Breast cancer screening patterns: Rural and urban

differences Presenter: Janni Leung

Co-authors: Deirdre McLaughlin, Sam McKenzie, Jennifer

Martin, Annette Dobson

Rural and urban differences in breast screening

Australian Longitudinal Study on Women’s Health

The Australian Longitudinal Study on Women’s Health•Longitudinal cohort study of the health and well-being of Australian women from 1996

•Funded by the Australian Government Department of Health and Ageing

•Initial random sample of over 40,000 women• 1973-78 birth cohort (18-23 years)• 1946-51 birth cohort (45-50 years)• 1921-26 birth cohort (70-75 years)

•Women re-surveyed every 3 years

Data

Australian Longitudinal Study on Women’s Health

Australian women Age 50-55 years followed to 59-64 years

Sample

Australian Longitudinal Study on Women’s Health

2001N=11, 15350-55 yrs

2004N=10,10553-58 yrs

2007N=9783

56-61 yrs

2010N=9103

59-64 yrs

1. Mammography service use, 77%

2. Clinical breast examinations, 71%

3. Breast self-examinations, 55%

Breast screening variables

Australian Longitudinal Study on Women’s Health

Rural urban definition: ARIA+

• 34% urban• 41% inner regional• 21% outer regional• 4% remote

Results: Breast screening patterns

2001

2004

2007

2010

2001

2004

2007

2010

2001

2004

2007

2010

Mammography service use

Clinical breast exam-ination (CBE)

Breast self-exam-ination (BSE)

0.00

0.20

0.40

0.60

0.80

1.00

Class 1: BSE only screeners (9%)Class 2: Non-screeners (7%)Class 3: Mammogram only screeners (15%)Class 4: Mammogram and CBE screeners (25%)Class 5: Mammogram and BSE screeners (14%)Class 6: All methods screeners (30%)

Pro

bab

ilit

ies

Mammogram and CBE screeners: Inner regional, outer regional, and remote less likely

Mammogram and BSE screeners: Inner regional, outer regional, and remote more likely

Results: Urban-rural differences in patterns

Australian Longitudinal Study on Women’s Health

Conclusions

Australian Longitudinal Study on Women’s Health

Thank youwww.alswh.org.au

Janni Leungj.leung1@uq.edu.au

BSE only screeners: Obese and not depressed

Mammogram only screeners: Residing in outer regional areas, better access, born in English speaking country, partnered.

Mammogram and CBE screeners: Better access, born in English speaking country, partnered, good financial status, satisfied with time use, not depressed.

Results: Characteristics of pattern

Australian Longitudinal Study on Women’s Health

Mammogram and BSE screeners: Residing in regional and remote areas, better mammogram access, partnered, obese, good financial status, lower education, not depressed.

All methods screeners:Better mammogram access, born in English speaking country, partnered, good financial status, lower education, not depressed.

Results: Characteristics of pattern

Australian Longitudinal Study on Women’s Health

Results: Breast screening (Urban = ref)

Inne

r re

gion

al**

*

Out

er r

egio

nal*

**

Rem

ote*

**

Inne

r re

gion

al

Out

er r

egio

nal

Rem

ote

Inne

r re

gion

al*

Out

er r

egio

nal

Rem

ote*

Inne

r re

gion

al

Out

er r

egio

nal

Rem

ote*

**

Inne

r re

gion

al**

*

Out

er r

egio

nal*

**

Rem

ote

Excellent or very good ease of ob-taining a

mammogram

Ever had a mammo-

gram†

Mammogram in the last 2

years†

Clinical breast exam-

ination†

Breast self-examination†

0.00

0.50

1.00

1.50

2.00

2.50

3.00

3.50

Adju

sted o

dds

ratio

s