{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:16:45Z","timestamp":1787498205276,"version":"build-2736575974"},"reference-count":58,"publisher":"American Medical Association (AMA)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n While eligibility for cancer screening tests varies by age, women aged 45 to 64 years should regularly screen for 3 cancers (breast, cervical, and colorectal). However, utilization of these screening tests varies.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate patterns of screening across 3 cancers in age-eligible women and to identify screening gaps.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This cross-sectional study used a retrospective analysis of the Behavioral Risk Factor Surveillance Survey\u2014a population-based survey of the US\u2014collected January to December 2024. Participants were survey respondents who were women aged 45 to 64 years, reflecting the ages in which women are currently recommended to complete screening for all 3 cancers.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Differences in screening patterns across sociodemographic characteristics, including age, insurance coverage, educational attainment, income, and past-year health care use, were evaluated.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Survey-weighted means and univariable and multivariable regressions were used to evaluate up-to-date (UTD) use of breast, cervical, and colorectal cancer screening. The proportion and total number of US women estimated to be due for each combination of screenings are reported. Factors associated with being UTD with any screening (vs no screening) and with all screenings (vs 1 or 2 screenings) are identified.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The final sample was 68\u202f111 women (mean [SD] age 54.8 [5.8] years), of whom 35\u202f047 (weighted percentage, 50.3%) reported being UTD with all 3 cancer screening tests, 19\u202f389 (weighted percentage, 28.8%) were UTD with 2 screenings, 8776 (weighted percentage, 13.2%) were UTD with only 1 screening, and 4899 (weighted percentage, 7.7%) were UTD with no screenings. Together, these reflect an estimated 17.9 million women aged 45 to 64 years who were due for 1 or more screening tests, with nearly half this group (42.2%; 7.6 million women) due for multiple tests. Socioeconomic factors were associated with all (vs 1 or 2) screenings, while access factors (eg, health insurance, having a regular health care practitioner) were associated with use of both any screening and all screenings.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this cross-sectional study of screening patterns, nearly 18 million middle-aged US women were estimated to be overdue for 1 or more cancer screening tests. Access-related policies or bundled clinical interventions that improve screening across multiple tests should be prioritized to most effectively reduce the burden of screen-detectable cancers.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.12976","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T15:30:18Z","timestamp":1778859018000},"page":"e2612976","source":"Crossref","is-referenced-by-count":1,"title":["Breast, Cervical, and Colorectal Cancer Screening Rates in Women Aged 45 to 64 Years"],"prefix":"10.1001","volume":"9","author":[{"given":"Jennifer C.","family":"Spencer","sequence":"first","affiliation":[{"name":"Department of Population Health, Dell Medical School, University of Texas at Austin"},{"name":"Department of Internal Medicine, Dell Medical School, University of Texas at Austin"},{"name":"Livestrong Cancer Institutes, Dell Medical School, University of Texas at Austin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane R.","family":"Montealegre","sequence":"additional","affiliation":[{"name":"Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Calder\u00f3n-Mora","sequence":"additional","affiliation":[{"name":"Department of Population Health, Dell Medical School, University of Texas at Austin"},{"name":"Livestrong Cancer Institutes, Dell Medical School, University of Texas at Austin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael P.","family":"Pignone","sequence":"additional","affiliation":[{"name":"Margolis Center for Health Policy, Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2026,5,15]]},"reference":[{"issue":"1","key":"zoi260388r2","doi-asserted-by":"publisher","first-page":"10","DOI":"10.3322\/caac.21871","article-title":"Cancer statistics, 2025.","volume":"75","author":"Siegel","year":"2025","journal-title":"CA Cancer J Clin"},{"key":"zoi260388r3","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1186\/2046-4053-2-35","article-title":"Screening for cervical cancer: a systematic review and meta-analysis.","volume":"2","author":"Peirson","year":"2013","journal-title":"Syst Rev"},{"issue":"3","key":"zoi260388r4","doi-asserted-by":"publisher","first-page":"458","DOI":"10.14309\/ajg.0000000000001122","article-title":"ACG clinical guidelines: colorectal cancer screening 2021.","volume":"116","author":"Shaukat","year":"2021","journal-title":"Am J Gastroenterol"},{"issue":"9855","key":"zoi260388r5","doi-asserted-by":"publisher","first-page":"1778","DOI":"10.1016\/S0140-6736(12)61611-0","article-title":"The benefits and harms of breast cancer screening: an independent review.","volume":"380","author":"Independent UK Panel on Breast Cancer Screening","year":"2012","journal-title":"Lancet"},{"key":"zoi260388r6","doi-asserted-by":"publisher","DOI":"10.5888\/pcd20.230071","article-title":"Up-to-date breast, cervical, and colorectal cancer screening test use in the United States, 2021.","volume":"20","author":"Sabatino","year":"2023","journal-title":"Prev Chronic Dis"},{"key":"zoi260388r7","doi-asserted-by":"publisher","DOI":"10.5888\/pcd18.200315","article-title":"Disparities in meeting USPSTF breast, cervical, and colorectal cancer screening guidelines among women in the United States.","volume":"18","author":"Benavidez","year":"2021","journal-title":"Prev Chronic Dis"},{"issue":"1","key":"zoi260388r8","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.43582","article-title":"Assessment of US Preventive Services Task Force guideline-concordant cervical cancer screening rates and reasons for underscreening by age, race and ethnicity, sexual orientation, rurality, and insurance, 2005 to 2019.","volume":"5","author":"Suk","year":"2022","journal-title":"JAMA Netw Open"},{"issue":"4","key":"zoi260388r9","doi-asserted-by":"publisher","first-page":"667","DOI":"10.1016\/j.amepre.2023.04.016","article-title":"Racial and ethnic disparities in cervical cancer screening from three U.S. healthcare settings.","volume":"65","author":"Spencer","year":"2023","journal-title":"AJPM"},{"issue":"10","key":"zoi260388r10","doi-asserted-by":"publisher","first-page":"1569","DOI":"10.1002\/cncr.34696","article-title":"Understanding the role of access in Hispanic cancer screening disparities.","volume":"129","author":"Spencer","year":"2023","journal-title":"Cancer"},{"issue":"6","key":"zoi260388r11","doi-asserted-by":"publisher","DOI":"10.1093\/jncics\/pkae113","article-title":"Rural-urban disparities and trends in cancer screening: an analysis of Behavioral Risk Factor Surveillance System data (2018-2022).","volume":"8","author":"Benavidez","year":"2024","journal-title":"J Natl Cancer Inst Cancer Spectr"},{"issue":"1","key":"zoi260388r12","doi-asserted-by":"publisher","DOI":"10.1148\/rg.230090","article-title":"Breast cancer disparity and outcomes in underserved women.","volume":"44","author":"Ozcan","year":"2024","journal-title":"Radiographics"},{"key":"zoi260388r13","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmedr.2025.102976","article-title":"Predictors of colorectal cancer screening and screening modalities among patients seen at federally qualified health centers funded by the United States Health Resources and Services Administration.","volume":"50","author":"Aaronson","year":"2025","journal-title":"Prev Med Rep"},{"issue":"6","key":"zoi260388r14","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1001\/jamainternmed.2024.0693","article-title":"National breast, cervical, and colorectal cancer screening use in federally qualified health centers.","volume":"184","author":"Amboree","year":"2024","journal-title":"JAMA Intern Med"},{"issue":"8","key":"zoi260388r15","doi-asserted-by":"publisher","first-page":"1094","DOI":"10.1089\/jwh.2018.7141","article-title":"Predictors of cervical cancer screening among infrequently screened women completing human papillomavirus self-collection: my body my test-1.","volume":"28","author":"Lea","year":"2019","journal-title":"J Womens Health (Larchmt)"},{"issue":"1","key":"zoi260388r16","doi-asserted-by":"publisher","DOI":"10.1016\/j.focus.2024.100289","article-title":"Preventive care needs of the North Carolina Medicaid expansion population.","volume":"4","author":"Spencer","year":"2024","journal-title":"AJPM Focus"},{"issue":"7","key":"zoi260388r17","doi-asserted-by":"publisher","first-page":"692","DOI":"10.1097\/MLR.0b013e31817893b1","article-title":"Disparities in mammography use among US women aged 40-64 years, by race, ethnicity, income, and health insurance status, 1993 and 2005.","volume":"46","author":"Sabatino","year":"2008","journal-title":"Med Care"},{"issue":"2","key":"zoi260388r18","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1136\/sextrans-2017-053235","article-title":"Acceptability and ease of use of mailed HPV self-collection among infrequently screened women in North Carolina.","volume":"94","author":"Anderson","year":"2018","journal-title":"Sex Transm Infect"},{"issue":"11","key":"zoi260388r19","doi-asserted-by":"publisher","first-page":"3441","DOI":"10.1007\/s11606-021-06691-y","article-title":"Effectiveness and cost-effectiveness of mailed fit in a safety net clinic population.","volume":"36","author":"Pignone","year":"2021","journal-title":"J Gen Intern Med"},{"issue":"1","key":"zoi260388r20","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1186\/s12885-017-3813-4","article-title":"A systematic review of clinic and community intervention to increase fecal testing for colorectal cancer in rural and low-income populations in the United States: how, what and when?","volume":"18","author":"Davis","year":"2018","journal-title":"BMC Cancer"},{"issue":"3","key":"zoi260388r21","doi-asserted-by":"publisher","first-page":"288","DOI":"10.1016\/j.clbc.2024.11.012","article-title":"Mobile mammography utilization and breast cancer screening adherence among Medicare fee-for-service beneficiaries.","volume":"25","author":"Pelzl","year":"2025","journal-title":"Clin Breast Cancer"},{"issue":"5","key":"zoi260388r22","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1177\/10901981221074918","article-title":"Comparison of narrative video and flipchart presentation to promote cervical cancer screening among Latinas along the border.","volume":"50","author":"Calder\u00f3n-Mora","year":"2023","journal-title":"Health Educ Behav"},{"issue":"6","key":"zoi260388r23","doi-asserted-by":"publisher","first-page":"1114","DOI":"10.1158\/1055-9965.EPI-20-1673","article-title":"Cost-effectiveness of offering cervical cancer screening with HPV self-sampling among African-American women in the Mississippi Delta.","volume":"30","author":"Campos","year":"2021","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"issue":"4","key":"zoi260388r24","doi-asserted-by":"publisher","first-page":"250","DOI":"10.3322\/caac.21457","article-title":"Colorectal cancer screening for average-risk adults: 2018 guideline update from the American Cancer Society.","volume":"68","author":"Wolf","year":"2018","journal-title":"CA Cancer J Clin"},{"issue":"19","key":"zoi260388r25","doi-asserted-by":"publisher","first-page":"1965","DOI":"10.1001\/jama.2021.6238","article-title":"Screening for colorectal cancer: US Preventive Services Task Force recommendation statement.","volume":"325","author":"Davidson","year":"2021","journal-title":"JAMA"},{"issue":"15","key":"zoi260388r26","doi-asserted-by":"publisher","first-page":"1599","DOI":"10.1001\/jama.2015.12783","article-title":"Breast cancer screening for women at average risk: 2015 guideline update from the American Cancer Society.","volume":"314","author":"Oeffinger","year":"2015","journal-title":"JAMA"},{"issue":"22","key":"zoi260388r27","doi-asserted-by":"publisher","first-page":"1918","DOI":"10.1001\/jama.2024.5534","article-title":"Screening for breast cancer: US Preventive Services Task Force recommendation statement.","volume":"331","author":"Nicholson","year":"2024","journal-title":"JAMA"},{"issue":"8","key":"zoi260388r28","doi-asserted-by":"publisher","first-page":"1010","DOI":"10.1097\/DCR.0000000000003789","article-title":"Disparities in uptake of the 2021 US Preventive Services Task Force colorectal cancer screening recommendations among adults aged 45 to 49 years.","volume":"68","author":"Myers","year":"2025","journal-title":"Dis Colon Rectum"},{"issue":"12","key":"zoi260388r29","doi-asserted-by":"publisher","first-page":"1073","DOI":"10.1007\/s10552-023-01758-z","article-title":"Associations between sociodemographic factors and breast, cervical, and colorectal cancer screening in the United States.","volume":"34","author":"Mondrag\u00f3n M\u00e1rquez","year":"2023","journal-title":"Cancer Causes Control"},{"issue":"7","key":"zoi260388r31","doi-asserted-by":"publisher","first-page":"674","DOI":"10.1001\/jama.2018.10897","article-title":"Screening for cervical cancer: US Preventive Services Task Force recommendation statement.","volume":"320","author":"Curry","year":"2018","journal-title":"JAMA"},{"issue":"2 Pt 1","key":"zoi260388r32","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1097\/AOG.0b013e318299a6cf","article-title":"Nationwide trends in the performance of inpatient hysterectomy in the United States.","volume":"122","author":"Wright","year":"2013","journal-title":"Obstet Gynecol"},{"issue":"3","key":"zoi260388r33","doi-asserted-by":"publisher","first-page":"710","DOI":"10.1016\/j.ygyno.2020.05.030","article-title":"Historical and projected hysterectomy rates in the USA: implications for future observed cervical cancer rates and evaluating prevention interventions.","volume":"158","author":"Simms","year":"2020","journal-title":"Gynecol Oncol"},{"issue":"7","key":"zoi260388r35","doi-asserted-by":"publisher","first-page":"702","DOI":"10.1093\/aje\/kwh090","article-title":"A modified Poisson regression approach to prospective studies with binary data.","volume":"159","author":"Zou","year":"2004","journal-title":"Am J Epidemiol"},{"issue":"1","key":"zoi260388r36","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2025.03.005","article-title":"Asking about cervical cancer screening in national surveys: implications for health literacy and research.","volume":"69","author":"Morenz","year":"2025","journal-title":"Am J Prev Med"},{"key":"zoi260388r37","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v009.i08","article-title":"Analysis of complex survey samples.","volume":"9","author":"Lumley","year":"2004","journal-title":"J Stat Softw"},{"issue":"8","key":"zoi260388r38","first-page":"597","article-title":"Emerging role of HPV self-sampling in cervical cancer screening for hard-to-reach women: focused literature review.","volume":"63","author":"Madzima","year":"2017","journal-title":"Can Fam Physician"},{"issue":"7","key":"zoi260388r39","doi-asserted-by":"publisher","first-page":"2643","DOI":"10.1016\/j.acra.2023.12.013","article-title":"Identifying and addressing barriers to screening mammography in a medically underserved community.","volume":"31","author":"Zeballos Torrez","year":"2024","journal-title":"Acad Radiol"},{"issue":"6","key":"zoi260388r40","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1001\/jamainternmed.2024.0702","article-title":"Cancer screening through federally qualified health centers.","volume":"184","author":"Spencer","year":"2024","journal-title":"JAMA Intern Med"},{"key":"zoi260388r41","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/j.ygyno.2024.06.028","article-title":"Impact of Medicaid expansion on cervical cancer screening: a state-specific difference in difference analysis.","volume":"189","author":"Bergstein","year":"2024","journal-title":"Gynecol Oncol"},{"issue":"6","key":"zoi260388r42","doi-asserted-by":"publisher","first-page":"1351","DOI":"10.1002\/cncr.32662","article-title":"Colorectal cancer screening patterns after the American Cancer Society\u2019s recommendation to initiate screening at age 45 years.","volume":"126","author":"Fedewa","year":"2020","journal-title":"Cancer"},{"issue":"9","key":"zoi260388r43","doi-asserted-by":"publisher","first-page":"1435","DOI":"10.1002\/pon.5997","article-title":"Factors promoting breast, cervical and colorectal cancer screenings participation: a systematic review.","volume":"31","author":"Vallone","year":"2022","journal-title":"Psychooncology"},{"key":"zoi260388r44","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmedr.2023.102353","article-title":"Barriers and facilitators of colorectal cancer screening using the 5As framework: a systematic review of US studies.","volume":"35","author":"Agunwamba","year":"2023","journal-title":"Prev Med Rep"},{"issue":"0","key":"zoi260388r45","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2023.11.017","article-title":"Medicaid expansion states see long-term improvement in colorectal cancer screening uptake among low-income individuals.","volume":"0","author":"Aaronson","year":"2023","journal-title":"Gastroenterology"},{"issue":"11","key":"zoi260388r46","doi-asserted-by":"publisher","first-page":"1630","DOI":"10.2105\/AJPH.2022.307027","article-title":"Differences in cancer screening responses to state Medicaid expansions by race and ethnicity, 2011\u20132019.","volume":"112","author":"Friedman","year":"2022","journal-title":"Am J Public Health"},{"issue":"6","key":"zoi260388r47","doi-asserted-by":"publisher","first-page":"1202","DOI":"10.1158\/1055-9965.EPI-21-1077","article-title":"Role of Medicaid in early detection of screening-amenable cancers.","volume":"31","author":"Bradley","year":"2022","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"issue":"5","key":"zoi260388r48","doi-asserted-by":"publisher","first-page":"657","DOI":"10.1007\/s10552-015-0553-0","article-title":"Breast cancer screening of underserved women in the USA: results from the National Breast and Cervical Cancer Early Detection Program, 1998-2012.","volume":"26","author":"Howard","year":"2015","journal-title":"Cancer Causes Control"},{"issue":"7","key":"zoi260388r49","doi-asserted-by":"publisher","first-page":"691","DOI":"10.1007\/s10552-020-01314-z","article-title":"Estimating the impact of increasing cervical cancer screening in the National Breast and Cervical Cancer Early Detection Program among low-income women in the USA.","volume":"31","author":"Pollack","year":"2020","journal-title":"Cancer Causes Control"},{"issue":"8","key":"zoi260388r50","doi-asserted-by":"publisher","first-page":"819","DOI":"10.1007\/s10552-019-01178-y","article-title":"Cost-effectiveness of breast cancer screening in the National Breast and Cervical Cancer Early Detection Program.","volume":"30","author":"Rim","year":"2019","journal-title":"Cancer Causes Control"},{"key":"zoi260388r51","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2019.105836","article-title":"Mailed FIT (fecal immunochemical test), navigation or patient reminders? using microsimulation to inform selection of interventions to increase colorectal cancer screening in Medicaid enrollees.","volume":"129S","author":"Davis","year":"2019","journal-title":"Prev Med"},{"key":"zoi260388r52","doi-asserted-by":"publisher","DOI":"10.5888\/pcd20.230083","article-title":"Mail-based self-sampling to complete colorectal cancer screening: accelerating colorectal cancer screening and follow-up through implementation science.","volume":"20","author":"Gupta","year":"2023","journal-title":"Prev Chronic Dis"},{"issue":"9","key":"zoi260388r53","doi-asserted-by":"publisher","first-page":"1119","DOI":"10.1001\/jamainternmed.2025.2971","article-title":"Self-collection for cervical cancer screening in a safety-net setting: the PRESTIS randomized clinical trial.","volume":"185","author":"Montealegre","year":"2025","journal-title":"JAMA Intern Med"},{"key":"zoi260388r54","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1016\/j.clinimag.2021.02.040","article-title":"Project ScanVan: mobile mammography services to decrease socioeconomic barriers and racial disparities among medically underserved women in NYC.","volume":"78","author":"Tsapatsaris","year":"2021","journal-title":"Clin Imaging"},{"key":"zoi260388r55","doi-asserted-by":"publisher","DOI":"10.5888\/pcd21.230266","article-title":"Costs and projected effect of a federally qualified health center-based mailed colorectal cancer screening program in Texas.","volume":"21","author":"Olmstead","year":"2024","journal-title":"Prev Chronic Dis"},{"issue":"62","key":"zoi260388r56","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1093\/jncimonographs\/lgad015","article-title":"Adapting a model of cervical carcinogenesis to self-identified Black women to evaluate racial disparities in the United States.","volume":"2023","author":"Spencer","year":"2023","journal-title":"J Natl Cancer Inst Monogr"},{"issue":"1","key":"zoi260388r57","doi-asserted-by":"publisher","first-page":"62","DOI":"10.18043\/ncm.79.1.62","article-title":"Toward value in health care: perspectives, priorities, and policy.","volume":"79","author":"Wheeler","year":"2018","journal-title":"N C Med J"},{"key":"zoi260388r58","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmedr.2022.102063","article-title":"Factors associated with the accurate self-report of cancer screening behaviors among women living in the rural Midwest region of the United States.","volume":"30","author":"Katz","year":"2022","journal-title":"Prev Med Rep"},{"key":"zoi260388r1","doi-asserted-by":"crossref","unstructured":"Curtin? S, Betzalda? TV, Bastian? B. Deaths: leading causes for 2021. National Vital Statistics Reports. 2024. Accessed April 2, 2026. https:\/\/stacks.cdc.gov\/view\/cdc\/147882","DOI":"10.15620\/cdc:147099"},{"key":"zoi260388r30","unstructured":"Centers for Disease Control and Prevention. 2024 BRFSS survey data and documentation. Behavioral Risk Factor Surveillance System. 2025. Accessed December 12, 2025. https:\/\/www.cdc.gov\/brfss\/annual_data\/annual_2024.html"},{"key":"zoi260388r34","unstructured":"Centers for Disease Control and Prevention. Complex sampling weights and preparing 2024 BRFSS module data for analysis. 2025. Accessed April 3, 2026. https:\/\/www.cdc.gov\/brfss\/annual_data\/2024\/pdf\/Complex-Sampling-Weights-and-Preparing-Module-Data-for-Analysis-2024-508.pdf"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2849096\/spencer_2026_oi_260388_1778259663.32777.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T15:30:21Z","timestamp":1778859021000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2849096"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,15]]},"references-count":58,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2026.12976","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,15]]}}}