Organizational Factors Associated with Disparities in Cervical and Colorectal Cancer Screening Rates in Community Health Centers

Introduction. Community health centers provide care to underserved populations least likely to adhere to cancer screening guidelines, but vary in their ability to ensure eligible patients are identified and screened. This study examines organizational factors associated with cervical and colorectal cancer screening rates among health centers funded by the Health Resources and Services Administration (HRSA). Methods. Data were drawn from the 2015 Uniform Data System and analyzed using negative binomial regression. Results. On average, 53% of eligible health center patients were screened for cervical cancer and 37% for colorectal cancer. Organizational characteristics positively associated with cancer screening rates include provider-patient staffing ratios, electronic health record status, percentage revenue from public capitated managed care, and local primary care provider availability. Percentage of homeless patients was negatively associated with screening. Conclusion. Efforts to improve cancer screening among underserved populations should address organizational factors that may contribute to disparities in screening uptake.