title: Colorectal cancer screening practices among men and women in rural and nonrural areas of the United States, 1999.
abstract: BACKGROUND
  Previous studies have suggested that men and women in rural areas are less likely than those in urban areas to receive routine cancer screening.
  
  
  METHODS
  We examined the colorectal cancer screening practices of men (n = 23,565) and women (n = 37,847) aged > or = 50 years living in rural areas and other areas of the United States using data from the 1999 Behavioral Risk Factor Surveillance System (BRFSS). Geographic areas of residence were classified as rural areas and small towns, suburban areas and small metropolitan areas, and larger metropolitan areas using US Department of Agriculture (USDA) urban/rural continuum codes.
  
  
  RESULTS
  The estimated median response rate across states was 55.2%. Approximately 16.2% (95% confidence interval [CI] = 15.3% to 17.2%) of persons aged > or = 50 years who resided in rural areas had received a fecal occult blood test in the past year, compared with 22.0% of those living in the larger metropolitan areas (95% CI = 21.4% to 22.7%). About 28.2% (95% CI = 27.1% to 29.4%) of those who resided in rural areas had received a sigmoidoscopy or colonoscopy in the past 5 years, compared with 35.2% of those in the larger metropolitan areas (95% CI = 34.5% to 36.0%).
  
  
  CONCLUSIONS
  These results underscore the need for continued efforts to increase colorectal cancer screening in the United States. Special efforts may be required to increase screening in rural areas.
authors.affiliation: Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy, NE (K-55), Atlanta, GA 30341, USA. sic9@cdc.gov
authors.forename: Steven S
authors.initials: SS
authors.lastname: Coughlin
authors.forename: Trevor D
authors.initials: TD
authors.lastname: Thompson
mesh_terms: D017677:Age Distribution; D000368:Aged; D040343:Behavioral Risk Factor Surveillance System; D003113:Colonoscopy / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000097:blood / Q000453:epidemiology / Q000208:ethnology / Q000517:prevention & control*; D005260:Female; D005843:Geography; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D015999:Multivariate Analysis; D009780:Occult Blood; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D019035:Rural Health Services / Q000706:statistics & numerical data*; D017678:Sex Distribution; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D019037:Urban Health Services / Q000706:statistics & numerical data*