Association of food insecurity with reduced cancer screening rates.

Abstract

e18609 Background: Social determinants of health, including access to adequate food and nutrition, may influence many aspects of healthcare, including cancer screening. This study explored the associations between food insecurity and cancer screening. Methods: A retrospective analysis was conducted using the National Health Interview Series from 2021 to capture contemporary events. Based on scaled questionnaires, food security was stratified into either food secure or insecure, and then subgrouped into high, marginal, or low security (i.e. most insecure). Associations were made with rates of having at least one screening test. Relationships between variables were evaluated using Chi-Square and Cochran-Armitage trend tests. Logistic regression models were used to find factors associated with cancer screening. Results: Patients included in analyses included: 19,916 for colon, 15,293 for cervical, and 8,589 for prostate cancer screening. Those with food insecurity had significantly lower rates of cancer screening than those with food security across all 3 cancer screens, including for colon (51.3% vs. 61.8% p < 0.0001), cervical (78.1% vs. 85.2% p < 0.0001), and prostate (36.0% vs. 51.5%, p < 0.0001). This was similar when comparing low, marginal, and high food security, respectively, for colonoscopies (50.1% vs. 52.6% vs. 61.8%, p < 0.0001), cervical cancer screening (78% vs. 78.2% vs. 85.1%; p < 0.0001), and prostate-specific antigen testing (31.2% vs. 41.2% vs. 51.5%; p < 0.0001). Other social determinants were analyzed, including insurance type (public vs. private), age, and race. Patients with public health insurance had lower screening rates across all three cancers compared to those with private insurance (p < 0.0001). Lower food security was linked with younger age (p < 0.0001), and Black patients were disproportionately affected by food insecurity compared to other races (p < 0.001). Adjusted for covariates, low food security, minority racial groups, and public insurance were associated with lower odds of cancer screening. Conclusions: Individuals with self-reported food insecurity were found to have lower cancer screening rates than those who were food secure. Further analysis of demographic and clinical information revealed associations between low food security status and public health insurance, younger age, and Black race. These data suggested that measures can be taken to address food insecurity in these populations that appear to be most vulnerable to lacking appropriate cancer screening. [Table: see text]