The associations between household food insecurity and cancer: A comprehensive systematic review and meta-analysis of observational studies among adults.

In 30 seconds

This systematic review and meta-analysis examined observational evidence on household food insecurity (HFI) and cancer-related outcomes in adults. It included 44 studies involving 1,135,888 adults from the United States, Iran, and Brazil. In a meta-analysis of six studies, HFI was associated with lower cancer screening uptake (pooled relative effect estimate = 0.91; 95% CI: 0.87, 0.96; I² = 78.8%; p < 0.001). The review also reported associations with poorer treatment and survivorship outcomes, including mortality and quality of life.

Key findings

• HFI was associated with lower cancer screening uptake: pooled relative effect estimate = 0.91; 95% CI: 0.87, 0.96.
• Associations were reported for colorectal screening (0.83; 95% CI: 0.70, 0.98) and breast screening (0.72; 95% CI: 0.54, 0.96).
• Among cancer patients, reported HFI prevalence ranged from 14% to 78%, with higher rates in low-income clinical sub-populations.
• HFI was associated with poorer treatment and survivorship outcomes, including complications, longer hospital stays, mortality, non-adherence, and lower quality of life.

Why it matters

Food insecurity may intersect with cancer care at multiple stages, from access to screening through treatment and survivorship. The reported associations highlight a potentially important social determinant of unequal cancer outcomes. Recognising this relationship can inform assessment of barriers and support needs, while the observational evidence does not establish that HFI directly causes the reported outcomes.

What to keep in mind

The evidence is observational, and the screening meta-analysis showed substantial heterogeneity (I² = 78.8%). Included studies came from only three countries, limiting the settings represented.