Although improving cancer screening participation in the United States is central to the country’s national goals for reducing disability and death, currently, participation is lagging behind the Healthy People 2030 targets set by the U.S. Department of Health and Human Services.

A study by the American Cancer Society investigating the association between social support and the increased use of preventive care services has found that social support measures were associated with improved cancer screening by varying degrees by tumor site and age. According to the study results, women who reported never or rarely receiving social-emotional support were nearly 40% less likely to be up-to-date with mammogram screening compared to those reporting receiving social support always. The study was published in Cancer Causes & Control.

Study Methodology

The researchers analyzed data from the Centers for Disease Control and Prevention 2021 National Health Interview Survey. Participants were classified as up-to-date or not with female breast cancer, cervical cancer, and colorectal cancer screening recommendations. The analytic sample included 6,041 females eligible for breast cancer screening (corresponding to a weighted national population estimate of 43.8 million persons); 8,517 females eligible for cervical cancer screening (75.3 million); and 6,349 females and 5,302 males eligible for colorectal cancer screening (45.7 million and 42.0 million, respectively).

Most participants were non-Hispanic White, lived in urban counties, and reported excellent or very good overall health. The vast majority were insured and had at least a high school education. The proportion with a household income < 200% of the federal poverty level ranged from 20.9% of males eligible for colorectal cancer screening to 29.3% of females eligible for cervical cancer screening.

Multivariable logistic regression was used to model associations between screening and residential stability (< 1 year, 1–3 years, 4–10 years, 11–20 years, or > 20 years); living arrangement (with spouse/partner only, children only, both, or neither); and perceived social support (rarely/never, sometimes, usually, or always available) overall and stratified by sex (colorectal cancer screening) and age-group (cervical cancer screening).

Results

The researchers found that the adjusted odds of screening were 39% lower for breast cancer (odds ratio [OR] = 0.61, 95% confidence interval [CI] = 0.45–0.81) and 24% lower for cervical cancer (OR = 0.76, 95% CI = 0.60–0.96) among those who reported never/rarely vs always having social support. The adjusted odds of breast cancer (OR = 1.44, 95% CI = 1.22–1.70) and female colorectal cancer (OR = 1.42, 95% CI = 1.20-1.68; OR = 1.61, 95% CI = 1.35-1.90) screening were higher for those living with a spouse/partner only compared to those living with neither spouse/partner nor children.

Several unique patterns were observed among females 21 to 34 years of age, for whom less residential stability and living with children were associated with increased cervical cancer screening. In this group, upward social mobility and access to prenatal care likely enhance screening utilization. 

“Social support measures were associated with screening to varying degrees by site and age, but higher perceived social support and living with a spouse/partner only demonstrated a consistent positive association. Interventions that mobilize social support networks and address the unmet social needs of parents/caregivers may improve cancer control,” concluded the study authors.

Jordan A. Baeker Bispo, PhD, MPH, a principal scientist of Cancer Disparity Research in the Department of Surveillance and Health Equity Science at the American Cancer Society, is the corresponding author of this study.

Disclosure: For full disclosures of all study authors, visit Cancer Causes & Control.