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Homelessness and Cancer: A Multi-Site, Mixed Methods Study of Delayed or No Cancer Therapy
Robert J Haemmerle1, Kelliann Fee-Schroeder2, Lynn Phelan2
1Department of Medicine, Mayo Clinic, Rochester, MN, USA.
The American Journal of Hospice & Palliative Care
|March 18, 2025
Summary
Cancer treatment is frequently delayed for patients experiencing homelessness due to communication barriers and logistical challenges. Addressing these issues, like providing phones, could improve timely cancer care.
Area of Science:
- Oncology
- Public Health
- Health Services Research
Background:
- Patients experiencing homelessness often face poor cancer outcomes attributed to treatment delays.
- Limited mixed-methods research exists on patient- and healthcare staff-level factors contributing to these delays.
Purpose of the Study:
- To investigate patient- and healthcare staff-level factors contributing to cancer treatment delays in patients experiencing homelessness.
- To identify specific barriers and facilitators for timely cancer care initiation in this population.
Main Methods:
- A single-institution, multi-site study analyzed medical records from January 2019 to October 2023.
- Quantitative and qualitative data from thousands of patient records were rigorously analyzed.
- Focus on 43 patients experiencing homelessness with cancer diagnoses.
Main Results:
- 63% of patients (27 out of 43) experienced cancer treatment delays exceeding 4 weeks.
- Median time to cancer therapy initiation was 9 weeks.
- Key barriers included communication challenges (e.g., lack of phone access), patient reluctance, and medical complexities.
Conclusions:
- Cancer therapy initiation is frequently delayed for patients experiencing homelessness.
- Lack of consistent communication channels (e.g., phone access) is a significant barrier.
- Potential interventions, such as providing basic communication tools, may help mitigate delays.
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