Differences in Rural and Urban Perceptions and Behaviors to Prevent Cervical Cancer: A Secondary Analysis of the Health Information National Trends Survey

More than 12,000 cases of cervical cancer are diagnosed in the U.S. every year, resulting in greater than 4,000 deaths. Fewer women in rural United States obtain pap smears, and more rural women die from cervical cancer than do women in urban areas. Elimination of the rural/urban differences in screening will decrease the cervical cancer morbidity rate. The Health Belief Model (HBM) states that perceptions regarding health screenings will predict health screening behaviors. Utilizing the HBM as a foundation, the purpose of this study was to investigate the differences between rural and urban perceptions and behaviors towards cervical cancer prevention, through a secondary analysis of the Health Information National Trends Survey, a large public dataset. Four independent sample Mann Whitney U tests were conducted, identifying significant differences in perceived susceptibility, benefits, and costs in cervical cancer screening. The rural population perceived more than the urban population that there was not much they could do to lower the risk of getting cancer, that it was likely they would develop cancer in the future, and that getting checked frequently was probably not beneficial. There were also significant differences in cervical cancer pap screening behaviors by location (rural vs. urban). For the rural population, it had been longer since they had obtained a pap smear and they expected to wait longer before they got their next pap smear. Knowledge of the rural-urban differences demonstrated in this study will result in a positive social change of informed educational programs for health care professionals, and promotion of reduced morbidity and mortality from cervical cancer in the United States.