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Background: Compared with national averages, women experiencing housing insecurity demonstrate significantly lower rates of recommended breast and cervical cancer screenings and, perhaps predictably, more advanced cancer stages at time of diagnosis. Qualitative studies have described a breadth of factors underpinning these inequalities, including barriers internal to patients (traumatic healthcare experiences, health literacy) and external/material (access to transport, insurance status). Disparities in screening uptake and cancer mortality, together with the overlapping barriers outlined by members of this population, evidence an ongoing need for adaptive screening modalities tailored to the needs of housing-insecure patients.

Objective: This project is a pilot initiative aiming to provide on-site breast and cervical cancer screenings to clients residing at Union Rescue Mission, a shelter in the Skid Row neighborhood of downtown Los Angeles. Recognizing this population’s poorly characterized and evolving needs, efforts to provide clinical services have been paired with educational events focused on cancer screenings as well as ongoing qualitative research to better characterize and evaluate the impact of these interventions. Since December 2025, this initiative has hosted educational town halls, each including distribution of hygiene kits, as well as our first on-site mammography event in partnership with City of Hope’s mobile unit.

Methods: The data collection and analysis portion of this project utilizes qualitative methods, comprising written surveys and group discussions. Two surveys are being distributed: one eliciting feedback from clients on educational town halls and their suggestions for future educational topics, and one focused on clients’ past experiences accessing mammograms and Pap smears and the factors they consider most salient when deciding whether to pursue cancer screenings.

Results: Data collection is ongoing. To date, we have encountered prominent themes of negative past experiences with healthcare providers and screenings, lack of knowledge on the guidelines for and utility of cancer screenings, and prohibitive time and financial burdens as significant barriers faced by this population. Surveys returned on educational events (total of 27 surveys, respondent ages 18-72) have shown the greatest interest in education surrounding nutrition, mammograms, and Pap smears, and the least interest in family planning and menopause.

Conclusions and Lessons Learned: Our findings support the efficacy of on-site educational and clinical services in ameliorating some of the barriers to cancer screenings among women at Union Rescue Mission. Alongside ongoing efforts to organize cervical cancer screenings, plans for expanded mammography events in partnership with other organizations in Skid Row are underway, offering additional opportunities for coalition-building. By putting research to use refining our educational and clinical interventions, our hope is to practice scholarship on housing-insecure populations that is not purely for academic benefit, but rather works towards stronger community partnership and more accessible care.