Barriers to Cancer Screening among Emergency Department Patients: Assessing Readiness and Hesitancy

Document Type

Conference Proceeding

Publication Date

5-13-2025

Publication Title

Acad Emerg Med

Keywords

adult, aged, cancer screening, conference abstract, controlled study, diagnosis, emergency ward, female, health disparity, health equity, health literacy, Hispanic, human, major clinical study, male, mammography, medicaid, medically uninsured, medicare, morbidity, mortality, Papanicolaou test, social determinants of health, traffic and transport, undergraduate student

Abstract

Background and Objectives: Emergency departments (EDs) are vital safety nets for underserved populations, yet significant barriers to preventive care, including cancer screenings, persist. These disparities contribute to preventable morbidity and mortality. This study assessed ED patients' readiness to schedule cancer screenings and identified barriers shaping attitudes toward preventive care. Methods: From 2017 to 2024, surveys were administered by undergraduate students in a single urban ED as part of the National Alliance of Research Associates Programs (NARAP). Data collected included demographics, insurance status, screening history, and perceived barriers. A descriptive analysis was performed. Results: Among 5,476 ED patients surveyed, 73.6% were Black, 4.9% Hispanic/Latino, and 55.7% female; 21.3% were uninsured, 18.4% employer-based insured (EBI), 32.1% on Medicaid, and 14.6% on Medicare. Readiness to schedule screenings was reported as follows: 25.3% for mammograms, 47.8% for Pap tests, and 49.6% for colorectal screenings. This readiness was notably lower among uninsured individuals (19.2%) compared to those with insurance (33.5%). Barriers included cost (42.7%), limited health literacy (36.8%), and transportation (28.4%), disproportionately affecting uninsured (68.9%, 52.4%, and 41.2%, respectively). Medicaid recipients faced challenges with cost (37.8%), health literacy (43.6%), and transportation (35.7%). EBI patients reported fewer barriers (cost: 21.4%, health literacy: 21.4%, transportation: 13.8%), and Medicare patients faced the least barriers (cost: 14.9%, health literacy: 18.7%, transportation: 9.6%). Conclusion: This study demonstrates disparities in readiness to undo cancer screening among ED patients, particularly Black and uninsured individuals. These inequities stem from societal factors like cost, limited health literacy, and logistical barriers. Addressing these social determinants in the ED setting offers an opportunity to promote health equity in underserved communities through targeted public health interventions. Further research is needed to evaluate the impact of such initiatives on screening rates and health disparities.

Volume

32

Issue

S1

First Page

141

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