Background Previous studies have examined the impact of material financial hardship on cancer screening but without focusing on the psychological aspects of financial hardship. Purpose This study examined the effects of different types of financial anxiety on adherence to breast cancer screening in women at high risk of breast cancer. Adherence to cervical cancer screening was also examined to determine whether associations between financial anxiety and screening adherence were unique to breast cancer screening or more general. Methods Women (n = 324) aged 30–50 and at high risk for inherited breast cancer completed a survey on general financial anxiety, worry about affording healthcare, financial stigma due to cancer risk, and adherence to cancer screening. Multivariate analyses controlled for poverty, age, and race. Results More financial anxiety was associated with lower odds of mammogram adherence (odds ratio [OR] = 0.97, confidence interval [CI] = 0.94, 0.99), Pap smear adherence (OR = 0.98, CI = 0.96, 0.996), and clinical breast examination adherence (OR = 0.98, CI = 0.96, 0.995). More worry about affording healthcare was associated with lower odds of clinical breast examination adherence (OR = 0.95, CI = 0.91, 0.9992) but not mammogram or Pap smear adherence (p > .05). Financial stigma due to cancer risk was associated with lower odds of Pap smear adherence (OR = 0.87, CI = 0.77, 0.97) but no other cancer screenings (p > .07). Conclusions Financial anxiety may impede cancer screening, even for high-risk women aware of their risk status. Clinical interventions focused on social determinants of health may also need to address financial anxiety for women at high risk of breast cancer.

中文翻译：

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财务焦虑与乳腺癌高风险女性的癌症筛查依从性有关

背景 以前的研究已经检查了物质经济困难对癌症筛查的影响，但没有关注经济困难的心理方面。目的 本研究探讨了不同类型的财务焦虑对乳腺癌高危女性乳腺癌筛查依从性的影响。还检查了对宫颈癌筛查的依从性，以确定财务焦虑与筛查依从性之间的关联是否是乳腺癌筛查所独有的或更普遍的。方法 30-50 岁和遗传性乳腺癌高风险的女性 (n = 324) 完成了一项关于一般财务焦虑、担心提供医疗保健、因癌症风险导致财务耻辱以及坚持癌症筛查的调查。多变量分析控制了贫困、年龄和种族。结果 更多的财务焦虑与乳房 X 线照片依从性（优势比 [OR] = 0.97，置信区间 [CI] = 0.94, 0.99）、巴氏涂片依从性（OR = 0.98, CI = 0.96, 0.996）和临床乳腺检查依从性（OR = 0.98，CI = 0.96，0.995）。对提供医疗保健的更多担忧与较低的临床乳房检查依从性相关（OR = 0.95，CI = 0.91，0.9992），但与乳房 X 光检查或巴氏涂片检查的依从性无关（p > .05）。由于癌症风险导致的财务耻辱与宫颈抹片检查依从性降低相关（OR = 0.87，CI = 0.77，0.97），但与其他癌症筛查无关（p > .07）。结论 财务焦虑可能会阻碍癌症筛查，即使对于意识到自身风险状况的高危女性也是如此。