According to a survey of low-income, rural women over age 40, nearly 7 out of 10 say their physicians have never prompted them to get a mammogram.

Moreover, the new report found that more than 40 percent of the women did not know mammograms check for breast cancer, and half did not know that Pap smears check for cervical cancer.

Overall, African-American and Native American knew less about cancer screening than white women, the authors report in the journal Cancer.

“Although all low-income rural women experienced significant barriers to receiving cancer screening tests, these barriers were more common for minority women, compared with white women,” write the researchers, led by Dr. Electra D. Paskett of the Ohio State University in Columbus.

More research is needed to investigate how to “overcome such barriers,” they add.

Currently, the American Cancer Society recommends that every woman over 40 should receive an annual mammogram. Low-income women are more likely to die of breast cancer, largely due to the fact that many are diagnosed with the disease at a later stage than women with higher incomes, the team points out.

For their study, Paskett and colleagues interviewed 897 women over the age of 40 about cancer screening. None had received a mammogram within the past 12 months.

All of the women received care through the Robeson Health Care Corporation (RHCC), a health care provider in North Carolina. Most RHCC clients live below the poverty level, and most are minorities.

Paskett and her colleagues found that 43 percent of women, when asked about breast cancer screening, did not mention mammograms. African-American and Native American women were less likely to know about the screening test than white women.

One-quarter of women also said they had never had a mammogram; African-Americans were most likely to report never getting the test.

More than one-half of women did not know that Pap tests check for cervical cancer, although nearly all had received one. Again, white women were more likely to recognize that this test served as a screen for cervical cancer.

Two-thirds of the participants said that a doctor had never encouraged them to seek a mammogram, although 75 percent said they had received a regular checkup within the last 12 months.

Many women said they didn’t have time for a mammogram, and that they were embarrassed, scared of the radiation or pain, or believed that if they felt okay, a mammogram was not necessary.

The researchers conclude that their findings have “important implications” for designing programs “aimed at improving cancer screening for all women.”

SOURCE: Cancer, December 1, 2004.