Socio-Economic Determinants of Cancer Screening Adherence Among Cancer Survivors: Analysis from 2020 Behavioral Risk Factor Surveillance System
Menée aux Etas-Unis à partir de données du "2020 Behavioral Risk Factor Surveillance System" portant sur 64 958 personnes ayant survécu à un cancer, cette étude identifie les facteurs socio-économiques associés à l'adhésion aux dépistages des cancers recommandés
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 , article en libre accès, 2023