UNASSIGNED: 188 Background: Despite advances in therapy and supportive care, prognosis for @entity5 remains poor. Rigorous processes ensure quality of research, clinical care and education at NCICCC. However, impact of site of care on survival and access to NCICCC for vulnerable subpopulations (race/ethnicity, payor) remains unstudied. METHODS: We constructed a population-based cohort of 53,618 @entity1 diagnosed between 22y-65y with adult-onset @entity5 and reported to LA County @entity5 registry between 1998-2008. Geographic Information Systems (ArcGIS) was used for geospatial analysis. RESULTS: Across multiple diagnoses, @entity1 at NCICCC showed superior 5y @entity1349 ( @entity1349 ) as compared to those at community sites (Breast [n=31,770]: 89% vs. 86%, p<0.01; Lung [n=10,855]: 28% vs. 17%, p<0.01; Hepatobiliary [n=4,296]: 34% vs. 19%, p<0.01; Gastric [n=2,678] 32% vs. 22%, p<0.01; Pancreas [n=2,326]: 13% vs. 6%, p<0.01; Oral [n=1,838]: 68% vs. 59%, p=0.01). Adjusting for clinical (age, stage, gender) and sociodemographic (race/ ethnicity, payor, socioeconomic status [SES]) characteristics, multivariable Cox regression revealed an increased risk of mortality in @entity1 receiving care at non-NCICCC sites: Breast: hazard ratio (HR)=1.2, p<0.01; Lung: HR=1.5, p<0.01; Hepatobiliary: HR=1.4, p<0.01; Gastric: HR=1.4, p<0.01; Pancreas (n=2,326), HR=1.5, p<0.01; Oral: HR=1.3, p=0.05. Overall 7% of @entity1 were seen at NCICCC (range 4-16%, p<0.01). Multivariable logistic regression adjusting for clinical characteristics revealed that low SES (OR range across diagnoses: 0.4-0.5, p<0.01), public (OR 0.4-0.9, p<0.03) or no (OR 0.1-0.7, p<0.04) insurance, African-American race (OR 0.4-0.6, p<0.03) or Hispanic ethnicity (OR 0.5-0.7, p<0.02), and residing > 9 miles from nearest NCICCC (OR 0.5-0.9, p<0.01) decreased likelihood of care at NCICCC. CONCLUSIONS: Population-based data reveal superior @entity1349 among adult-onset @entity5 @entity1 receiving care at NCICCC. @entity1 without private insurance, from low SES, African-American and Hispanic backgrounds or living more than 9 miles from an NCICCC, are less likely to use NCICCC. Barriers to care at NCICCC are currently being explored.

Impact of care at NCI XXXX (NCICCC) on @entity5 outcome: Results from a population-based study.

@entity5 :: ('MESH:D009369', 'Disease') :: ['cancers', 'cancer', 'certain cancers'] @entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity1349 :: ('MESH:D011475', 'Disease') :: ['OS', 'overall survival']
@entity5 :: (MESH:D009369,Disease) :: ['Comprehensive Cancer Centers']
