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Examining the Association of Food Insecurity and Being Up-To-Date for Breast and Colorectal Cancer Screenings.

BACKGROUND
Food insecurity (FI) has been associated with poor access to healthcare. It is unclear if this association is beyond that predicted by income, education, and health insurance. FI may serve as a target for intervention given the many programs designed to ameliorate FI. We examined the association of FI with being up-to-date to colorectal cancer (CRC) and breast cancer (BC) screening guidelines.


METHODS
Nine NCI-designated cancer centers surveyed adults in their catchment areas using demographic items and a two-item FI questionnaire. For the CRC screening sample (n=4,816), adults ages 50-75 years who reported having a stool test in the past year or a colonoscopy in the past ten years were considered up-to-date. For the BC screening sample (n=2,449), female participants ages 50-74 years who reported having a mammogram in the past two years were up-to-date. We used logistic regression to examine the association between CRC or BC screening status and FI, adjusting for race/ethnicity, income, education, health insurance, and other sociodemographic covariates.


RESULTS
The prevalence of FI was 18.2% and 21.6% among CRC and BC screening participants, respectively. For screenings, 25.6% of CRC and 34.1% of BC participants were not up-to-date. In two separate adjusted models, FI was significantly associated with lower odds of being up-to-date with CRC screening (OR=0.7, 95% CI [0.5, 0.99]) and BC screening (OR=0.6, 95% CI [0.4, 0.96]).


CONCLUSION
FI was inversely associated with being up-to-date for CRC and BC screening.


IMPACT
Future studies should combine FI and cancer screening interventions to improve screening rates.