Self-reported cancer screening among elderly Medicare beneficiaries: a rural-urban comparison

J Rural Health. Summer 2012;28(3):312-9. doi: 10.1111/j.1748-0361.2012.00405.x. Epub 2012 Apr 4.


Purpose: We examined the rural-urban disparity of screening for breast cancer and colorectal cancer (CRC) among the elder Medicare beneficiaries and assessed rurality's independent impact on receipt of screening.

Methods: Using 2005 Medicare Current Beneficiary Survey, we applied weighted logistic regression to estimate the overall rural-urban disparity and rurality's independent impact on cancer screening, controlling for patient, and area factors.

Results: From urban, large rural, small rural, and isolated rural areas, the rates for mammogram last year were 53%, 52%, 45%, and 44%, respectively. They were 56%, 50%, 48%, and 43% for CRC screening, respectively. After controlling for patient and area level characteristics, rurality is significantly associated with CRC screening, but not mammogram.

Conclusions: We found rural-urban disparities for both mammogram and CRC screenings. Patient and area factors totally eliminated the rural-urban disparity for mammogram but not CRC screening. Health promotions to improve cancer screening should focus more on small and isolated rural areas.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / prevention & control
  • Colorectal Neoplasms / prevention & control
  • Cross-Sectional Studies
  • Early Detection of Cancer / statistics & numerical data*
  • Female
  • Healthcare Disparities
  • Humans
  • Male
  • Medicare / statistics & numerical data*
  • Rural Population / statistics & numerical data*
  • Self Report
  • United States
  • Urban Population / statistics & numerical data*