1666P - Impact of substance use and mental health disorders on cancer care in urban underserved communities

Background

Substance use and mental health disorders significantly contribute to disparities in cancer care, particularly in urban underserved areas like the South Bronx, characterized by a substantial Latinx and Black population. This study aimed to evaluate the influence of substance use and mental illness on cancer care among newly diagnosed patients at the Lincoln Cancer Center.

Methods

A retrospective analysis was conducted on newly diagnosed cancer patients treated between January and August 2022. Various aspects of their cancer care journey were assessed, including delays in diagnosis, treatment selection, compliance with care, incidence of unscheduled emergency department/inpatient visits, rates of follow-up loss, and mortality. Substance use and mental health disorders were evaluated through electronic health record reviews and structured telephone interviews. Statistical analysis was performed using descriptive statistics and the independent samples T-test in SPSS. This study was approved by the Institutional Review Board at our hospital.

Results

The study included 208 patients, with 106 (51%) having substance use disorders, 41 (19.1%) with mental health disorders and 31 (14.9%) having both. Among patients with mental health disorders, 34% received medication and 12% had regular psychiatric care. Patients with mental health disorders but no substance use, tended to be diagnosed at later cancer stages (50% vs 41.3% at stage 4). Patient with either mental health disorders or substance use disorder has delayed cancer diagnosis from initial suspicion date (64.09 days vs 46.71 days, p = 0.154) and higher non-compliance to clinic visits (20.9% vs 14.0%, p=0.015) and higher ED visit (1.67 vs 1.27, p = 0.71), admission rate (0.98 vs 0.57, p=0.232) and mortality compared to those without, showing odds ratios of 1.203 [95% CI 0.50-2.89] although statistically insignificant due to the small sample size.

Conclusions

Patients with either mental health disorders or substance use disorder exhibited more diagnostic delays, higher non-compliance with their cancer care journey, increased ED/inpatient visits, and mortality rates. Addressing both physical and mental health is crucial for narrowing cancer disparities in this vulnerable population.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.