Article Summary
Food insecurity is linked to lower cancer screening rates among adults, but participation in the Supplemental Nutrition Assistance Program (SNAP) significantly increases screening adherence for breast, colorectal, and cervical cancers. Healthcare providers should routinely screen for food insecurity and refer eligible patients to SNAP and other nutritional programs to improve preventive care equity.
- Food insecurity affects approximately one in five U.S. adults and is associated with lower cancer screening participation.
- Food-insecure adults show significantly lower screening rates: breast cancer 61.2% vs. 72.5% in food-secure adults, colorectal 51.6% vs. 63.8%, and cervical 39.8% vs. 50.3%.
- SNAP participation increases screening probabilities: breast 56.1% vs. 52.7% non-participants, colorectal 48.2% vs. 46.3%, and cervical 51.3% vs. 45.2%.
- Healthcare systems should routinely assess food insecurity during preventive visits and encourage SNAP referrals to advance screening equity.
Food insecurity is tied to lower adherence to preventive cancer screening, including for breast cancer, according to findings published July 1 in JAMA Network Open.
However, among food-insecure adults, participation in the Supplemental Nutrition Assistance Program (SNAP) was associated with higher adjusted screening probabilities than non-participation, wrote a team led by Areesh Mevawalla, MD, from the Ohio State University Wexner Medical Center and James Comprehensive Cancer Center in Columbus.
“By easing financial strain and reducing resource trade-offs, SNAP participation may allow individuals greater capacity to attend to health needs, said corresponding author Timothy Pawlik, MD, PhD, to AuntMinnie.
Food insecurity affects about one in five adults in the U.S. This socioeconomic condition is associated with barriers to preventive healthcare, including for health screening with imaging. Prior research suggests that women with food insecurity are less likely to report attending mammography screening.
However, the researchers noted a lack of data on whether food insecurity is linked to lower national cancer screening adherence and whether participation in SNAP reduces related disparities. Mevawalla and colleagues sought to answer these questions, using data from 251,107 adults included in the 2022 Behavioral Risk Factor Surveillance System for their evaluation. Of the cohort analyzed, 47,453 reported having food insecurity.
Compared to food-secure adults, food-insecure adults had lower participation in guideline-concordant screening for the following: breast (61.2% vs. 72.5%), colorectal (51.6% vs. 63.8%), and cervical cancer (39.8% vs. 50.3%).
In adjusted analyses stratified by SNAP participation, food-insecure adults not enrolled in SNAP were significantly less likely to participate in colorectal (adjusted odds ratio [aOR], 0.78; p = 0.008), breast (aOR, 0.69; p = 0.01), and cervical cancer screening (aOR, 0.63; p = 0.02).
However, food-insecure adults who are SNAP participants were more likely to be up to date with screening compared to non-participants.
Adjusted probabilities of being up to date with screening by SNAP participation | ||
Screening exam | Non-participants | SNAP participants |
Breast | 52.7% | 56.1% |
Colorectal | 46.3% | 48.2% |
Cervical | 45.2% | 51.3% |
*All results achieved statistical significance.
The study authors suggested that healthcare systems and professionals should “routinely” assess food insecurity during preventive visits and encourage SNAP and other nutritional programs referrals.
“Addressing food insecurity is both a moral obligation and a practical policy consideration to advance equitable early detection and ensure that no community is left behind,” they wrote.
Pawlik told AuntMinnie the team is working on the Reporting and Addressing Health related Needs Information to Improve Surgical Outcomes and Experience (RISE) initiative. This consists of a patient mobile (mHealth) app, wearable sensors, care team portal, nurse navigator, and virtual coaching sessions for evidence-based health related pathways.
"Our multi-disciplinary team will utilize evidence from the proposed trial to quantify efficacy and ascertain facilitators and barriers to successful implementation of the intervention," Pawlik said. "We are seeking to identify and intervene on specific barriers in collaboration with community partners to address food insecurity and other health related social needs."
Read the full study here.
