Cancer Screening among Rural People Who Use Drugs: Colliding Risks and Barriers

Abstract

Rural cancer disparities are associated with lesser healthcare access and screening adherence. The opioid epidemic may increase disparities as people who use drugs (PWUD) frequently experience healthcare-associated stigmatizing experiences which discourage seeking routine care. Rural PWUD were recruited to complete surveys and interviews exploring cancer (cervical, breast, colorectal, lung) risk, screening history, and healthcare experiences. From July 2020–July 2021 we collected 37 surveys and 8 interviews. Participants were 24.3% male, 86.5% White race, and had a mean age of 44.8 years. Females were less likely to report seeing a primary care provider on a regular basis, and more likely to report stigmatizing healthcare experiences. A majority of females reporting receiving recommendations and screens for cervical and breast cancer, but only a minority were adherent. Similarly, only a minority of males and females reported receiving screening tests for colorectal and lung cancer. Screening rates for all cancers were substantially below those for the US generally and rural areas specifically. Interviews confirmed stigmatizing healthcare experiences and suggested screening barriers and possible solutions. The opioid epidemic involves millions of individuals and is disproportionately experienced in rural communities. To avoid exacerbating existing rural cancer disparities, methods to engage PWUD in cancer screening need to be developed.

Tobacco/nicotine dependence as a risk factor for substance use disorders and related mental health conditions among cancer patients

“…This has also contributed to increased mortality risk among this patient group, underscoring the crucial need for comprehensive interventions. 9,10 However, the specific relationship between TND and the risk of substance use disorders and mental health conditions in cancer patients remains underexplored.…”

“…Furthermore, the complex interactions between these conditions can exacerbate each other, amplifying the negative impact on a patient's quality of life and prognosis. This has also contributed to increased mortality risk among this patient group, underscoring the crucial need for comprehensive interventions 9,10 . However, the specific relationship between TND and the risk of substance use disorders and mental health conditions in cancer patients remains underexplored.…”