Cancer Screening and Barriers to Screening Among Unhoused Individuals in Rhode Island

Unhoused individuals have higher mortality from cancer than the overall population. We aimed to determine cancer screening uptake and the barriers to screening faced by unhoused individuals in Rhode Island.

Surveys focused on cancer screenings. Logistic regressions were used to identify interactions between having undergone screening and demographic characteristics. Responses to open-ended questions were analyzed to inform the findings.

Amongst 502 participants, the screening rates for breast, cervical and colorectal cancer were 27%, 58%, and 39%, all below the national averages. Cancer risk factors such as smoking and alcohol were highly prevalent. Not having a primary care provider (PCP), lack of transportation, fear and logistical issues were among the most self-identified barriers to cancer screening. There was a statistically significant interaction between sex and access to PCP (P=.03) with regards to having up to date colorectal cancer screening. Specifically, unhoused men with a PCP were significantly more likely to be screened for colorectal cancer than those without PCP (52% vs 18%, P<.0001).

Improving cancer screening among unhoused communities is critical. Access to PCP and health insurance can be leveraged to improve uptake of screening recommendations.