Rural, minority women need more breast, cervical cancer screenings









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Shingairai Feresu, Ph.D.

Health disparities for Nebraska’s rural and minority women still persist, according to a 10-year study of the state’s Every Woman Matters program. The study’s results are published in the August edition of the Journal of Health Care for the Poor and Underserved.

Nebraska was one of 12 sites across the United States to launch the prevention program after Congress passed the Breast and Cervical Cancer Mortality Prevention Act in 1990. At that time, 45 percent of Nebraska’s rural and minority women were not receiving potentially life-saving mammogram screenings.

“For women over 40, receiving a mammogram should be equal across income, education, racial and geographical levels,” said the study’s lead author, Shingairai Feresu, Ph.D., assistant professor in the College of Public Health. “Our study discovered rural, African American and Native American women were less likely to receive the screening.”

Dr. Feresu’s team of researchers found that rural women received clinical breast exams and pap tests from their local health care providers. However, obtaining a mammogram required additional travel for the patient to be seen by a specialty health care provider. The transportation barrier may explain the lack of additional screenings, Dr. Feresu said.

For minority women, the long-term results indicated that black and American Indian women were less likely to receive a clinical breast exam or have a mammogram ordered. Black women also were less likely to have a pap test.

“The results indicate a greater need to educate women, particularly with culturally sensitive messages, about the importance of these screenings,” Dr. Feresu said. “It also is imperative that we work with health professionals to provide culturally competent care.”







“The results indicate a greater need to educate women, particularly with culturally sensitive messages, about the importance of these screenings.”



Shingairai Feresu, Ph.D.



Providing crucial screenings to low-income, uninsured and underserved women has made a difference. Thanks to the screenings:
  • Mortality rates in Nebraska dropped from 34 percent in 1990 to 24 percent in 2002;
  • The number of women receiving screenings increased;
  • The percentage of women who did not receive mammograms dropped from 45 percent in 1990 to 20 percent in 2002;
  • Nebraska moved from 26th to 16th in the United States for the number of mammograms and pap tests performed;
  • The number of women who had not had a pap test in the state dropped from 20 percent in 1991 to 15 percent in 2002.

“This program has had a tremendous impact on the lives of women,” said Melissa Leypoldt, director of Every Woman Matters. “Of course, we can always do more to educate women on the importance of these screenings. We continue to evaluate the program looking for ways to serve women better.”

The Every Woman Matters project together with other efforts in the state of Nebraska might have helped to improve or increase the number of preventative screenings for breast and cervical cancer, Dr. Feresu said.

Other initiatives, which may have helped in improving screening, include other mobile screening programs that were brought to the Omaha and Winnebago reservations.

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