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Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

1300 - Patient reported stressors in the practical domain of a cancer diagnosis: The impact of socioeconomic status and geographic location

Date

22 Oct 2018

Session

Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

Topics

Bioethical Principles and GCP

Tumour Site

Presenters

Cheryl Ho

Citation

Annals of Oncology (2018) 29 (suppl_8): viii562-viii575. 10.1093/annonc/mdy297

Authors

C. Ho1, B. Leung1, H. Rennie2, J. Laskin1, J. Wu3, A. Bates2

Author affiliations

  • 1 Medical Oncology, BC Cancer, V5Z 4E6 - Vancouver/CA
  • 2 Psychosocial Oncology, BC Cancer, V5Z 4E6 - Vancouver/CA
  • 3 Radiation oncology, BC Cancer, V5Z 4E6 - Vancouver/CA
More

Resources

Abstract 1300

Background

Socioeconomic status (SES) and geographic location may influence access to cancer care. In the Canadian health care system, cancer care is publically funded however, other factors including workplace absences and travel for treatment can be additional stressors. We aimed to assess patient reported distress in the practical aspects of accessing cancer treatment in relation to their SES and community size.

Methods

BC Cancer provides cancer care to a population of 4.6 million dispersed over 944, 735 km2. All patients referred to BC Cancer from 2011 – 2016 who completed the Psychosocial Screen for Cancer (PSSCAN-R) within 6 months of cancer diagnosis were included in the study. Baseline characteristics were collected from the BC Cancer registry. The Canadian Postal Code Conversion File Plus (PCCF+) was used to link the patients’ postal codes with standard 2011 census geographic areas and neighbourhood income quintiles. Chi squared test was used for comparisons.

Results

48,954 patients completed the PSSCAN-R and 45 164 had PCCF+ data available. Baseline characteristics: median age 66, 55% female, 17% presented with metastatic disease. Tumor distribution: 22% breast, 19% GI, 13% GU, 13% lung and 33% other. Income quintiles were grouped into lowest/mid-lower, middle, mid-higher/highest. Community size: >1.5M 53%, 1.5M – 10K 17%, <10K 30%. Patients in lowest/mid-lower compared to mid-higher/highest income groups reported more distress around finances (19% vs 14.1%), getting to appointments (15.3% vs 9.7%) and accommodations during treatment (5.6% vs 3.8%). Concerns regarding school/work were similar (10.5% vs 10.9%). Patients in rural versus large communities (1.5M+) reported more distress around finances (19% vs 15.1%), getting to appointments (15% vs 11.9%), accommodations during treatment (9.7% vs 2.7%) and less distress around school/work (9.7% vs 11.8%).

Conclusions

Lower SES and rural geographic location are associated with higher levels of cancer patient distress in the practical domain, despite a publically funded medical system. Local navigational support services for workplace and income assistance should be developed to alleviate distress for patients in rural areas or with low income.

Clinical trial identification

Legal entity responsible for the study

BC Cancer.

Funding

BC Cancer Foundation.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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