US cancer screening implementation times differ by socioeconomic and racial groups

An observational study in Implementation Science examined national trends in implementation of four cancer control practices: clinicians’ smoking cessation advice, colorectal cancer screening, mammography and HPV vaccination. Researchers used the National Cancer Institute’s 2022 Cancer Trends Progress Report and National Health Interview Survey data from 2000–2018. Implementation time was defined as years between the first guideline publication and uptake by at least 50% of the eligible population, assessed across racial/ethnic, educational and income groups.

Implementation time differed by education for mammography and by race/ethnicity, education and income for colorectal cancer screening. No major subgroup differences were observed for smoking cessation advice or HPV vaccination. Associations of education and income with colorectal screening were similar across racial/ethnic groups. In sequential analyses, including socioeconomic indicators, time in the US and US citizenship largely reduced racial/ethnic differences in colorectal screening over time.

The findings support attention to socioeconomic and migration-related factors when designing screening implementation efforts, but the observational analysis cannot establish causation. The supplied text does not report sample sizes, exact implementation intervals or effect estimates, limiting assessment of the magnitude of disparities. The 50% uptake threshold measures implementation rather than clinical outcomes.