Cancer Doesn't Check Papers: The Screening Gap Widening Along Citizenship Lines

A new JAMA study of 131,501 Americans finds noncitizens are 65% less likely to be screened for colorectal cancer — and 97% of the breast cancer gap is structural, not behavioral.

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Cancer is the leading cause of death among noncitizen residents of the United States. Not heart disease. Not diabetes. Cancer.

That fact should stop every health system leader in their tracks. A landmark study published this month in JAMA Network Open makes it more alarming: noncitizens are being screened for the three most preventable cancers at rates dramatically below their US-born neighbors — and the gap is almost entirely structural, not cultural.

This is not a story about patients who don't want screening. It is a story about a system not designed to reach them.

The Study

Researchers analyzed 131,501 respondents from the National Health Interview Survey (NHIS) spanning 2010 to 2023 — the largest citizenship-stratified cancer screening analysis in the peer-reviewed literature. The study was published August 3, 2026 in JAMA Network Open (PMID: 42574011). Findings are nationally representative and adjusted for demographics, socioeconomic status, insurance coverage, and hea…