# Prevalence of Adult Asthma and History of Screening for Cancer Among US Adults: Results from 2016, 2018, 2020, and 2022 National Level Cross-Sectional Study

## TL;DR

People with asthma in the US are more likely to follow cancer screening recommendations than those without asthma, according to a four-year national study.

## Contribution

This is the first national study to examine the association between adult asthma and cancer screening adherence over four years.

## Key findings

- Adults with asthma had significantly higher odds of receiving prostate, breast, cervical, and colorectal cancer screenings compared to those without asthma.
- Education level and heavy drinking habits were key modifiers of cancer screening behavior among individuals with asthma.
- Tailored outreach and low-literacy interventions may improve cancer screening rates in populations with chronic respiratory diseases.

## Abstract

In the United States (US), cancer remains a leading cause of death, yet cancer screening tests can save lives by detecting it at an early stage. The present study aims to understand whether people with asthma and without a history of cancer are more likely to receive recommended cancer screenings compared to people without asthma. Both asthma and cancer are chronic conditions that contribute to long-term disease burden, which makes it crucial to examine how the presence of one may influence preventive care behaviors for the other. Using a 4-year national survey data, this study aimed to investigate the receipt of prostate, female breast, cervical, and colorectal cancer screening. Our study results show that US adults without a history of cancer and having asthma were actually more likely to follow cancer screening recommendations than those without asthma. In particular, men with asthma were more likely to receive prostate and colorectal screening, and women with asthma were more likely to receive breast, cervical, and colorectal screening, when compared to their counterparts without asthma. Education level and heavy drinking habits also influenced these patterns. These findings suggest that people with asthma may be more engaged in their healthcare including the receipt of cancer screening, and that tailored outreach may help further improve cancer screening across the US population.

Public health relevance—How does this work relate to a public health issue?
This study addresses two prevalent chronic conditions—asthma and cancer—that together contribute substantially to morbidity and mortality in the United States, linking respiratory disease management with preventive oncology care.By examining national-level data across multiple cancer screening sites and survey years, the research highlights how individuals with adult asthma engage differently in preventive cancer screening behaviors, offering new insights into chronic disease interconnections at the population level.

This study addresses two prevalent chronic conditions—asthma and cancer—that together contribute substantially to morbidity and mortality in the United States, linking respiratory disease management with preventive oncology care.

By examining national-level data across multiple cancer screening sites and survey years, the research highlights how individuals with adult asthma engage differently in preventive cancer screening behaviors, offering new insights into chronic disease interconnections at the population level.

Public health significance—Why is this work of significance to public health?
The findings challenge prevailing assumptions that chronic illnesses such as asthma hinder preventive cancer screening uptake, showing instead that adults with asthma were significantly more likely to undergo cancer screening for prostate, breast, cervical, and colorectal cancers.This national analysis identifies education and alcohol consumption as key modifiers of screening behavior, underscoring the importance of behavioral and social determinants in shaping preventive health outcomes.

The findings challenge prevailing assumptions that chronic illnesses such as asthma hinder preventive cancer screening uptake, showing instead that adults with asthma were significantly more likely to undergo cancer screening for prostate, breast, cervical, and colorectal cancers.

This national analysis identifies education and alcohol consumption as key modifiers of screening behavior, underscoring the importance of behavioral and social determinants in shaping preventive health outcomes.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?
This study suggests that chronic disease management visits—particularly for asthma—represent valuable opportunities for integrating cancer screening reminders and patient education within routine care.Policymakers and practitioners should leverage these findings to design integrated care models that link asthma follow-up with preventive service delivery, emphasizing health literacy and equitable access to screening for populations with chronic respiratory diseases.

This study suggests that chronic disease management visits—particularly for asthma—represent valuable opportunities for integrating cancer screening reminders and patient education within routine care.

Policymakers and practitioners should leverage these findings to design integrated care models that link asthma follow-up with preventive service delivery, emphasizing health literacy and equitable access to screening for populations with chronic respiratory diseases.

Cancer is the second leading cause of death in the U.S., with 612,000 deaths estimated in 2023. Cancer screening (CS) reduces mortality through early detection, but the impact of chronic conditions like adult asthma (AA) on screening is less understood. This study explores the association between AA and uptake of prostate, breast, cervical, and colorectal CS using BRFSS 2016, 2018, 2020 and 2022 data. Weighted and adjusted multivariable logistic regression assessed the association between AA and CS across sex and age-based subgroups with significant effect modification testing and subsequent subgroup analyses. Results showed significantly higher CS adherence among individuals with AA across all four CS sites compared to counterparts without asthma (CCWA). Males (55–69 years old (YO)) with AA had 15% significantly higher weighted and adjusted odds (WAO) of prostate CS (95% CI: 1.04–1.27). Women (50–74 YO) with AA had 16% significantly higher WAO of breast CS (95% CI: 1.01–1.32), with non-depressed, heavy-drinking women showing 300% significantly higher WAO (95% CI: 2.20–7.22) of breast CS. Women (21–65 YO) with AA had 9% significantly higher WAO of cervical CS (95% CI: 1.02–1.17), with education significantly modifying the association (WAOR for college-educated women = 1.23, 95% CI: 1.11–1.36). When CCWA, colorectal CS showed significantly higher odds of 36% for men aged 50–75 (95% CI: 1.24–1.49) and 24% for women aged 50–75 (95% CI: 1.15–1.33). This is the first national study to examine the association between AA and uptake of prostate, female breast, cervical, and colorectal CS over four years. Individuals with AA had significantly greater odds of CS adherence than CCWA. Effect modification by heavy drinking and education suggests the need for targeted outreach and low-literacy interventions.