Cervical, breast, and colorectal cancer screening adherence and uptake among overweight/obese Latinas enrolled in a lifestyle education program.

154 Background: Cervical (CC), breast (BC), and colorectal (CRC) cancer screening rates lag for US Latinas compared to non-Latina white women. Obesity/overweight, a known cancer risk factor, is prevalent among Latinas, making cancer screening a pressing priority in this population. This study investigates determinants of CC, BC, and CRC screening adherence at baseline and screening uptake at study completion among overweight/obese Latinas in SANOS (Health and Nutrition for All), a 6-month culturally tailored lifestyle program with navigation to insurance, primary care, and screening. Methods: We enrolled 412 Spanish-speaking Latinas with BMI ≥25 kg/m 2 (2019-2024). Surveys conducted at baseline and study completion captured participants’ time in the US, English proficiency, primary care physician (PCP) access, health insurance status, and cancer screening adherence per USPSTF guidelines. Logistic regression assessed determinants of screening adherence, and Fisher’s exact tests compared screening uptake at study completion, with significance at p < 0.05. Results: Of 412 participants (mean age 43.4 ± 9.7), 77.5% had limited English proficiency, and 39.9% were insured, mainly through Medicaid (73.0%). Baseline adherence was high for CC (75.7%; 311/411 eligible) and BC (66.5%; 165/248), while only 45.9% (68/148) for CRC. Logistic regression showed that more time living in the US (CRC: OR = 1.06, p = 0.001; BC: OR = 1.06, p < 0.001), having insurance (CRC: OR = 2.97, p = 0.002; BC: OR = 2.26, p = 0.006), and more recent PCP access (CRC: OR = 0.08, p < 0.001; BC: OR = 0.24, p < 0.001) predicted CRC and BC adherence. Having insurance (OR = 1.76, p = 0.026) and more recent PCP access (OR = 0.24, p < 0.001) predicted CC adherence. Participants reporting CC adherence were 13.3 (CI .95 = 5.38, 37.87) and 7.76 (CI .95 = 2.05, 50.87) times more likely to report BC and CRC adherence, respectively. At study completion, among those non-adherent at baseline, CRC uptake (13.6%, 9/66) was significantly lower than BC uptake (44.8%, 30/67; p < 0.001) and CC uptake (35.8%, 24/67; p < 0.018). Conclusions: High CC and BC screening adherence among overweight/obese Latinas demonstrates regular engagement with the healthcare system; however, disproportionately low CRC screening reflects a critical missed opportunity for prevention. Interventions to promote CRC screening adherence in this population should include both provider education and culturally tailored patient education on CRC risk and screening. Further research is needed on Latinas' perceived barriers to CRC screening and their awareness of screening options.