We recruited women (primarily non-Hispanic White) from 14 rural, segregated counties in a Northeastern US state for an explanatory sequential study: 100 women (ages 50–65 years) completed a survey, and 16 women participated in focus groups. We sought to identify personal (e.g., healthcare mistrust) and environmental (e.g., travel time to healthcare providers) factors related to colorectal and cervical cancer screening. Quantitatively, 89% of participants were up-to-date for cervical screening, and 65% for colorectal screening. Factors interacted such that compounding barriers were associated with lower odds of screening (e.g., insurance status and healthcare mistrust: interaction p = .02 for cervical; interaction p = .05 for colorectal). Qualitatively, three themes emerged regarding barriers to screening: privacy concerns, logistical barriers, and lack of trust in adequacy of healthcare services. While cancer screening was common in rural, segregated counties, women who reported both environmental and personal barriers to screening had lower uptake. Future interventions to promote screening can target these barriers.

我们从美国东北部一个州的 14 个偏远农村县招募了女性（主要是非西班牙裔白人）进行解释性序贯研究：100 名女性（50-65 岁）完成了一项调查，16 名女性参加了焦点小组。我们试图确定与结直肠癌和宫颈癌筛查相关的个人（例如，医疗保健不信任）和环境（例如，前往医疗保健提供者的旅行时间）因素。从数量上看，89% 的参与者接受了最新的宫颈筛查，65% 的参与者接受了结直肠筛查。因素相互作用，使得复合障碍与较低的筛查几率相关（例如，保险状况和医疗保健不信任：宫颈相互作用p  = .02；相互作用p = .05 对于结直肠）。定性地，出现了关于筛查障碍的三个主题：隐私问题、后勤障碍和对医疗保健服务充分性缺乏信任。虽然癌症筛查在偏远的农村县很常见，但报告说环境和个人都存在筛查障碍的女性接受率较低。未来促进筛查的干预措施可以针对这些障碍。