Nearly 18 Million Middle-Aged US Women Overdue for Cancer Screening, Study Finds

Nearly 18 million US women aged 45 to 64 years were overdue for at least 1 recommended cancer screening test in 2024, with colorectal cancer screening representing the most common gap, according to a cross-sectional analysis published in JAMA Network Open.¹

The findings point to a practical intervention target: many patients missing 1 screening are missing more than 1, suggesting that bundled outreach for breast, cervical, and colorectal cancer may be more efficient than single-test reminders.

Investigators analyzed 2024 Behavioral Risk Factor Surveillance System data from 68 111 women aged 45 to 64 years. Screening status was defined using US Preventive Services Task Force-recommended intervals and modalities for breast, cervical, and colorectal cancer screening.²-⁴

Only 50.3% of respondents were up to date with all 3 recommended screening tests. Another 28.8% were up to date with 2 screenings, 13.2% with 1 screening, and 7.7% with none. Nationally, these patterns represented 17.9 million women overdue for at least 1 screening test, including 7.6 million overdue for multiple tests and 3.2 million overdue for all 3.

Colorectal cancer screening accounted for the largest gap. An estimated 12.6 million women were overdue for colorectal cancer screening; 6.6 million of them also were overdue for breast and/or cervical cancer screening. Among those overdue for breast cancer screening, 72.9% were also overdue for at least 1 other screening; among those overdue for cervical cancer screening, 70.8% were also overdue for another test.

Access to care was strongly associated with screening completion. Among women who had completed at least 1 screening, being fully up to date with all 3 tests was more likely among those with a wellness visit in the past year (adjusted risk ratio [aRR], 1.71; 95% CI, 1.57-1.86), a regular health care practitioner (aRR, 1.43; 95% CI, 1.24-1.63), and private insurance vs no insurance (aRR, 1.42; 95% CI, 1.22-1.66).

In the partially screened group, 15.2 million women were up to date with some, but not all, recommended tests. More than 80% reported a wellness visit in the past year, pointing to missed opportunities during routine care, according to the researchers.

The study was limited by self-reported screening data and a survey response rate below 50%, but the authors said the findings support bundled clinical interventions.

References

1. Spencer JC, Montealegre JR, Calderón-Mora J, Pignone MP. Breast, cervical, and colorectal cancer screening rates in women aged 45 to 64 years. JAMA Netw Open. 2026;9(5). doi:10.1001/jamanetworkopen.2026.12976
2. US Preventive Services Task Force. Screening for colorectal cancer: US Preventive Services Task Force recommendation statement. JAMA. 2021;325(19):1965-1977. doi:10.1001/jama.2021.6238
3. US Preventive Services Task Force. Screening for breast cancer: US Preventive Services Task Force recommendation statement. JAMA. 2024;331(22):1918-1930. doi:10.1001/jama.2024.5534
4. Curry SJ, Krist AH, Owens DK, et al; US Preventive Services Task Force. Screening for cervical cancer: US Preventive Services Task Force recommendation statement. JAMA. 2018;320(7):674-686. doi:10.1001/jama.2018.10897