Factors associated with cancer survivors' preventive health behaviors are understudied. We hypothesized that socioeconomic and healthcare access factors may be associated with adherence to recommended cancer screenings.
We conducted a cross-sectional analysis using the 2020 Behavioral Risk Factor Surveillance System. Cancer survivors eligible for United States Preventive Services Task Force-recommended breast, cervical, prostate, and colorectal screenings were included. Multivariable logistic regression models were used to identify socioeconomic factors significantly associated with screening adherence.
Overall, 64,958 (Weighted National Estimate 29,066,143) cancer survivors were included. Adherence rates varied across cancer types: 80.9% for breast, 88.9% for cervical, 54.1% for prostate, and 84.7% for colorectal cancer. Key predictors of low adherence included lower income (breast: aOR 0.56; 95%CI 0.43 to 0.74, cervical: aOR 0.38; 95%CI 0.24 to 0.59, prostate: aOR 0.36; 95%CI 0.24 to 0.52, colorectal: aOR 0.74; 95%CI 0.57 to 0.96), lack of healthcare coverage for colorectal cancer (aOR 0.51; 95%CI 0.36 to 0.73), time since last checkup between one and two years prior for breast (aOR 0.58; 95%CI 0.45 to 0.75), prostate (aOR 0.66; 95%CI 0.47 to 0.91), and colorectal (aOR 0.69; 95%CI 0.56 to 0.86) cancer, and no healthcare provider for breast (aOR 0.68; 95%CI 0.47 to 0.98), prostate (aOR 0.45; 95%CI 0.31 to 0.65), and colorectal (aOR 0.51; 95%CI 0.40 to 0.66) cancer.
Cancer survivors' adherence to screening is associated with factors including lack of healthcare coverage, lower income, time since the last exam, and having a personal provider. Targeted interventions accounting for such factors may help mitigate these disparities.
JNCI cancer spectrum. 2024 Dec 19 [Epub ahead of print]
Edoardo Beatrici, Zhiyu Qian, Dejan K Filipas, Benjamin V Stone, Filippo Dagnino, Muhieddine Labban, Stuart R Lipsitz, Giovanni Lughezzani, Nicolò M Buffi, Alexander P Cole, Quoc-Dien Trinh
Department of Urology and Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA., Department of Urology, Humanitas Research Hospital-IRCCS, Milan, Italy.