Low-Income Americans Face Major Cancer Screening Gaps at Federal Clinics, Study Finds

People living in low-resource areas are significantly less likely to receive cancer screenings at federally funded clinics, according to a new study. The findings highlight persistent health disparities tied to socioeconomic factors.

About one in 11 Americans—roughly 29.8 million people—receive care from Federally Qualified Health Centers (FQHCs), which provide medical treatment, preventive services, and social support such as housing, food, and transportation assistance to low-income communities.

The study uncovered major gaps in cancer screening rates among FQHCs, with clinics serving the most vulnerable populations reporting the lowest screening numbers.

• Colorectal cancer: Screening rates were 15 percentage points lower in the most underserved communities compared to higher-resource areas.
• Breast cancer: Screening rates were 11 percentage points lower.
• Cervical cancer: Screening rates were 8 percentage points lower.

“These findings are really concerning because studies have shown that people in these more vulnerable areas tend to have a poorer diet, are not involved in physical activities, and have a higher tobacco utilization rate. Those factors lead to a higher risk of developing cancer. Yet they are not getting services that can be lifesaving.”

The research analyzed 2022 data from the Health Resources and Services Administration Uniform Data System, which includes records from over 1,300 FQHCs across all 50 states and Washington, D.C.

Socioeconomic status—including income, unemployment, and education levels—had the strongest influence on screening disparities. Additional barriers included low health literacy, inability to take time off work, disabilities, and limited English proficiency.

“Those who live in areas with low education levels and low income face a lot of logistical barriers to receiving preventive services.”

Researchers suggest that at-home test kits for colorectal cancer and telehealth services could help bridge gaps by making screenings more accessible from home or local community centers.

FQHCs also face financial and staffing challenges that hinder their ability to provide services. Reforming reimbursement models could improve their capacity to serve patients, the study notes.

“We need to pay more attention to these FQHC patients. When we talk about health systems, people talk about hospitals and physicians, but FQHCs play such an important role.”

Shin emphasized the need for further research and policy changes to address cancer disparities and other chronic health conditions in underserved communities.

The study was published in the Journal of General Internal Medicine.

Source: University of Georgia