Health Service Accessibility and Risk in Cervical Cancer Prevention

Comparing Rural Versus Nonrural Residence in New Mexico

Yolanda J. McDonald, Daniel W. Goldberg, Isabel C. Scarinci, Philip E. Castle, Jack Cuzick, Michael Robertson, Cosette M. Wheeler

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Purpose: Multiple intrapersonal and structural barriers, including geography, may prevent women from engaging in cervical cancer preventive care such as screening, diagnostic colposcopy, and excisional precancer treatment procedures. Geographic accessibility, stratified by rural and nonrural areas, to necessary services across the cervical cancer continuum of preventive care is largely unknown. Methods: Health care facility data for New Mexico (2010-2012) was provided by the New Mexico Human Papillomavirus Pap Registry (NMHPVPR), the first population-based statewide cervical cancer screening registry in the United States. Travel distance and time between the population-weighted census tract centroid to the nearest facility providing screening, diagnostic, and excisional treatment services were examined using proximity analysis by rural and nonrural census tracts. Mann-Whitney test (P <.05) was used to determine if differences were significant and Cohen's r to measure effect. Findings: Across all cervical cancer preventive health care services and years, women who resided in rural areas had a significantly greater geographic accessibility burden when compared to nonrural areas (4.4 km vs 2.5 km and 4.9 minutes vs 3.0 minutes for screening; 9.9 km vs 4.2 km and 10.4 minutes vs 4.9 minutes for colposcopy; and 14.8 km vs 6.6 km and 14.4 minutes vs 7.4 minutes for precancer treatment services, all P <.001). Conclusion: Improvements in cervical cancer prevention should address the potential benefits of providing the full spectrum of screening, diagnostic and precancer treatment services within individual facilities. Accessibility, assessments distinguishing rural and nonrural areas are essential when monitoring and recommending changes to service infrastructures (eg, mobile versus brick and mortar).

Original languageEnglish (US)
Pages (from-to)382-392
Number of pages11
JournalJournal of Rural Health
Volume33
Issue number4
DOIs
StatePublished - Sep 1 2017

Fingerprint

Health Services Accessibility
Uterine Cervical Neoplasms
Preventive Health Services
Colposcopy
Preventive Medicine
Censuses
Registries
Geography
Continuity of Patient Care
Health Facilities
Therapeutics
Early Detection of Cancer
Population
Delivery of Health Care

Keywords

  • cervical cancer
  • cervical cancer prevention
  • geographic accessibility
  • health care accessibility
  • health service delivery

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Health Service Accessibility and Risk in Cervical Cancer Prevention : Comparing Rural Versus Nonrural Residence in New Mexico. / McDonald, Yolanda J.; Goldberg, Daniel W.; Scarinci, Isabel C.; Castle, Philip E.; Cuzick, Jack; Robertson, Michael; Wheeler, Cosette M.

In: Journal of Rural Health, Vol. 33, No. 4, 01.09.2017, p. 382-392.

Research output: Contribution to journalArticle

McDonald, Yolanda J. ; Goldberg, Daniel W. ; Scarinci, Isabel C. ; Castle, Philip E. ; Cuzick, Jack ; Robertson, Michael ; Wheeler, Cosette M. / Health Service Accessibility and Risk in Cervical Cancer Prevention : Comparing Rural Versus Nonrural Residence in New Mexico. In: Journal of Rural Health. 2017 ; Vol. 33, No. 4. pp. 382-392.
@article{8ccc69b0694e4d2d9ede6f00cc4aabfb,
title = "Health Service Accessibility and Risk in Cervical Cancer Prevention: Comparing Rural Versus Nonrural Residence in New Mexico",
abstract = "Purpose: Multiple intrapersonal and structural barriers, including geography, may prevent women from engaging in cervical cancer preventive care such as screening, diagnostic colposcopy, and excisional precancer treatment procedures. Geographic accessibility, stratified by rural and nonrural areas, to necessary services across the cervical cancer continuum of preventive care is largely unknown. Methods: Health care facility data for New Mexico (2010-2012) was provided by the New Mexico Human Papillomavirus Pap Registry (NMHPVPR), the first population-based statewide cervical cancer screening registry in the United States. Travel distance and time between the population-weighted census tract centroid to the nearest facility providing screening, diagnostic, and excisional treatment services were examined using proximity analysis by rural and nonrural census tracts. Mann-Whitney test (P <.05) was used to determine if differences were significant and Cohen's r to measure effect. Findings: Across all cervical cancer preventive health care services and years, women who resided in rural areas had a significantly greater geographic accessibility burden when compared to nonrural areas (4.4 km vs 2.5 km and 4.9 minutes vs 3.0 minutes for screening; 9.9 km vs 4.2 km and 10.4 minutes vs 4.9 minutes for colposcopy; and 14.8 km vs 6.6 km and 14.4 minutes vs 7.4 minutes for precancer treatment services, all P <.001). Conclusion: Improvements in cervical cancer prevention should address the potential benefits of providing the full spectrum of screening, diagnostic and precancer treatment services within individual facilities. Accessibility, assessments distinguishing rural and nonrural areas are essential when monitoring and recommending changes to service infrastructures (eg, mobile versus brick and mortar).",
keywords = "cervical cancer, cervical cancer prevention, geographic accessibility, health care accessibility, health service delivery",
author = "McDonald, {Yolanda J.} and Goldberg, {Daniel W.} and Scarinci, {Isabel C.} and Castle, {Philip E.} and Jack Cuzick and Michael Robertson and Wheeler, {Cosette M.}",
year = "2017",
month = "9",
day = "1",
doi = "10.1111/jrh.12202",
language = "English (US)",
volume = "33",
pages = "382--392",
journal = "Journal of Rural Health",
issn = "0890-765X",
publisher = "Wiley-Blackwell",
number = "4",

}

TY - JOUR

T1 - Health Service Accessibility and Risk in Cervical Cancer Prevention

T2 - Comparing Rural Versus Nonrural Residence in New Mexico

AU - McDonald, Yolanda J.

AU - Goldberg, Daniel W.

AU - Scarinci, Isabel C.

AU - Castle, Philip E.

AU - Cuzick, Jack

AU - Robertson, Michael

AU - Wheeler, Cosette M.

PY - 2017/9/1

Y1 - 2017/9/1

N2 - Purpose: Multiple intrapersonal and structural barriers, including geography, may prevent women from engaging in cervical cancer preventive care such as screening, diagnostic colposcopy, and excisional precancer treatment procedures. Geographic accessibility, stratified by rural and nonrural areas, to necessary services across the cervical cancer continuum of preventive care is largely unknown. Methods: Health care facility data for New Mexico (2010-2012) was provided by the New Mexico Human Papillomavirus Pap Registry (NMHPVPR), the first population-based statewide cervical cancer screening registry in the United States. Travel distance and time between the population-weighted census tract centroid to the nearest facility providing screening, diagnostic, and excisional treatment services were examined using proximity analysis by rural and nonrural census tracts. Mann-Whitney test (P <.05) was used to determine if differences were significant and Cohen's r to measure effect. Findings: Across all cervical cancer preventive health care services and years, women who resided in rural areas had a significantly greater geographic accessibility burden when compared to nonrural areas (4.4 km vs 2.5 km and 4.9 minutes vs 3.0 minutes for screening; 9.9 km vs 4.2 km and 10.4 minutes vs 4.9 minutes for colposcopy; and 14.8 km vs 6.6 km and 14.4 minutes vs 7.4 minutes for precancer treatment services, all P <.001). Conclusion: Improvements in cervical cancer prevention should address the potential benefits of providing the full spectrum of screening, diagnostic and precancer treatment services within individual facilities. Accessibility, assessments distinguishing rural and nonrural areas are essential when monitoring and recommending changes to service infrastructures (eg, mobile versus brick and mortar).

AB - Purpose: Multiple intrapersonal and structural barriers, including geography, may prevent women from engaging in cervical cancer preventive care such as screening, diagnostic colposcopy, and excisional precancer treatment procedures. Geographic accessibility, stratified by rural and nonrural areas, to necessary services across the cervical cancer continuum of preventive care is largely unknown. Methods: Health care facility data for New Mexico (2010-2012) was provided by the New Mexico Human Papillomavirus Pap Registry (NMHPVPR), the first population-based statewide cervical cancer screening registry in the United States. Travel distance and time between the population-weighted census tract centroid to the nearest facility providing screening, diagnostic, and excisional treatment services were examined using proximity analysis by rural and nonrural census tracts. Mann-Whitney test (P <.05) was used to determine if differences were significant and Cohen's r to measure effect. Findings: Across all cervical cancer preventive health care services and years, women who resided in rural areas had a significantly greater geographic accessibility burden when compared to nonrural areas (4.4 km vs 2.5 km and 4.9 minutes vs 3.0 minutes for screening; 9.9 km vs 4.2 km and 10.4 minutes vs 4.9 minutes for colposcopy; and 14.8 km vs 6.6 km and 14.4 minutes vs 7.4 minutes for precancer treatment services, all P <.001). Conclusion: Improvements in cervical cancer prevention should address the potential benefits of providing the full spectrum of screening, diagnostic and precancer treatment services within individual facilities. Accessibility, assessments distinguishing rural and nonrural areas are essential when monitoring and recommending changes to service infrastructures (eg, mobile versus brick and mortar).

KW - cervical cancer

KW - cervical cancer prevention

KW - geographic accessibility

KW - health care accessibility

KW - health service delivery

UR - http://www.scopus.com/inward/record.url?scp=85030643719&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85030643719&partnerID=8YFLogxK

U2 - 10.1111/jrh.12202

DO - 10.1111/jrh.12202

M3 - Article

VL - 33

SP - 382

EP - 392

JO - Journal of Rural Health

JF - Journal of Rural Health

SN - 0890-765X

IS - 4

ER -