Breast, Cervical, and Colorectal Cancer Screening Rates in Women Aged 45 to 64 Years

Importance While eligibility for cancer screening tests varies by age, women aged 45 to 64 years should regularly screen for 3 cancers (breast, cervical, and colorectal). However, utilization of these screening tests varies. Objective To evaluate patterns of screening across 3 cancers in age-eligible women and to identify screening gaps. Design, Setting, and Participants This cross-sectional study used a retrospective analysis of the Behavioral Risk Factor Surveillance Survey—a population-based survey of the US—collected January to December 2024. Participants were survey respondents who were women aged 45 to 64 years, reflecting the ages in which women are currently recommended to complete screening for all 3 cancers. Exposure Differences in screening patterns across sociodemographic characteristics, including age, insurance coverage, educational attainment, income, and past-year health care use, were evaluated. Main Outcomes and Measures Survey-weighted means and univariable and multivariable regressions were used to evaluate up-to-date (UTD) use of breast, cervical, and colorectal cancer screening. The proportion and total number of US women estimated to be due for each combination of screenings are reported. Factors associated with being UTD with any screening (vs no screening) and with all screenings (vs 1 or 2 screenings) are identified. Results The final sample was 68 111 women (mean SD age 54.8 5.8 years), of whom 35 047 (weighted percentage, 50.3%) reported being UTD with all 3 cancer screening tests, 19 389 (weighted percentage, 28.8%) were UTD with 2 screenings, 8776 (weighted percentage, 13.2%) were UTD with only 1 screening, and 4899 (weighted percentage, 7.7%) were UTD with no screenings. Together, these reflect an estimated 17.9 million women aged 45 to 64 years who were due for 1 or more screening tests, with nearly half this group (42.2%; 7.6 million women) due for multiple tests. Socioeconomic factors were associated with all (vs 1 or 2) screenings, while access factors (eg, health insurance, having a regular health care practitioner) were associated with use of both any screening and all screenings. Conclusions and Relevance In this cross-sectional study of screening patterns, nearly 18 million middle-aged US women were estimated to be overdue for 1 or more cancer screening tests. Access-related policies or bundled clinical interventions that improve screening across multiple tests should be prioritized to most effectively reduce the burden of screen-detectable cancers.