Abstract B026: Everyday discrimination and cervical cancer screening among eligible women in the All of Us Research Program

Abstract

Abstract Introduction: Cervical cancer is largely preventable if found early through routine screening, yet uptake remains uneven across social groups. Social drivers of health may shape screening behavior, but the role of interpersonal discrimination is not well characterized. The purpose of this study is to examine social drivers of health associated with cervical cancer screening uptake among participants in the All of Us (AOU) Research Program. Materials and Methods: We analyzed data from 61,388 participants in AOU. Eligible participants were women aged 21-65 years at the time of Social Determinants of Health survey completion, with no history of cervical cancer or hysterectomy, who completed the Social Determinants of Health survey and had linked electronic health record (EHR) data. Two outcomes were examined: any cervical screening (Pap, HPV, or co-test within 5 years before and after survey completion) and up-to-date screening (Pap within 3 years or HPV within 5 years) among screened women. Multivariable logistic regression models were fitted, adjusting for age, race and ethnicity, income, education, insurance, marital status, birthplace, and home language. Results: Of 61,388 women, 14,249 (23.2%) had documented screening; among screened women with ascertainable status (n=13,386), 84.5% were up to date. Everyday discrimination was independently associated with both outcomes. A 10-unit increase in discrimination scores was associated with 4% lower odds of any screening (OR=0.96, 95% CI: 0.93-0.99) and 12% lower odds of up-to-date screening (OR=0.88, 95% CI: 0.82-0.95). Quartile models confirmed a graded pattern (highest vs. lowest quartile, OR=0.79 for up-to-date screening). A 10-unit increase in perceived stress (OR=0.94;0.92-0.97) and religious experiences (OR=0.96;0.94-0.98) were associated with lower odds of any screening, whereas supportive relationships were not. Racial and ethnic disparities persisted after adjustment: compared with non-Hispanic White women, non-Hispanic Black (OR=0.83;0.77-0.89), Hispanic (OR=0.78;0.73-0.83), and non-Hispanic Other women (OR=0.72; 0.67-0.78) had lower odds of any screening, and non-Hispanic Black women remained less likely to be up to date (OR=0.70; 0.60-0.84). Conclusions: Everyday discrimination was independently associated with lower cervical cancer screening uptake and lower up-to-date status, beyond socioeconomic factors, and racial and ethnic disparities persisted after adjustment. Family history of cervical cancer was not modeled due to high missingness, and screening proportions reflect EHR-documented tests that likely undercount screening performed outside linked health systems; findings for access-related covariates should be interpreted accordingly. These cross-sectional findings position discrimination as a candidate social driver of cervical screening and underscore the need for equity-focused interventions that address experiences of unfair treatment alongside material barriers. Citation Format: Adaeze C. Aroh, Feitong Lei, Adebola Adegboyega, Bin Huang. Everyday discrimination and cervical cancer screening among eligible women in the All of Us Research Program [abstract]. In: Proceedings of the 19th AACR Conference on the Science of Cancer Health Disparities; 2026 Oct 18-21; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2026;35(10 Suppl):Abstract nr B026.