Study: Rural ND women get later cancer diagnosis

GRAND FORKS - Women living in rural North Dakota are less likely to have their breast cancer diagnosed until it has reached an advanced stage, according to a recent University of North Dakota study.
One of the authors of the study, fourth-year medical student Krishan Jethwa said this highlights rural women’s lack of easy access to mammograms and the need for greater awareness of the disease among rural residents.
The study followed a group of 260 white women, ages 29 to 94, who were receiving treatment at a Fargo cancer center. They had no prior cancer history.
About 38 percent of the women lived within 15 miles of Fargo, about 28 percent lived more than 60 miles away and the rest fell in between.
Other study authors are fourth-year students Brooke Settergren and Brittany Berg, and their professor, James Beal.
Less access
Jethwa, who wants to go into oncology after graduating in May, said he hypothesizes that rural women don’t get mammograms as frequently as those living in cities because they have to travel farther for them.
If rural women aren’t screened for breast cancer as often, there could be fewer chances for cancer to be detected, he said. “As travel distance increases, those women who were diagnosed with breast cancer were diagnosed at higher stages.”
Women between ages 50 and 75 are encouraged to have a mammogram every year, Jethwa said. Some doctors also suggest that women ages 40 to 50 should have one every other year, he said.
Rural areas also generally have trouble accessing all types of health care, even regular physicians, he said. That could also contribute to rural women not being screened for breast cancer because typically a physician refers a patient to mammography, he said.
Women can schedule a mammogram without a physician’s help, though, he said.
There are 26 cities in North Dakota that offer mammography services daily, according to the North Dakota Department of Health website. There are also 35 cities that receive limited service by one of five mobile mammography providers in the state.
Breast cancer is also not as well publicized in rural areas, Jethwa said, which contributes to low awareness of the disease.
The results of the study and his hypothesis about the rural women’s need for mammograms, he said, are consistent with other medical literature that shows rural women around the nation not having adequate access to health care.
Jethwa said he plans to eventually do further research into comparing the rate of women who get mammograms in rural versus urban North Dakota.