Longitudinal patterns of breast cancer screening: mammography, clinical, and breast self-examinations in a rural and urban setting.

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

METHODS: 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).

FINDINGS: 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.

CONCLUSIONS: 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.