Associations Between Transportation Barriers in the Context of Other Social Needs and Cancer Screening Adherence

Abstract

Introduction

Socioeconomic inequities in breast and cervical cancer screening persist and may be driven by unmet social needs, such as transportation barriers. The association between transportation barriers and screening adherence, while adjusting for other social needs, remains poorly characterized.

Methods

A cross-sectional analysis of 2023 National Health Interview Survey data was conducted from October to December 2024. Multivariable logistic regression was used to assess associations between transportation barriers and breast and cervical cancer screening adherence.

Results

A total of 5,851 (survey-weighted 42.3 million) and 8,461 (survey-weighted 78.6 million) individuals were eligible for breast and cervical cancer screening, respectively. In adjusted analyses, transportation barriers were associated with lower likelihood of breast cancer screening (AOR=0.6; 95% CI=0.5, 0.9) but no difference in the likelihood of cervical cancer screening (AOR=0.9; 95% CI=0.7, 1.1). Low income, lack of health insurance, and low levels of formal education were also associated with lower adherence for both breast and cervical cancer screening.

Conclusion

After accounting for other social needs, transportation barriers are associated with lower likelihood of breast cancer screening—an inequity that may benefit from public health and healthcare interventions. Additional work is needed to understand the relationship between SES and cervical cancer screening adherence to inform future interventions.