Addressing Colorectal Cancer Disparities in Unhoused Populations: A Call for Equitable Access and Compassionate Care

Area of Science:

• Oncology
• Public Health
• Health Equity

Background:

• Housing is fundamental to health, and unhoused individuals experience significantly worse health outcomes, including higher premature mortality rates.
• Cancer, especially colorectal cancer, is a leading cause of death among older unhoused adults.
• Providing comprehensive oncologic care for unhoused patients presents unique challenges across prevention, screening, diagnosis, treatment, and follow-up.

Purpose of the Study:

• To highlight the challenges in colorectal cancer care for unhoused individuals.
• To underscore the impact of these challenges on diagnosis and survival.
• To propose strategies for health systems to improve health equity in colorectal cancer care for unhoused patients.

Main Methods:

• This study synthesizes existing knowledge on the intersection of housing status, colorectal cancer, and healthcare delivery.
• It analyzes the barriers faced by unhoused individuals at each stage of cancer care.
• The review focuses on identifying actionable steps for health systems.

Main Results:

• Challenges in care lead to later-stage colorectal cancer diagnosis and reduced overall survival among unhoused populations.
• Existing healthcare systems often fail to adequately address the multifaceted needs of unhoused patients.
• Targeted interventions are necessary to overcome systemic barriers.

Conclusions:

• Health systems must prioritize improving access to care, care transitions, and healthcare quality for unhoused patients with or at risk for colorectal cancer.
• Addressing socioeconomic and environmental factors is critical for advancing health equity.
• Systemic changes are required to ensure equitable colorectal cancer outcomes for all individuals, regardless of housing status.