rural settings. English language articles from peer-reviewed journals published from January 2006 to December 2016 were included if they reported results for BCC screening interventions in rural communities in the United States.

Results: Our search yielded 228 articles that were reviewed and resulted in 21 articles matching our inclusion criteria. Studies varied in sample population characteristics, geographic location, design, and mode of intervention delivery. Interventions included community-based participatory research strategies, educational and mobile outreach programs, and telemedicine initiatives. Interventions focused on promoting uptake of initial or one-time screening and none targeted repeat screening. Few studies detailed the cost-effectiveness or theoretical foundations of the interventions.

Conclusions/Implications: Additional research is needed to examine the theoretical foundations, design, delivery, and cost-effectiveness of BCC screening interventions for rural communities. Future research should focus on methods to promote repeat BCC screening and effective translation of these interventions for other rural populations. This review may inform efforts to develop strategies to increase BCC screening among rural women.