Inadequate Cancer Screening: Lack of Provider Continuity is a Greater Obstacle than Medical Mistrust

Abstract

BACKGROUND: Racial minorities and low-income individuals are generally less likely to have adequate cancer screening than Whites or higher-income individuals. PURPOSE: To examine the roles of medical mistrust and lack of provider continuity in cancer screening in a low-income minority population. METHODS: A total of 144 urban federally qualified health center patients completed a cross-sectional survey that included the Group Based Medical Mistrust Scale and questions on provider continuity and cancer-screening-history. RESULTS: Breast cancer screening was associated with continuity of care but not mistrust (respectively p = .002, p > .05); colon cancer screening was not significantly associated with either factor (p > .05). CONCLUSIONS: Findings suggest that among low-income minority adults continuity of care is more strongly associated with screening than medical mistrust. Shifting focus from medical mistrust-a patient-level issue-to establishing health care homes-a system-level issue-may be a more effective strategy for reducing racial and socioeconomic disparities in cancer screening.