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Comment
. 2024 Jun 1;184(6):671-679.
doi: 10.1001/jamainternmed.2024.0693.

National Breast, Cervical, and Colorectal Cancer Screening Use in Federally Qualified Health Centers

Trisha L Amboree  1 , Jane R Montealegre  1 , Susan L Parker  1 , Ashvita Garg  2   3 , Haluk Damgacioglu  2   3 , Kathleen M Schmeler  4 , Elizabeth Y Chiao  5   6 , Elizabeth G Hill  2   3 , Kalyani Sonawane  2   3 , Ashish A Deshmukh  2   3 , Prajakta Adsul  7   8
Affiliations
Comment

National Breast, Cervical, and Colorectal Cancer Screening Use in Federally Qualified Health Centers

Trisha L Amboree et al. JAMA Intern Med. .

Abstract

Importance: Federally qualified health centers (FQHCs) deliver health care to nearly 30 million underserved persons across the US, yet nationwide and state-level breast, cervical, and colorectal cancer screening use in FQHCs is not described. Furthermore, it is unknown how the underscreened FQHC population contributes to the total underscreened population at national and state levels.

Objective: To describe national- and state-level breast, cervical, and colorectal cancer screening use among individuals served by FQHCs in the US and to estimate the percentage of underscreened individuals in the general population served by FQHCs.

Design, setting, and participants: This cross-sectional analysis of cancer screening used data from January 1 through December 31, 2020, from the FQHC Uniform Data System, reported by 1364 FQHCs across the US, and self-reported estimates from the Behavioral Risk Factor Surveillance System. Participants were 16 696 692 US adults served by FQHCs who were eligible for breast (age, 50-74 years), cervical (age, 21-64 years), and colorectal (age, 50-75 years) cancer screening. Analyses were conducted between January 1 and June 30, 2023.

Exposures: Breast, cervical, and colorectal cancer screening.

Main outcomes and measures: Percentages of breast, cervical, and colorectal cancer screening-eligible individuals up to date on screening.

Results: A total of 3 162 882 breast, 7 444 465 cervical, and 6 089 345 colorectal screening-eligible individuals were served by FQHCs in 2020. Nationally, screening use in FQHCs was 45.4% (95% CI, 45.4%-45.5%) for breast cancer, 51.0% (95% CI, 51.0%-51.1%) for cervical cancer, and 40.2% (95% CI, 40.1%-40.2%) for colorectal cancer. Screening use among the US general population was 78.2% (95% CI, 77.6%-78.9%) for breast cancer, 82.9% (95% CI, 82.3%-83.4%) for cervical cancer, and 72.3% (95% CI, 71.7%-72.8%) for colorectal cancer. The contribution of the underscreened population served by FQHCs to the national underscreened general population was 16.9% (95% uncertainty interval [UI], 16.4%-17.4%) for breast cancer, 29.7% (95% UI, 28.8%-30.7%) for cervical cancer, and 14.7% (95% UI, 14.4%-15.0%) for colorectal cancer.

Conclusions and relevance: Findings from this national cross-sectional study indicated major gaps in cancer screening use in FQHCs in the US. Improved prevention is urgently needed to address screening disparities.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Chiao reported receiving grants from the National Institutes of Health during the conduct of the study and outside the submitted work. Dr Sonawane reported receiving personal fees from Value Analytics Labs outside the submitted work. Dr Deshmukh reported consulting for Value Analytics Lab and Merck outside the submitted work. No other disclosures were reported.

Figures

Figure 1.
Figure 1.. National Cancer Screening Use in Federally Qualified Health Centers (FQHCs) and the Behavioral Risk Factor Surveillance System (BRFSS), 2020
Figure 2.
Figure 2.. State-Level Cancer Screening Use in Federally Qualified Health Centers (FQHCs) and the Statewide Behavioral Risk Factor Surveillance System, 2020
Solid lines through circles represent 95% CIs.
Figure 3.
Figure 3.. National Federally Qualified Health Center (FQHC) Population Contribution to Total and Underscreened Populations, 2020
B, The FQHC underscreened percentage was estimated to account for 16.9% (95% uncertainty interval [UI], 16.4%-17.4%) of the overall underscreened US population for breast cancer, 29.7% (95% UI, 28.8%-30.7%) for cervical cancer, and 14.7% (95% UI, 14.4%-15.0%) for colorectal cancer.
Figure 4.
Figure 4.. State-Level Federally Qualified Health Center (FQHC) Population Contribution to Total and Underscreened Populations, 2020
UI indicates uncertainty interval.
See this image and copyright information in PMC

Comment on

References

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MeSH terms