Abstract B169: Association between social determinants of health and compliance with recommended breast, cervical, and colorectal cancer screenings
Abstract
Social determinants of health (SDOH) are the social conditions and factors that impact people’s ability to live healthy lives. Previous research has identified that the presence of certain SDOH factors can make it harder for people to utilize important health services and resources, including cancer screenings. Skipping recommended cancer screenings can delay diagnosis, which is associated with increased severity of diagnosis and a higher likelihood of mortality. It is important to understand which SDOH factors impact screening uptake to reduce barriers to care and improve cancer equity. This study uses 2022-2024 Behavioral Risk Factor Surveillance System (BRFSS) data to analyze the association between each SDOH factor and non-compliance for breast, cervical, and colorectal cancer screenings. Breast and cervical cancer screening data were only analyzed for age eligible female respondents, and colorectal cancer screening data were analyzed for both age eligible males and females. A generalized linear model with an identity link was used to estimate weighted crude and weighted adjusted prevalence differences for each SDOH factor and breast, cervical, and colorectal screening non-compliance. A total of 360,871 respondents with complete responses for variables of interest were included in this analysis. After adjusting for age, race, insurance, employment, education, and income, the SDOH factors with the largest effect for breast cancer screening non-compliance were not having medical care due to cost (aPD 4.72%; 95%CI, 3.75-5.68%), food insecurity (aPD 4.42%; 95%CI, 3.23-5.61%), and housing insecurity (aPD 4.02%; 95%CI, 2.91-5.12%). The SDOH factors with the largest effect for cervical cancer screening non-compliance were not having medical care due to cost (aPD 7.50%; 95%CI, 5.90-9.11%), receiving food stamps or SNAP (aPD 6.51%; 95%CI, 4.88-8.14%), and housing insecurity (aPD 5.28%; 95%CI, 3.73-6.83%). This analysis demonstrates that SDOH factors may impact engagement with breast, cervical, and colorectal cancer screenings. Cost-related barriers to medical care and housing insecurity were associated with breast and cervical cancer screening non-compliance, while food insecurity was associated with breast screening non-compliance and SNAP participation with cervical screening non-compliance. These findings highlight the importance of addressing barriers to improve cancer screening uptake. Healthcare systems should conduct SDOH assessments and partner with community-based organizations to create effective referral pathways and warm handoffs. Partnerships between organizations and healthcare systems can ensure that patients are educated about cancer screenings and how to access them. Overall, it is important to understand and address SDOH needs, such as food and housing insecurity, to increase engagement with cancer screenings, improve health equity, and reduce the burden of cancers in the United States. Emily Kidd, Grace Kadubek, Paris Thomas, Sarah Lomahan. Association between social determinants of health and compliance with recommended breast, cervical, and colorectal cancer screenings [abstract]. In: Proceedings of the 19th AACR Conference on the Science of Cancer Health Disparities; 2026 Oct 18-21; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2026;35(10 Suppl):Abstract nr B169.