Multimorbidity and Being up to Date with Cancer Screening in Portugal: Implications for Primary Care–based Prevention

To examine the association between multimorbidity and being up to date with breast, cervical, and colorectal cancer screening in Portugal. Cross-sectional analysis of data from the most recent nationally representative Portuguese National Health Survey. The current study included 9,045 individuals aged 25–74 years. Multimorbidity was defined as the presence of two or more chronic conditions, consistent with the standard definition. However, for analytical purposes participants were categorized into four mutually exclusive groups according to the number of chronic conditions reported (0, 1, 2, and ≥ 3). The outcomes were being up to date with breast, cervical, and colorectal cancer screening according to national recommendations. Multivariable logistic regression models were used to assess associations, adjusting for sociodemographic and healthcare-related factors. Overall, 59.7% of participants had multimorbidity. Among eligible individuals, 78.8% were up to date with breast cancer screening and 69.8% with cervical cancer screening. Among those eligible for colorectal cancer screening, 17.5% of men and 17.1% of women were up to date with screening. Compared with women without chronic conditions, those with two (OR = 1.47; 95% CI 1.05–2.06) or ≥ 3 chronic conditions (OR = 1.76; 95% CI 1.31–2.36) had higher odds of being up to date with breast cancer screening. Three or more conditions were also associated with higher odds of being up to date with cervical cancer screening and colorectal cancer screening among women. No association was observed between multimorbidity and being up to date with colorectal cancer screening among men. Recent consultation with a general practitioner or specialist was consistently associated with higher odds of being up to date with screening. Regional and socioeconomic differences persisted across screening types. In a primary care–oriented health system, multimorbidity was positively associated with being up to date with cancer screening among women, likely reflecting increased healthcare contact. Strengthening integration between chronic disease management and organised screening programmes may enhance screening coverage, while targeted outreach is needed to reduce persistent regional and socioeconomic disparities.