Abstract C157: Disparities in routine cancer screening by depression and anxiety status in the US

Abstract Depression and anxiety are associated with a significantly increased risk of cancer incidence and mortality. Poor cancer screening adherence may, partially, explain these increased risks, as screening helps to detect and treat cancer at an earlier, or even precancerous, stage. The purpose of this study was to quantify disparities in the receipt of recommended cancer screenings according to depression and anxiety status within a contemporary US sample. Data were obtained from the National Health Interview Survey, which is a nationally representative cross-sectional household survey of non-institutionalized adults. Concordant with the US Preventive Services Task Force screening recommendations, prevalence estimates were calculated for breast, colorectal, and prostate cancer (2021 and 2023) and cervical cancer (2019 and 2021). Items from the Washington Group Short Set on Functioning-Enhanced measured depression and anxiety. Regular depression/anxiety was defined as daily feelings of either illness at “medium” or “high” intensity or weekly feelings at “high” intensity. Those who reported lower frequency or intensity feelings were defined as not having regular depression/anxiety. Logistic regression models estimated adjusted prevalence ratios (aPRs) comparing cancer screening in those with vs. without regular depression/anxiety. Models were adjusted for age, survey year, race/ethnicity, education, geographic region, and having a usual source of care. Post-hoc analyses explored variability in reasons for screening participation by depression/anxiety status. Approximately 13.2%, 10.7%, 15.4%, and 8.1% of individuals` eligible for breast (n=13,275), colorectal (n=25,331), cervical (n=18,966), and prostate (n=6,836) cancer screening reported regular depression/anxiety. Breast cancer screening prevalence was 8% (aPR=0.92, 95%CI:0.89-0.96) lower in those with (71.2%) vs. without (79.1%) regular depression/anxiety. Cervical and prostate cancer screening were 3% (aPR=0.97, 95%CI:0.94-1.00) and 23% (aPR=0.77, 95%CI:0.66-0.90) lower in those with (cervical=70.9%, prostate=26.1%) vs. without (cervical=74.1%, prostate=36.9%) regular depression/anxiety. Colorectal cancer screening did not significantly vary by depression/anxiety status (69.6% v 72.7%). Among those up to date with cancer screening, the proportion screened as “part of a routine exam” was lower in those with vs. without regular depression/anxiety (breast: 91.6% vs. 94.7%, colonoscopy: 69.1% v. 83.1%, cervical: 87.1% vs. 93.6%, prostate: 80.2% vs. 91.3%). Conversely, the proportion screened mainly “because of a problem” was higher in those with vs. without regular depression/anxiety (breast: 5.9% vs. 3.9%, colonoscopy: 19.3% vs. 8.7%, cervical: 6.8% vs. 2.9%, prostate: 16.3% v. 6.5%). In the US, most recommended cancer screenings, and their receipt as part of routine exams, were lower in individuals with vs. without regular depression or anxiety. Interventions to improve cancer screening in those with depression or anxiety can be a major step toward addressing their disparate cancer outcomes. Citation Format: Jessica Star, Jordan Baeker Bispo, Priti Bandi. Disparities in routine cancer screening by depression and anxiety status in the US [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr C157.