LAUSR

e18107 Background: Appalachian women have a higher burden of both morbidity and mortality from female cancers of the breast, ovary and cervix, and have documented treatment delay and poor adherence. The environmental and sociobehavioral risk factors that could contribute towards these issues such as patient non adherence and treatment delay have not been studied. Methods: We conducted a detailed survey of women seeking cancer related preventative care in a tertiary care cancer center in the Appalachian region of Virginia. Survey questions included health behaviors, financial issues, and past health history. The survey was administered to 200 women and a total of 158 complete responses (42 in women with cancer in the recent past) were obtained. Results: There were significant differences between women with and without female cancers with the cancer group being older, less likely to be married, be unemployed and more likely to have received mammograms (All p < 0.05). In multivariate analyses , the major risk factor associated with delaying treatment was the lack of health insurance in the previous year (RR: 0.25, 95% CI: 0.082-0.73). Conclusions: Women in Appalachia face significant barriers in receiving diagnoses and treatment for female cancer including lack of employment, health care insurance and social support. These factors need to be considered while designing interventions to improve access and adherence to cancer treatments in this population.