Cohort study of association of barriers to health care with cancer screening

Identification of health care access-related factors associated with lower rates of cancer screening may help inform targeted interventions to mitigate barriers and ameliorate screening disparities. A cohort study using data from the National Institutes of Health All of Us (AoU) Research Program (2017-2013) examined the multifaceted obstacles associated with screening for breast, cervical, colorectal, lung, and prostate cancer in a diverse population. In this cohort study of 160,691 adults eligible for cancer screening, out-of-pocket costs, nervousness about seeing clinicians, and inability to get time of work were the most cited barriers. In multivariable analyses, cost concerns and logistical barriers were associated with lower screening rates for breast, cervical, and colorectal cancer. The authors conclude that improved policies and interventions are needed to target multiple dimensions of screening acces simultaneously.