This document summarizes a study examining differences in breast cancer screening patterns between rural and urban Australian women aged 50-64 years. The study used survey data from over 11,000 women participating in the Australian Longitudinal Study on Women's Health. The study identified six distinct patterns of breast cancer screening and found rural women were less likely to undergo mammography and clinical breast examinations but more likely to do breast self-examinations compared to urban women. Characteristics like geographic location, access to services, and socioeconomic status were associated with different screening patterns.

1. Breast cancer screening
patterns: Rural and urban
differences
Presenter: Janni Leung
Co-authors: Deirdre McLaughlin, Sam McKenzie, Jennifer
Martin, Annette Dobson

2. Rural and urban differences
in breast screening
Australian Longitudinal Study on Women’s Health

3. Data
The Australian Longitudinal Study on Women’s
Health
•Longitudinal cohort study of the health and well-being
of Australian women from 1996
•Funded by the Australian Government Department of
Health and Ageing
•Initial random sample of over 40,000 women
•1973-78 birth cohort (18-23 years)
•1946-51 birth cohort (45-50 years)
•1921-26 birth cohort (70-75 years)
•Women re-surveyed every 3 years
Australian Longitudinal Study on Women’s Health

4. Sample
Australian women
Age 50-55 years followed to 59-64 years
2001
N=11, 153
50-55 yrs
2004
N=10,105
53-58 yrs
Australian Longitudinal Study on Women’s
Health
2007
N=9783
56-61 yrs
2010
N=9103
59-64 yrs

5. Breast screening variables
1. Mammography service use,
77%
2. Clinical breast examinations,
71%
3. Breast self-examinations, 55%
Australian Longitudinal Study on Women’s Health

6. Rural urban definition: ARIA+
• 34% urban
• 41% inner regional
• 21% outer regional
• 4% remote

7. Results: Breast screening patterns
1.00
0.80
0.60
0.40
0.20
0.00
2001200420072010 2001200420072010 2001200420072010
Mammography service
use
Clinical breast
examination (CBE)
Breast self-examination
(BSE)
Probabilities
Class 1: BSE only screeners (9%)
Class 2: Non-screeners (7%)
Class 3: Mammogram only screeners (15%)
Class 4: Mammogram and CBE screeners (25%)
Class 5: Mammogram and BSE screeners (14%)
Class 6: All methods screeners (30%)

8. Results: Urban-rural differences in
patterns
Mammogram and CBE screeners:
Inner regional, outer regional, and remote less
likely
Mammogram and BSE screeners:
Inner regional, outer regional, and remote more
likely
Australian Longitudinal Study on Women’s Health

9. Conclusions
Australian Longitudinal Study on Women’s Health

10. Thank you
www.alswh.org.au
Janni Leung
j.leung1@uq.edu.au

11. Results: Characteristics of pattern
BSE only screeners:
Obese and not depressed
Mammogram only screeners:
Residing in outer regional areas, better access, born in
English speaking country, partnered.
Mammogram and CBE screeners:
Better access, born in English speaking country, partnered,
good financial status, satisfied with time use, not depressed.
Australian Longitudinal Study on Women’s Health

12. Results: Characteristics of pattern
Mammogram and BSE screeners:
Residing in regional and remote areas, better
mammogram access, partnered, obese, good financial
status, lower education, not depressed.
All methods screeners:
Better mammogram access, born in English speaking
country, partnered, good financial status, lower
education, not depressed.
Australian Longitudinal Study on Women’s Health

13. Results: Breast screening (Urban = ref)
3.50
3.00
2.50
2.00
1.50
1.00
0.50
0.00
Inner regional***
Outer regional***
Remote***
Inner regional
Outer regional
Remote
Inner regional*
Outer regional
Remote*
Inner regional
Outer regional
Remote***
Inner regional***
Outer regional***
Remote
Excellent or
very good ease
of obtaining a
Ever had a
mammogram†
Mammogram
in the last 2
years†
Clinical breast
examination†
Breast self-examination†
Adjusted odds ratios