Association of Socio-Environmental Burden and Inequality With Cancer Screening and Mortality.

BACKGROUND AND OBJECTIVES

Social and environmental injustice may influence accessibility and utilization of health resources, affecting outcomes of patients with cancer. We sought to assess the impact of socio-environmental inequalities on cancer screening and mortality rates for breast, colon, and cervical cancer.

METHODS

Data on cancer screening and environmental justice index social and environmental ranking (SER) was extracted from the CDC PLACES and ATSDR, respectively. Mortality rates were extracted using CDC WONDER. Screening targets were defined by Healthy People 2030.

RESULTS

Among census tracts, 14 659 were classified as "low," 29 534 as "moderate," and 15 474 as "high" SER (high SER denoting greater socioenvironmental injustice). Screening targets were achieved by 31.1%, 16.2%, and 88.6% of tracts for colon, breast, and cervical cancers, respectively. High SER tracts were much less likely to reach screening targets compared with low SER tracts for colon (OR: 0.06), breast (OR: 0.24), and cervical cancer (OR: 0.05) (all p < 0.001). Median mortality rates for low and high SER were 16.7, and 21.0, respectively, for colon, 13.4, 14.75, respectively, for breast, and 1.0, 1.6, respectively, for cervical cancer (all p < 0.05).

CONCLUSION

Socioenvironmental disparities negatively influence cancer screening and mortality, underscoring the need to reduce environmental injustices through measures like equitable cancer screening services.