October is Breast Cancer Awareness Month, and it’s also a good time to reflect on how breast cancer can uniquely pose a risk to women living and working in rural areas.
Catching breast cancer early is important in the successful treatment of the disease. Unfortunately, according to the Radiological Society of North America, only half of eligible women in the U.S. get regular exams.
Often, when rural women have breast cancer, it’s diagnosed at a later stage than women residing in urban and suburban regions. The earlier breast cancer is detected and treatment is begun, the higher the rate of survival. Consequently, the survival rate for rural breast cancer patients is lower than their less rural counterparts.
Dr. Amy Patel, medical director of Liberty University’s breast care center, addressed why rural women aren’t getting screened as often as they should. “Many rural women struggle to find nearby screenings,” she said.
According to data compiled by University of North Carolina’s Cecil G. Sheps Center for Health Services Research, over the last 18 years, 195 rural hospitals in the U.S. have either closed completely or converted to emergency care only. There are several reasons for this. In the year before closure, most rural hospitals suffer from a negative operating margin. In comparison with rural hospitals that remained open during that time period, most that closed were more unprofitable and less financially liquid.
Since women in rural regions encounter obstacles in traveling for their healthcare, including arranging for child care, long commutes and not being able to take too much time away from their agricultural operations, many simply forgo having regular exams.
Patel said that creative solutions may be required. “We need to look at all avenues to serve these patients, from boots-on-the-ground advocacy to mobile mammography,” she said.
Knowing when to start and how often to have screenings can help in the timely detection and treatment of breast cancer:
- Women aged 40 – 44 – These women should have the option of beginning annual screenings.
- Women aged 45 – 54 – Women in this age group should receive mammograms every year.
- Women aged 55 and up – This age group can continue with annual screenings, but the reduced risk posed to these women allows them to revert to screening every other year, should they want.
That said, although it’s rare, remember that men can also develop breast cancer. About one out of every 100 breast cancers diagnosed in the U.S. is found in a man, according to the CDC. Risk factors men should keep in mind include their age (as most breast cancers are found after age 50), a family history of the cancer, previous radiation therapy for another disease, liver disease (as it can lower androgen levels and raise estrogen levels) and being overweight or obese.
Another obstacle can be prohibitive costs for rural residents who are without health insurance. The CDC’s National Breast Cancer Early Detection Program provides reduced-cost and no-cost breast (and cervical) cancer screenings. Anyone interested in this program should call 888.842.6355 or visit cdc.gov/cancer/nbccedp.
by Enrico Villamaino
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