Comparisons of Colorado women's cancer screening practices by residence: metropolitan, non-metropolitan, and farm.

Combining farm residents and non-farm rural residents into a single category designated as rural may obscure differences in preventive care utilization, including cancer screening practices in each group, because of distinctive characteristics of farmers. This study compared three cancer screening practices (mammography, breast physical examination, and Pap smears) across three residence groups (metropolitan, non-metropolitan, and farms) of Colorado women and described demographic and socioeconomic characteristics of the groups. Females interviewed in the 1993 Colorado Behavioral Risk Factor Surveillance System (BRFSS) were divided into residence as metropolitan or non-metropolitan. Farm residents were female respondents interviewed as part of the Colorado Farm Family Health and Hazard Survey (CFFHHS) conducted in 1993-1997. Univariate and multivariate analyses were conducted to determine characteristics related to the screening practices. Farm women were more likely to be non-Hispanic white and older, to report their health as very good, and to have medical insurance and at least one source of primary care compared to non-metropolitan women. After controlling for related variables, residence was not associated with the screening practices, with the exception of breast physical examination; farm women were less likely to have a recent examination than metropolitan women (OR = 1.50, 95% CI = 1.07-2.10). When non-metropolitan and farm women were combined, there was no association between residence and having had a physical breast examination. There were important differences between non-metropolitan women and farm women in demographic and socioeconomic characteristics, which influenced screening practices. Further studies are needed to examine farm residents' cancer screening practices separately from other rural residents in order to fully understand the implications of these differences for health status in other geographic areas.