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Cancer patients experiencing homelessness: What’s happening to them?

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e18153 Background: Over three million people in the United States of America (USA) experience homelessness each year. Homeless patients have high rates of cancer risk factors, later stage diagnoses, and… Click to show full abstract

e18153 Background: Over three million people in the United States of America (USA) experience homelessness each year. Homeless patients have high rates of cancer risk factors, later stage diagnoses, and increased rates of cancer death. Despite this, little is known about the treatment of homeless patients with cancer. General recognition exists that homelessness is accompanied by socioeconomic challenges, but their effect on cancer treatment is unknown. This analysis identifies published data on cancer care in homeless populations and evaluates the difference in information volume related to screening and treatment. Methods: A PubMed, MEDLINE, and Web of Science search was performed using combinations of: “homeless, homeless persons, homelessness, street people, neoplasm, neoplasia, tumor, malignancy, cancer, screening, early detection of cancer, treatment, and therapy”. Each result was reviewed to identify primary research articles (excluded case reports and review articles) reporting data about cancer screening and/or treatment for homeless patients. For each included study, information was recorded including publication year, country, study type, patient numbers, and relevance to screening and/or treatment. Results: From this search, 61 publications were identified of which 29 were excluded due to inappropriate scope and/or publication type. In total, 32 publications were included for analysis. Most (81%) reported data from the USA and all were published in 1998 or later. Thirty (94%) reported data about cancer screening in homeless patients. In contrast, only two (6%) reported data about treatment and outcomes. Combined, these studies report screening data from over 8,000 patients compared to treatment data from less than 100. Only one publication reported utilization rates of different treatment modalities. Conclusions: This analysis highlights a disparity in published data about cancer screening and treatment for homeless patients. Little data exists regarding treatment and outcomes of homeless patients following a cancer diagnosis, with even less data about modalities, side effects, and follow-up. Future studies on treatment and outcomes of homeless cancer patients will identify barriers unique to this population and contribute to more evidence-based practices.

Keywords: screening treatment; treatment; cancer screening; cancer; homeless patients; data cancer

Journal Title: Journal of Clinical Oncology
Year Published: 2019

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