Association of prevalent social risks with treatment initiation among patients with cancer
| Autor: | Ana I. Velazquez Manana, John F. Dickerson, Matthew P. Banegas |
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| Rok vydání: | 2022 |
| Předmět: | |
| Zdroj: | Journal of Clinical Oncology. 40:137-137 |
| ISSN: | 1527-7755 0732-183X |
| DOI: | 10.1200/jco.2022.40.28_suppl.137 |
| Popis: | 137 Background: Social risks are adverse conditions that may serve as barriers to health care and lead to poor health outcomes. Among individuals with cancer, social risks like financial hardship have been associated with delayed treatment and increased mortality. However, little is known about the association of multiple prevalent social risks with cancer treatment initiation. In this study, we assessed the prevalence of social risks at time of cancer diagnosis and their association with treatment initiation. Methods: Data from patients aged ≥18, enrolled at Kaiser Permanente Northwest, diagnosed with cancer between June 1, 2017-December 31, 2019 and screened for social risks within 90 days pre-cancer diagnosis (baseline) were included. Baseline social risks included financial hardship, food insecurity, housing instability, and transportation difficulties. Cox proportional hazards regression models were used to assess the outcome of time to treatment initiation. Patients were censored at disenrollment or end of the study observation (February 29, 2020). Separate models were used to measure associations of any baseline social risks and time-to-treatment, each individual social risk, and a combined model with all 4 social risk variables. Confounding was controlled propensity score overlap weighting, estimated as a function of age at diagnosis, sex, race/ethnicity, Elixhauser comorbidity index, education, household income, NDI, cancer type, stage, and days from social risk assessment to cancer diagnosis. Results: Among the 549 patients, 49% were female and the mean age was 66 years (SD = 14). 105 (19%) patients reported any baseline social risk. The most common prevalent social risk was financial hardship (12.8%), followed by housing instability (9.1%), food insecurity (6.4%), and transportation difficulties (5.7%). In separate adjusted models, presence of any baseline social risk was associated with lower risk of treatment initiation (HR = 0.69, p = 0.040) and financial hardship was associated with lower risk of treatment initiation (HR = 0.63, p = 0.032). Conclusions: This study provides evidence that social risks at the time of cancer diagnosis are associated with lower risk of treatment initiation. Among individual social risks, financial hardship was a major barrier to initiation of cancer treatment. Our findings highlight the importance of screening for and addressing social risks at time of cancer diagnosis to reduce the risk of poor cancer care and subsequent health outcomes. |
| Databáze: | OpenAIRE |
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