Abstract 4799: Hidden epidemics: The gender divide in HCV and cancer screenings among the unhoused
Authors: Al-Assil Talal , Kalina Claire , Laird Madison , Dawood Nataly , Riordan Raven , Kumar Neya Suresh , Olivier Ryan , Dickson Cheryl , Munene Gitonga 
Published: March 2024

Background & Methodology: In the United States, the unhoused population experiences disproportionately higher rates of cancer incidence and mortality—double that of the general populace. Despite these startling statistics, there is a notable dearth of research on this topic within medical literature. Our medical student-led pilot study aimed to bridge this knowledge gap by evaluating the uptake of cancer screenings and identifying the barriers faced by the unhoused in Southwest Michigan. Our objective was to enhance the understanding of cancer care disparities and identify factors that hinder access to cancer screenings for this marginalized group. Utilizing questionnaires distributed in homeless shelters, we collected data on the prevalence and impediments to screenings for hepatitis C virus (HCV), and lung, breast, colon, and cervical cancers in a local community.

Results: The study encompassed 143 participants, revealing that women reported a shorter median duration of homelessness (5 months) than men (18 months). The primary barriers to cancer screening were access to services and lack of awareness, rather than insurance coverage. Gender disparities were evident in HCV screening, with an overall rate of 55%; however, willingness to screen was higher among women (83%) compared to men (49%). Colon cancer screening showed no significant gender disparity, standing at 45% uptake. The prevalence of smoking was high at 78%, yet a higher proportion of men were amenable to lung cancer screening. Interestingly, Pap smear uptake surpassed national averages, while mammogram rates were below expected at 40%.

Discussion & Conclusion: While the discrepancies between genders may not be immediately apparent, our data shows that developing targeted interventions and tailoring the delivery of adequate cancer screenings to the unhoused require consideration of gender as a key factor. Women’s perceived barriers differ slightly from men’s, and generally-speaking, they undergo more cancer screenings per year compared with men. The reluctance among male participants to engage in HCV screening has been observed in other studies as well and as our study demonstrates, it may be related to informational barriers. Although preliminary, our findings shed light on the critical health care issues faced by the unhoused and serves as a steppingstone towards improving our understanding on their challenges in hopes of improving their health outcomes. Comprehensive research is imperative to unravel the complex causes of these gender-based discrepancies. In the interim, the implementation of a navigator social worker system could prove beneficial in facilitating the unhoused with the logistics of screening processes, overcoming transportation hurdles, and reinforcing the importance of ongoing health management.

Citation Format: Talal Al-Assil, Claire Kalina, Madison Laird, Nataly Dawood, Raven Riordan, Neya Suresh Kumar, Ryan Olivier, Cheryl Dickson, Gitonga Munene. Hidden epidemics: The gender divide in HCV and cancer screenings among the unhoused [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4799.