Key result
Housing instability linked to ~62% lower odds of colorectal cancer screening recommendations among Hispanic adults.
Why the study?
Little was known about how specific health-related social needs and co-occurring social risk patterns relate to clinician recommendations for colorectal cancer screening in nationally representative populations.
Do specific health-related social needs (HRSNs) affect the likelihood of receiving a clinician recommendation for colorectal cancer screening in adults aged 45-75?
Do specific health-related social needs (HRSNs) affect the likelihood of receiving a clinician recommendation for colorectal cancer screening in adults aged 45-75?
Specific health-related social needs, such as food insecurity and housing instability, are differentially associated with clinician recommendations for colorectal cancer screening depending on race and ethnicity.
Race-specific social needs assessment may enhance equity in CRC screening recommendations; extends evidence on differential effects but leaves open causal pathways.
Background: Health-related social needs (HRSNs), including food insecurity, housing instability, and financial hardship, are increasingly recognized as barriers to preventive care. Clinician recommendation is a primary driver of colorectal cancer (CRC) screening uptake. However, little is known about how specific HRSNs and co-occurring social risk patterns relate to clinician recommendations in nationally representative populations. Methods We analyzed pooled 2021 and 2023 National Health Interview Survey (NHIS) cross-sections among adults 45-75 years without cancer history (unweighted n = 6,500; weighted = 27.6 million). Survey-weighted logistic regression estimated adjusted odds ratios (aORs) for clinician recommendations in the past 12 months. We examined granular food insecurity categories, HRSN burden counts, and latent social-risk subgroups using latent class analysis (LCA). Analyses were stratified by race/ethnicity and nativity; interaction terms tested effect modification. Results: Overall, roughly 16% of adults reported a clinician's screening recommendation in the past 12 months. Among non-Hispanic White adults, financial hardship was associated with increased odds (aOR = 1.32, 95% CI: 1.11-1.56). Among Hispanic adults, food insecurity was associated with higher odds (aOR = 2.94, 95% CI: 1.59-5.42) while housing instability was associated with lower odds (aOR = 0.38, 95% CI: 0.16-0.88). LCA identified three distinct HRSN configurations: Low/No HRSN (85%), Moderate/Mixed (5%), and High HRSN Burden (10%). High-burden adults had marginally higher odds of recommendation (aOR = 1.33, 95% CI: 0.99-1.78). Race-by-HRSN interactions were statistically significant for housing instability. Conclusions Specific and clustered social needs are associated with clinician recommendations for CRC screening, with differential patterns by race/ethnicity and nativity. Social risk assessment may support more equitable preventive care engagement. Disclosure: During the preparation of this work, the author used OpenAI ChatGPT to assist with wording and clarity. After using this tool, the author reviewed and edited the content and takes full responsibility for the accuracy and integrity of the abstract. Citation Format: Isaiah Casarez, Humberto Parada, Matthew P. Banegas, Uriel Nataren Geronimo, Benjamin Aceves. HRSNs and CRC screening recommendation in NHIS [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 2366.
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Casarez et al. (2026) studied this question. Health-related social needs impact colorectal cancer screening recommendations differently by race, with housing instability reducing odds among Hispanic adults (aOR 0.38).
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