Routine Social Health Screening Helps Improve Adherence to Time-Sensitive Cancer Treatment

Chan K, Francescatti AB, Cotler JH, et al. Current Practices in Social Determinants of Health Screening in Commission on Cancer Hospitals. J Am Coll Surg. March 2026.

Social determinants of health (SDOH) are associated with adverse cancer outcomes, yet the prevalence and impact of SDOH screening across Commission on Cancer (CoC)-accredited programs are unknown. Authors of this study evaluated national SDOH screening practices and their association with adherence to CoC quality measures.

A cross-sectional survey of 1,445 CoC-accredited programs (October–December 2024) was linked to National Cancer Database data (2020–2022). Adult patients treated at 435 responding hospitals (30.1%) were included. Programs were categorized by routine outpatient SDOH screening status. Multivariable logistic regression assessed associations between screening and receipt of quality measure–concordant care, adjusting for screening duration, age, race, ethnicity, Charlson Comorbidity Index, insurance status, rurality, and program type/case count.

Of 435 programs, 165 (37.9%) reported routine SDOH screening. Screening programs more frequently treated ≥10% Medicaid/uninsured patients (29.1% versus 19.6%, p = 0.023). Mean performance was higher at screening hospitals for breast radiation within 60 days (66.6% versus 64.6%, p = 0.046), colon adjuvant chemotherapy within 120 days (84.6% versus 81.9%, p = 0.018), and lung systemic therapy within 90 days (77.2% versus 75.4%, p = 0.043). On adjusted analysis, screening for >3 years was independently associated with timely colon adjuvant chemotherapy (OR 1.05; 95% CI 1.01–1.07; p = 0.033). Findings persisted after excluding safety net hospitals.

Surgical oncologists and support staff at CoC-accredited cancer care programs should know that sustained screening is independently associated with improved adherence to time-sensitive colon cancer chemotherapy, which supports integration of patient-level SDOH assessment into oncology care delivery.