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William J. Gradishar, MD, FACP, FASCO

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Ways to Improve Breast Cancer Screening Among Women Experiencing Homelessness

By: Jenna Carter, PhD
Posted: Tuesday, August 20, 2024

Estimates suggest that 30% of deaths in persons experiencing homelessness (including deaths from cancer) are attributable to preventable causes or to barriers to timely and appropriate treatment of medical conditions. A study recently published in JCO Oncology Practice reported findings following mobile onsite mammography and breast health education events, where data were collected on specific barriers to and uptake of cancer screenings in women experiencing homelessness. Heather McKee Hurwitz, PhD, and Chirag Shah, MD, of the Taussig Cancer Institute, Cleveland Clinic, reported that although 12% required follow-up for abnormal results, only two participants completed the necessary follow-up screenings.

“By creating enduring programs offering screening, navigation, and education, academic-community partnerships may begin to address the increased cancer mortality among persons experiencing homelessness by improving screening adherence,” the investigators commented.

A total of 46 women (aged 40 or older) had mammograms and were included in this study, and 41 participated in the patient surveys. The main study outcomes included mammogram and diagnostic imaging results as well as questionnaire responses to patients’ views and barriers related to social determinants of health.

The survey response rate was 89%, and findings revealed that 85% of patients held health insurance provided by a Medicaid-managed plan. Apart from housing insecurity barriers, five patients (12%) reported transportation barriers. A total of 68% of participants disagreed or strongly disagreed with the statement, “I’m afraid the mammogram will be painful,” and 76% disagreed or strongly disagreed with the statement, “I’m busy and do not have time.” Nearly all participants (90%) responded yes to the statement, “I believe in preventative care screenings,” and 20% of the participants completed at least one additional cancer screening. Based on these findings, the authors concluded that persons experiencing homelessness have interest in cancer screening, and addressing barriers to access may alleviate disparities in cancer mortality within this population.

Disclosure: For full disclosures of the study authors, visit coi.ascopubs.org.


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