Abstract A019: Substance use in uninsured cancer survivors from free clinics
Authors: MacDonald Madeline , Shah Shreni , Swanson Justin , Song Ethan , Mhaskar Rahul , Pabbathi Smitha , Mirza Abu-Sayeef 
Published: September 2020

Abstract
Introduction: Approximately 8% of Americans suffer from alcoholism and roughly one-third of Americans endorse illicit drug use. Compared to the general population, substance abuse disorders only occur within 5% of the cancer population. Among cancer survivors, the use of alcohol was comparable to non-cancer survivors while the use of tobacco and illicit drugs was lower. Substance use can decrease treatment adherence, impede pain management, and undermine their network of social support. Our study aims to document the prevalence of substance use in uninsured cancer survivors. Methods: A retrospective chart review was conducted to manually collect chronic disease parameters from electronic medical records and paper charts at 9 free clinics in the Tampa Bay Area of Florida. Data was abstracted using a questionnaire on Redcap software. There were 222 patients with a documented history of cancer in the study and 6,768 patients with a documented negative history of cancer. Demographics were compared between cancer survivors and patients without reported cancer history using chi-square test or independent samples t-test using an alpha of 0.05 for all tests. Results: The majority of the cancer patients were female, n=146 (66.1%). Survivors were significantly older than patients without cancer 54.1 (SD=12) vs. 41 (SD=16.7), p&lt;0.001. Cancer survivors were largely of Caucasian race (n=79, 44.1%) and Hispanic ethnicity (n=79, 44.1%). Patients with a reported cancer history were significantly less likely to be African American (n=6, 3.4%) compared to patients without a history of cancer (n=696, 14.1%) p&lt;0.001. There was no significant difference in current or past drug use between two groups. Cancer survivors were more likely to be current smokers (n=43, 25.6%) compared to patients without cancer history (n=763, 16.1%), p&lt;0.001. Cancer survivors were more likely to be past smokers (n=34, 20.2%) compared to patients without cancer history (n=472, 9.9%), p&lt;0.001. Patients with a history of cancer were more likely to be current drinkers (n=34, 26%) compared to patients without a cancer diagnosis in the study (n=942, 22.9%), p=0.003. Cancer survivors were also more likely to report a history of drinking (n=13, 9.9%) than patients without a history of cancer (n=139, 3.4%), p=0.003. Conclusions: Although current literature demonstrates substance use is associated with socioeconomic disparity, there is limited research on the prevalence of alcohol, tobacco, and illicit drug use among uninsured cancer survivors in the United States. Our study finds that uninsured cancer survivors are more likely to be current and past alcohol users but are just as likely to use illicit substances as uninsured patients without a history of cancer. Our study suggests survivors continue to be at risk for tobacco and alcohol use. More research is needed to evaluate substance use among uninsured cancer survivors.
Citation Format: Madeline MacDonald, Shreni Shah, Justin Swanson, Ethan Song, Rahul Mhaskar, Smitha Pabbathi, Abu-Sayeef Mirza. Substance use in uninsured cancer survivors from free clinics [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr A019.