A Brief Report Describing Cancer Outreach Events in the Rural Midwest

This brief report describes the findings of seven cancer prevention outreach efforts to rural locations in South Dakota and Minnesota with a specific focus on reaching agriculture workers and their families. The outreach events varied in size from a couple of hundred attendees to over 100,000 attendees. The purpose of these events also varied greatly from county fairs to health fairs. The goal of these outreach efforts was to connect with individuals in their communities in order to provide general cancer prevention and screening education and personalized cancer risk assessments. Methods used included one-on-one conversation between attendees and Avera Cancer Institute Navigation Center (ACINC) navigators as well as intake forms for individuals interested in personalized assessments. Findings showed the need for increased education on vulnerability to cancer and the need for cancer screenings. Moreover, findings indicated that smaller, focused, outreach events have the best outcomes in regards to the number of individuals directly receiving education on cancer screening and prevention.     

Rural Primary Care Providers’ Perceptions of Their Role in the Breast Cancer Care Continuum

Context: Rural women in the United States experience disparity in breast cancer diagnosis and treatment when compared to their urban counterparts. Given the 11% chance of lifetime occurrence of breast cancer for women overall, the continuum of breast cancer screening, diagnosis, treatment, and recovery are of legitimate concern to rural women and their primary care providers. Purpose: This analysis describes rural primary care providers’ perceptions of the full spectrum of breast cancer screening, treatment, and follow-up care for women patients, and it describes the providers’ desired role in the cancer care continuum. Method: Focus group interviews were conducted with primary care providers in 3 federally qualified community health centers serving a lower income, rural population. Focus group participants (N = 26) consisted of 11 physicians, 14 nurse practitioners, and 1 licensed clinical psychologist. Data were generated from audiotaped interviews transcribed verbatim and investigator field notes. Data were analyzed using constant comparison and findings were reviewed with a group of rural health professionals to judge the fit of findings with the emerging coding scheme. Findings: Provider relationships were characterized as being with women with cancer and comprised an active behind-the-scenes role in supporting their patients through treatment decisions and processes. Three themes emerged from the interview data: Knowing the Patient; Walking Through Treatment With the Patient; and Sending Them Off or Losing the Patient to the System. Conclusions: These findings should be a part of professional education for rural practitioners, and mechanisms to support this role should be implemented in practice settings.     

甘肃省基层地区乳腺癌筛查策略及结果分析

目的 探讨适合基层乳腺癌筛查的策略,调查甘肃省农村妇女乳腺癌的发病情况.方法 采用临床乳腺检查联合乳腺B超,选择性乳腺X线检查和病理活检的筛查方案,对甘肃省8 397名35～69岁妇女进行了乳腺癌筛查.结果 8 397名妇女共检出乳腺癌11例,检出率为131.0/10万（11/8 397）.11例乳腺癌患者中,导管内癌1例,浸润性导管癌9例,黏液癌1例;肿块直径＜2 cm者7例,＞2 cm者4例;0期1例,Ⅰ期4例,Ⅱ期4例,Ⅲ期1例,Ⅳ期1例.不同年龄段妇女乳腺癌检出率的差异有统计学意义（P＜0.05）,其中45～69岁妇女乳腺癌检出率明显高于35～44岁年龄段（P＜0.05）.结论 （1）应用临床乳腺检查联合乳腺B超,选择性乳腺X线检查和病理活检的筛查方案,检出率高,早期发现率高,医疗成本较低,适合基层推广;（2）本次筛查,甘肃省基层妇女乳腺癌检出率相对较高,开展乳腺癌筛查对乳腺癌的早期发现有重要意义.     

Variations in Guideline-Concordant Breast Cancer Adjuvant Therapy in Rural Georgia

ObjectiveTo examine factors associated with guideline-concordant adjuvant therapy among breast cancer patients in a rural region of the United States and to present an advancement in quality-of-care assessment in the context of multiple treatments.ConclusionsA number of factors were independently associated with receiving guideline-concordant adjuvant therapy. Identifying and addressing factors that lead to nonconcordance may reduce disparities in treatment and survival.     

镇江农村肿瘤高发的病因学研究

目的探讨农村肿瘤高发的病因,为采取预防措施提供依据。方法于2008-04/2009-12,选择肿瘤高发的1个洲2个村为观察区,选择环境相似的1个洲2个村为对照区,对比分析两区居民的肿瘤发生情况和相关影响因素。结果研究区肿瘤标化发病率497.64/10万,显著高于对照区肿瘤标化发病率187.42/10万（χ2=63.51,P〈0.01）,观察区和对照区前4位均为消化道肿瘤。肿瘤危险因素相对危险度OR值依次为：饮用水〉吃腌菜〉家族史〉常生气,13.712,8.235,4.185,P〈0.01,经常生气相对危险度OR=2.731,P〈0.05。OR值显示饮用水是影响肿瘤发生的主要危险因素。结论镇江地区农村肿瘤高发主要与饮用水相关,饮用水有机污染可能是镇江农村肿瘤高发的主要危险因素。