Association of food insecurity with reduced cancer screening rates.

Abstract

1592 Background: Social determinants of health, including access to adequate food and nutrition, influence many aspects of health, 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 2018-2022 to capture contemporary screening events. Based on scaled questionnaires, food security was stratified into either food secure or insecure, and then subgrouped into high, marginal, or low security. Associations were made with rates of undergoing at least one screening test. Relationships between variables were evaluated using Chi-Square and Cochran-Armitage trend tests. Logistic regression models were applied to find factors associated with cancer screening. Results: Patients included in analyses included: 51,957 for colon, 40,103 for breast, 45,983 for cervical, and 25,781 for prostate cancer screening. Between 2018-2022, those with food insecurity had significantly lower rates of cancer screening than those with food security across all four cancer screens, including colon (68.1% vs. 76.1%, p < 0.0001), cervical (83.3% vs. 87.5%, p < 0.0001), breast (73.3% vs. 79.5%, p < 0.0001) and prostate (41.3% vs. 54.0%, p < 0.0001) (Table). This was similar when comparing low, marginal, and high food security, respectively, for colon (68.1% vs. 68.2% vs. 76.1%, p < 0.0001), cervical (82.8% vs. 84.1% vs. 87.5%; p < 0.0001), breast (72.7% vs. 74.1% vs. 79.5%, p < 0.0001), and PSA screening (40.7% vs. 42.2% vs. 54.0%; p < 0.0001). Other variables were also analyzed, including insurance type, age, race, BMI, and health status. Those with public health insurance had lower screening rates for cervical cancer compared to those with private insurance (p < 0.0001). Individuals with food insecurity reported worse health than those who were food secure (p < 0.0001). Lower food security disproportionately affected Black patients (p < 0.001), and was associated with younger age (p < 0.0001) and higher rates of obesity (p < 0.0001). Conclusions: Individuals with self-reported food insecurity were found to have lower cancer screening rates than those who were food secure. Further analyses revealed associations between low food security status and obesity, public health insurance, younger age, and Black race. These data suggest that addressing food insecurity should be a priority, as these populations appear most vulnerable to lacking appropriate cancer screening. [Table: see text]