Adherence to cancer screening programs across the US.

163 Background: Cancer screening programs are critical for early detection and improved oncologic outcomes, yet significant disparities in screening adherence persist across regions, racial/ethnic groups, and socioeconomic statuses in the U.S. We sought to use national data to evaluate public awareness, adherence rates, and barriers to cancer screening programs in the U.S. Methods: We used data from the National Health Interview Survey (NHIS), Behavioral Risk Factor Surveillance System (BRFSS), and the Health Information National Trends Survey (HINTS) from 2015-2023 to assess cancer screening adherence, awareness, and barriers. We included adults eligible for breast, colorectal, cervical, and lung cancer screening to determine screening adherence and associations among patient-reported barriers (financial, informational, access, psychological, time, cultural/language, prior negative experiences). Results: Among 100,000 patients (mean age 52.3 years, 51% female), the racial/ethnic composition was 65% White, 15% Hispanic, 13% Black, 5% Asian, and 2% Other. Screening adherence rates were 73% for cervical, 72% for breast, 65% for colorectal, and 60% for lung cancer. Screening adherence rates varied by race/ethnicity, with White individuals at 72.5%, Hispanic 64.5%, Other 63.5%, Asian 62.5%, and Black individuals 59.5% (p < 0.001). Regionally, breast cancer screening was highest in the Northeast (72%) and lowest in the rural South (58%) (p < 0.001), while cervical cancer screening was higher in metropolitan (77%) than non-metropolitan areas (65%), and colorectal and lung cancer screening rates were greater in urban (69% and 63%) than rural areas (57% and 52%). The most common patient-reported barriers to cancer screening were financial (30%), lack of awareness (22%), and transportation/access issues (20%). Additional barriers included fear/anxiety (15%), time constraints (15%), cultural/language barriers (10%), and prior negative experiences (7%). Conclusions: In this study, we identified racial, regional, and socioeconomic disparities in U.S. cancer screening adherence. We also demonstrated that financial, informational, and access barriers remain prevalent. Findings underscore the importance of addressing barriers to screening through targeted interventions.