UNASSIGNED: 13 Background: Screening mammography leads to early detection of @entity0 and improved survival. We conducted a survey of predominantly rural U.S. @entity1 who receive health insurance through the National Rural Electric Cooperative Association (NRECA) to evaluate the prevalence of annual and biennial screening and to identify potential disparities and barriers to @entity0 screening. METHODS: We conducted a national cross-sectional survey of @entity1 between ages 40 and 65 who are insured by the NRECA regarding their utilization of mammography screening and barriers to screening. A study specific survey was mailed to 2,000 randomly selected eligible @entity1 without prior diagnosis of @entity0 . We assessed demographics and receipt of mammography within past 12 months (all @entity1 ) and number of screening mammograms within the @entity7873 years (among @entity1 age 44 and older) to identify consistent annual screening and biennial screening patterns. RESULTS: 1,204 @entity1 responded to the survey (response rate 60.2%). 74% live in rural areas, 18% suburban, 8% urban. 73% report less than 4 years college education and 19% have family incomes <  50,000/year. Overall, 72% reported screening mammography within 12 months, 59% reported consistent annual screening and 84% reported at least biennial screening. Rural @entity1 were less likely to undergo consistent annual (56% vs. 66%, p = 0.003) or biennial screening (82% vs. 89%, p = 0.01) compared to @entity1 in non-rural areas. @entity1 under 50 were less likely to report screening within 12 months (67% vs. 77%, p = 0.0002), consistent annual (49% vs. 63%, p < 0.0001) or biennial screening (79% vs. 86%, p = 0.002). Significantly more rural @entity1 cited cost and distance as barriers, while busy schedule, fear of diagnosis, and fear of discomfort were important barriers among all demographic groups. Fear of the test was a greater barrier among younger vs. older @entity1 (p < 0.02). In univariate analysis; household income did not correlate with screening, and education was only a factor among younger @entity1 . CONCLUSIONS: A substantial percentage of rural U.S. @entity1 fail to undergo screening mammography. Potentially modifiable barriers include out of pocket expenses, convenience of screening, and fear of diagnosis and the test itself.

National survey of XXXX screening in rural America.

@entity1 :: ('9606', 'Species') :: ['Women', 'women'] @entity7873 :: ('30844', 'Gene') :: ['past 4'] @entity0 :: ('MESH:D001943', 'Disease') :: ['breast cancer']
@entity0 :: (MESH:D001943,Disease) :: ['breast cancer']
