UTILIZATION OF CANCER EARLY DETECTION SERVICES AMONG FARM AND RURAL NONFARM ADULTS IN IOWA

An increase in the proportion of advanced malignancies among rural res idents has been noted and may be due to a combination of factors, incl uding availability of screening services, demographic characteristics, and access to health care facilities. A cross-sectional study was con ducted in 33 nonmetropolitan Iowa counties among randomly selected mid dle-aged farm and rural nonfarm adults to compare utilization of cance r early detection services. A total of 1,126 adults in 600 farm househ olds and 1,092 adults in 589 rural nonfarm households provided informa tion through a 155-item in-home interview. Differences in income, age, and health insurance coverage (including preventive services) between the farm and nonfarm study populations were found. Although farm men were less likely to have had a checkup during the past year than men i n the nonfarm population, no difference was found for women. Overall, differences in screening behaviors were small. Larger differences betw een both populations were observed for use of mammograms, prostate exa minations among men age 50 and older, use of sigmoidoscopy among women age 50 and older, and skirt cancer examinations among both sexes. Whe n controlling for demographic characteristics and insurance coverage, members of the farm and rural nonfarm population were equally likely t o use multiple screenings according to ACS guidelines. Because of the increased the risk of breast cancer, interventions aimed at increasing utilization of mammography among women age 50 and older should be imp lemented. Although the farm population was more likely to use skin exa minations, prevalence should be increased substantially to counteract the continuing rise in skin cancer.