Gaps in Prevention: Trends and Regional Variation in Cancer Screening in Illinois

Abstract

Geographic inequities in cancer screening continue to undermine cancer prevention efforts in the United States. Using weighted data from the 2020–2023 Illinois County Behavioral Risk Factor Surveys, this study evaluated regional variation in adherence to U.S. Preventive Services Task Force screening guidelines for breast, cervical (HPV), colorectal, and prostate cancers across six Illinois public health regions. Substantial disparities were identified, with screening participation varying widely by cancer type and geography. Mammography uptake was moderate overall but showed notable regional differences, while cervical cancer screening exhibited the greatest deficit, with more than half of eligible women never screened, and particularly low participation in the Peoria and Rockford regions. Colorectal cancer screening rates were more consistent across regions, yet remained below optimal levels statewide, and prostate cancer screening rates were uniformly low. Regions with poorer screening performance were consistently associated with socioeconomic disadvantages and limited access to healthcare. These findings highlight pronounced and uneven gaps in cancer screening across Illinois, underscoring the need for regionally tailored interventions, such as improved access to care, community-based outreach, and the expanded use of home-based screening, to advance equity in cancer prevention.