Social Risk Factors and Cancer Prevention Care among Patients in Community Health Care Settings
Menée aux Etats-Unis sur la période 2015-2020 à partir de données de 186 centres de santé communautaires portant sur 458 612 personnes éligibles au dépistage du cancer du côlon-rectum, du col de l'utérus et/ou du sein, cette étude analyse l'association entre des facteurs de risques sociaux, la réception d'une invitation au(x) dépistage(s) et la participation à ce(s) dernier(s)
Résumé en anglais
Social risks are negatively associated with receipt of cancer preventive care. As knowledge is lacking on the pathways underlying these associations, we investigated associations between patient-reported social risks and colorectal (CRC), cervical (CVC), and breast cancer (BC) screening order provision and screening completion.This study included patients eligible for CRC, CVC, or BC screening at 186 community-based clinics between July 1, 2015 and February 29, 2020. Outcomes included: up-to-date status for indicated cancer screenings at baseline; percent of subsequent study months in which patients were up to date on screenings; screening order receipt; and screening completion. Independent variables were patient-reported food insecurity, transportation barriers, and housing instability. Analyses used covariate-adjusted generalized estimating equation models, stratified by social risk.Patients with documented social risks were less likely to be up-to-date on any cancer screening at baseline and in most cases had a lower rate of total study months up to date on screenings. All cancer screenings were ordered less often for food-insecure patients. CVC screening was ordered less often for transportation-insecure patients. The likelihood of completing a screening test differed significantly by select social risks: CVC and CRC screening rates were lower in food-insecure patients and CRC screening rates were lower in transportation-insecure patients. Likelihood of BC screening completion did not differ by social risk status.Social risks affect both the ordering and receipt of cancer screening. Research is needed on strategies to mitigate the impact of different social risks on cancer early detection services.
