Original article| Volume 24, ISSUE 1, e139-e146, January 2014

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Longitudinal Patterns of Breast Cancer Screening: Mammography, Clinical, and Breast Self-Examinations in a Rural and Urban Setting



      We identified breast screening patterns over time and patterns among women residing in rural and urban areas by sociodemographic factors.


      This study employs a longitudinal design over 9 years from 2001 on 11,200 women aged 50 to 55 from the Australian Longitudinal Study on Women's Health. Area of residence was defined in accordance with the accessibility remoteness index of Australia Plus. Breast screening measures included mammography utilization, clinical breast examinations (CBE), and breast self-examinations (BSE).


      Most women had a mammogram in the past 2 years in combination with CBE or BSE or both. Despite poorer access to mammography services, women residing in rural areas had similar mammography screening rates to their urban counterparts. Women residing in rural areas were less likely to have CBEs, but more likely to conduct BSEs. The breast screening behaviors were generally consistent over time.


      The poorer breast cancer survival among rural women is unlikely to be explained by differences in mammography service use. A substantial proportion of the population may be experiencing overscreening by conducting all three types of breast screening.
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      Janni Leung, BHS, is a PhD candidate at The University of Queensland School of Population Health. Her research examines inequalities in breast cancer health services by socio-demographic factors and area of residence.


      Samantha McKenzie, PhD, is a Biostatistics lecturer at the School of Population Health. Her research interests are behavior and welfare and women's health, including the needs of mid-age and older women, their chronic conditions, mental health, service use, and caring responsibilities.


      Jennifer Martin, PhD, is Head of the PA-Southside Clinical School. She is a University of Otago medical graduate with specialty training in internal medicine and clinical pharmacology.


      Annette Dobson, PhD, is the director of the Women's Health Australia project. She is also Professor of Biostatitics with the School of Population Health. Her specific interests include smoking, ageing, rural health, cardiovascular disease, obesity and health services research.


      Deirdre McLaughlin, PhD, is a Senior Research Fellow with the Australian Longitudinal Study on Women's Health. Her current role includes managing data linkage activities. Her research interests is around ageing, including the impact of chronic conditions, rural and urban differences in mortality and morbidity, gender differences associated with ageing issues and psychosocial factors associated with ageing well.