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Social Risks and Nonadherence to Recommended Cancer Screening Among US Adults
Ami E Sedani1, Scarlett L Gomez2, Wayne R Lawrence3
1Department of Epidemiology, School of Public Health, University of Texas Health Sciences Center at Houston, Dallas.
JAMA Network Open
|January 3, 2025
Summary
Social risks like food insecurity and lack of support are linked to lower cancer screening adherence, varying by screening type and sex. Targeted interventions are needed to address these disparities in cancer prevention.
Area of Science:
- Public Health
- Social Epidemiology
- Cancer Prevention
Background:
- Social drivers of health significantly impact adherence to guideline-recommended cancer screenings.
- The precise magnitude of associations between individual-level social risks and cancer screening nonadherence requires further investigation.
Purpose of the Study:
- To investigate the associations between individual-level social risks and nonadherence to guideline-recommended cancer screenings.
- To explore variations in these associations by cancer screening type and sex.
Main Methods:
- Cross-sectional study utilizing 2022 Behavioral Risk Factor Surveillance System data from 39 US states and Washington, DC.
- Included screening-eligible adults for colorectal, lung, cervical, and breast cancer screenings.
- Assessed adherence using US Preventive Services Task Force (USPSTF) definitions and analyzed associations using modified Poisson regression.
Main Results:
- Life dissatisfaction was associated with nonadherence for cervical and breast cancer screenings.
- Lack of social support and social isolation were linked to nonadherence for colorectal and breast cancer screenings.
- Food insecurity increased nonadherence risk for colorectal, cervical, and breast cancer screenings. Transportation insecurity and cost barriers to healthcare access were also associated with increased nonadherence across multiple screening types, particularly for women undergoing lung cancer screening.
Conclusions:
- Notable variations exist in cancer screening adherence based on screening type and sex.
- Social risks, including dissatisfaction with life, lack of support, isolation, food insecurity, and transportation barriers, are associated with decreased adherence.
- Further research into specific target populations is crucial for developing effective, patient-centered interventions to improve cancer screening rates.
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