Using the 2022 Health Resources and Services Administration Uniform Data System, researchers examined screening performance at more than 1,300 Federally Qualified Health Centers (FQHCs) that serve 29.8 million patients in all 50 states and Washington, DC. The analysis revealed large variation in preventive care, with the lowest cancer screening rates concentrated in the most underserved communities.
The largest disparity was in colorectal cancer screening, which was about 15 percentage points lower in the most underserved areas than in better-resourced areas. Breast cancer screening was about 11 percentage points lower, and cervical cancer screening about 8 percentage points lower. The team found that socioeconomic status—factors such as income, unemployment and education—explained much of the difference.
Lead author Eunhae Shin of the University of Georgia College of Public Health highlights that people in vulnerable areas tend to have poorer diets, less physical activity and higher tobacco use, raising their cancer risk while they receive fewer lifesaving services. Practical barriers include low health literacy, the inability to take time off work, disability and limited English proficiency. Researchers suggest interventions such as at-home colorectal test kits and telehealth, and note financial and staffing limits at FQHCs; they recommend reforming reimbursement and more research and policy attention to reduce these disparities.
- Data source: 2022 HRSA Uniform Data System
- Coverage: 1,300+ FQHCs, 29.8 million patients
- Main screening gaps: colorectal ~15 points, breast ~11 points, cervical ~8 points
Difficult words
- screening — tests to detect disease before symptoms appear
- disparity — a significant difference in outcomes between groupsdisparities
- underserved — areas with few health services available locally
- socioeconomic status — combined social and economic position of people
- health literacy — ability to find, understand and use health information
- reimbursement — payment to providers for medical services rendered
- telehealth — medical care delivered remotely using technology
Tip: hover, focus or tap highlighted words in the article to see quick definitions while you read or listen.
Discussion questions
- Which of the practical barriers named in the article do you think is most important locally, and why? Give examples.
- Which suggested interventions (for example, at-home test kits or telehealth) would work best in your area, and what challenges might they face?
- How could changes in reimbursement help FQHCs increase preventive screening in underserved communities? Give specific ideas.
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