The researchers expected that there would be differences in mammography rates based on race, as African-American cancer outcomes tend to be much worse than among whites. But the results came as a surprise: Mammography screening was significantly higher in non-Hispanic Black women than in non-Hispanic white women. This difference could not be explained by location or other factors.

In response to their findings, the researchers are urging public health interventions to increase colorectal cancer screening among rural women. For example, rural residents may benefit from campaigns to increase awareness of home colorectal cancer testing that can be done by mail.


"While the rural health disparities observed in this study present substantial public health challenges, it is possible to improve cancer outcomes through appropriate public health interventions," said Balkrishnan, of UVA's Department of Public Health Sciences. "Interventions that improve patient navigation and education related to the importance of cancer screenings have a potential to improve access and use of cancer screening in rural areas."

Findings Published

The research team has published its findings in the scientific journal JAMA Network Open. The team consisted of Sanjay Shete, Yangyang Deng, Jackilen Shannon, Babalola Faseru, Deirdre Middleton, Ronaldo Iachan, Brittany Bernardo, Rajesh Balkrishnan, Sunny Jung Kim, Bin Huang, Morgan M. Miller, Bernard Fuemmler, Jakob D. Jensen, Jason A. Mendoza, Jinxiang Hu, DeAnn Lazovich, Linda Robertson, Wendy Denmark-Wahnefried and Electra D. Paskett

for the Rural Workgroup of the Population Health Assessment in Cancer Center Catchment Areas Initiative. Paskett has received grants from the Merck Foundation, Pfizer and the Breast Cancer Research Foundation unrelated to the work.

The study was funded by the National Institutes of Health's National Cancer Institute, grants P30CA016058, P30CA044579-27S5, P30CA013148-46S5, P30 CA168524-07S2, P30 CA06953-20S1, P30CA047904-28S3, 3P30 CA177558-04S5, P30CA015704-43S4, P30 CA016059-30, 3P30CA069533, P30 CA042014-29S7, P30 CA082709-17S6, and P30CA016672. The work was also supported by the American Cancer Society, grant CRP-19-175-06-COUN, and CTSA Award UL1TR002366.


About UVA Health
UVA Health is an academic health system that recently expanded to include four hospitals across Charlottesville, Culpeper and Northern Virginia, along with the UVA School of Medicine, UVA School of Nursing, UVA Physicians Group and the Claude Moore Health Sciences Library. With more than 1,000 inpatient beds, approximately 40,000 inpatient stays annually and more than 1 million outpatient encounters annually at UVA Health, more than 1,000 employed and independent physicians provide high-quality, comprehensive and specialized care to patients across the Commonwealth and beyond. Founded in 1819 as just the 10th medical school in America, the UVA School of Medicine – with 21 clinical departments, eight basic science departments and six research centers – consistently attracts some of the nation's most prominent researchers to develop breakthrough treatments to benefit patients around the world. Those research efforts are backed by more than $200 million in grant funding. UVA Medical Center is recognized as the No. 1 hospital in Virginia for children by U.S. News & World Report, with five specialties rated among the top in America. More than 230 UVA physicians are honored on the Best Doctors in America list.

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