A large U.S. study linking healthcare barriers to reduced cancer screening adherence across five major cancer types found that screening rates dropped as obstacle burden increased. Researchers analyzed data from 160,691 adults in the All of Us Research Program, examining adherence to breast, cervical, colorectal, lung, and prostate cancer screening recommendations.
Out-of-pocket costs, nervousness about clinician visits, and difficulty taking time off work were frequently cited reasons for delayed care. At least one barrier was reported by a significant portion of eligible adults: 37% for breast cancer, 50% for cervical, 28% for colorectal, 36% for lung, and 28% for prostate screening.
Screening adherence rates varied, with 52% for breast cancer, 29% for cervical, 54% for colorectal, 16% for lung, and 44% for prostate cancer. These rates steadily declined as the number of reported barriers increased, falling to 44% for breast cancer and 10% for lung cancer among those with three or more barriers.
Further analysis showed that barriers often clustered into cost concerns, physical or logistical issues, and competing obligations like work or caregiving. The study suggests that addressing cancer screening gaps requires multidimensional solutions that tackle affordability, transportation, work flexibility, and patient concerns concurrently.