Cancer Screening and Barriers to Screening Among Unhoused Individuals in Rhode Island

Area of Science:

• Public Health
• Health Disparities
• Cancer Epidemiology

Background:

• Unhoused populations experience higher cancer mortality rates compared to the general population.
• Significant disparities exist in cancer screening uptake among individuals experiencing homelessness.
• Prevalence of cancer risk factors like smoking and alcohol use is high in this demographic.

Purpose of the Study:

• To determine cancer screening uptake rates for breast, cervical, and colorectal cancers among unhoused individuals in Rhode Island.
• To identify barriers faced by unhoused individuals in accessing cancer screenings.
• To explore demographic factors influencing cancer screening adherence.

Main Methods:

• Cross-sectional survey administered to 502 unhoused participants.
• Logistic regression analysis to identify associations between screening status and demographic characteristics.
• Qualitative analysis of open-ended responses to elucidate self-identified barriers.

Main Results:

• Screening rates for breast (27%), cervical (58%), and colorectal (39%) cancers were below national averages.
• Key barriers included lack of a primary care provider (PCP), transportation challenges, fear, and logistical issues.
• Unhoused men with a PCP showed significantly higher colorectal cancer screening rates (52%) compared to those without a PCP (18%).

Conclusions:

• Enhancing cancer screening for unhoused communities is a critical public health priority.
• Improving access to primary care providers (PCPs) is a key strategy to increase screening rates.
• Health insurance and accessible healthcare services are vital for addressing cancer screening disparities in homeless populations.