Comfort With Sharing Food Insecurity Risk for Clinical Care Among Individuals With and Without a Cancer History: Findings From a National Survey

Introduction: Food insecurity negatively affects timely access to care, treatment adherence, quality of life, and survival among cancer survivors. There is limited knowledge about cancer survivors' comfort with sharing food insecurity risk for clinical care on a national scale. This study aims to assess comfort with sharing food insecurity risk for clinical care among adults with and without a cancer history and to identify factors that may be associated with comfort for sharing food insecurity risk. Methods: Data were obtained from the National Cancer Institute's Health Information National Trends Survey 6, which was administered from March 7, 2022, to November 8, 2022. Descriptive statistics were calculated to describe the study sample, and sample characteristics were compared by comfort with sharing food insecurity risk for clinical care. A multivariable logistic regression model was conducted to estimate the probability of comfort with sharing food insecurity risk for clinical care. Full-sample weights were applied to calculate population-level estimates, and jackknife replicate weights were applied to calculate SEs. Results: The weighted sample included 188,146,395 participants (6.7% were cancer survivors). Overall, most cancer survivors (64.9%) and adults without a cancer history (58.7%) reported comfort with sharing food insecurity risk for clinical care. Controlling other factors, cancer survivors reported a similar comfort level with sharing food insecurity risk (OR=1.33; 95% CI=0.97, 1.80) compared to individuals without a cancer history. Controlling other factors, individuals reporting at or above the mean patient-centered communication (OR=1.52; 95% CI=1.24, 1.87) were more likely to report comfort with sharing food insecurity risk than individuals reporting below the mean patient-centered communication. Individuals experiencing food insecurity reported a similar comfort level with sharing food insecurity risk (OR=0.93; 95% CI=0.5, 1.31) compared to adults not experiencing food insecurity. Conclusions: Study findings suggest that screening for food insecurity risk may be acceptable to cancer survivors and that patient-centered communication may support participation in food insecurity screening. Future studies are needed to assess cancer survivors' preferences for sharing food insecurity risk for clinical care (what, when, where, and how data are shared) to ensure that implementation is aligned with patient preferences.