ArticleCancer causes & control : CCC2021
Financial hardship is associated with lower uptake of colorectal, breast, and cervical cancer screenings.
Article in Cancer causes & control : CCC, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
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Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Financial strain measures and associations with adult health: A systematic literature review.Social science & medicine (1982) · 2025Pooled it
- Evaluation of financial toxicity and associated factors in female patients with breast cancer: a systematic review and meta-analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023Pooled it
- Barriers to Health Care and Cancer Screening.JAMA network open · 2026Article
- Colorectal Cancer Screening and Health-Related Social Needs in a National Sample of US Adults.JAMA network open · 2026Article
- Gendered Paths To Cancer Knowledge and Screening Behavior among Black Adults: Results from a Community-Partnered Study.Journal of racial and ethnic health disparities · 2026Article
- Racial and Ethnic Differences in Diabetes Care Quality in A National Sample of Cancer Survivors Relative to Non-Cancer Controls.Journal of racial and ethnic health disparities · 2025Article
- Associations between social drivers of health and breast cancer stage at diagnosis among U.S. Black women.NPJ breast cancer · 2025Article
- Hispanic Patients Reported Factors for Colonoscopy "No-Shows" Despite a Culturally Tailored Patient Navigation Program.Journal of immigrant and minority health · 2025Observational
- Social Risks and Nonadherence to Recommended Cancer Screening Among US Adults.JAMA network open · 2025Article
- Article
- Effect of a Theory-Based Narrative Video on Colorectal Cancer Screening Intention, Knowledge, and Psychosocial Variables Among a Predominantly Hispanic Population.Journal of cancer education : the official journal of the American Association for Cancer Education · 2024Article
- Uptake of Lung Cancer Screening CT After a Provider Order for Screening in the PROSPR-Lung Consortium.Journal of general internal medicine · 2024Observational
- Non-use and inadequate use of cervical cancer screening among a representative sample of women in the United States.Frontiers in public health · 2024Article
- Barriers and facilitators of colorectal cancer screening using the 5As framework: A systematic review of US studies.Preventive medicine reports · 2023Review
- Factors associated with breast cancer screening services use among women in the United States: An application of the Andersen's Behavioral Model of Health Services Use.Preventive medicine · 2023Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
purposeCancer screening uptake differs between groups in ways that cannot be explained by socioeconomic status alone. This study examined associations between material, psychosocial, and behavioral aspects of financial hardship and cancer screening behaviors.
methodsSurveys were mailed to 7,979 people ages 18-75 who were seen in the statewide health system in Indiana. Participants reported SES, feelings about finances, and whether they had to forgo medical care due to cost. This was compared to uptake of mammogram, colonoscopy/sigmoidoscopy, and Pap testing in best-fit multivariable logistic regression analyses controlling for demographic and healthcare characteristics.
resultsA total of 970 surveys were returned; the majority of respondents were female (54%), non-Hispanic White (75%), and over 50 years old (76%). 15% reported forgoing medical care due to cost; this barrier was higher among Black than White participants (24% vs. 13%; p = 0.001). In a best fit regression model for colonoscopy/sigmoidoscopy, those who reported they had to forgo medical care due to cost had lower odds of screening (aOR 0.41; 95% CI 0.22-0.74). Forgoing medical care due to cost was not significantly associated with Pap testing in bivariate analyses. For mammogram, forgoing medical care due to cost was significant in bivariate analyses (OR 0.44; 95% CI 0.22-0.88), but was not significant in the multivariable model.
conclusionAssociations between financial hardship and cancer screening suggest the need to reduce barriers to cancer screening even among patients who have access to healthcare. Future research should explore barriers related to both healthcare and personal costs.
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