Abstract PO-231: Exploring social vulnerability in locally advanced cervical cancer patients undergoing brachytherapy irradiation
Authors: McAlarnen Lindsey A. , Sona Melanie , Tischer Kristin , Small Christina , Bedi Meena , Erickson Beth , Hopp Elizabeth E. 
Published: January 2022

Abstract
Racial and ethnic disparities in access to care and treatment of cervical cancer exist. Despite being the standard of care, brachytherapy as an essential component of definitive irradiation is not successfully completed by all patients with locally advanced cervical cancer. Milwaukee, WI, is a city known for segregation and there is a profound gap in access to care as women continue to be diagnosed with advanced cancer of the cervix, a disease that can be detected early and now even prevented with the HPV vaccine. Using geocoding, the relationship between patients' geography, demographic factors, and diagnosis of cervical cancer was examined. By querying a cohort discovery tool, data was obtained from 66 patients with locally advanced cervical cancer from 2016 to 2021 who received brachytherapy as a part of their treatment. Patients' census tract numbers were matched to social vulnerability indices from the Centers for Disease Control's (CDC) Social Vulnerability Index (SVI). The SVI rankings range from least vulnerable, 0, to most vulnerable, 1, for four themes: socioeconomic status, household composition and disability, minority status and language, and housing type and transportation. Results were analyzed using the Kruskal-Wallis rank sum test and Fisher's exact test. Seventy-one percent of patients included were Caucasian, 21 % African American, 4.5% Hispanic, and 1.5% Asian, and 1.5% American India/Alaska Native. The median SVI value when comparing patients to all census tracts in the United States was 0.39 (range 0.0001-0.9907) in this population. The socioeconomic status theme was most correlated with the overall US themes (Spearman correlation 0.927). Median SVI values suggested that Asian patients were most vulnerable with an SVI of 0.96, followed by African American 0.86, Hispanic 0.53, American Indian or Alaska Native 0.30, and Caucasian 0.29 (p = 0.005). Asian patients were most vulnerable in socioeconomic status with an SVI of 0.93, in minority status and language with an SVI of 0.90, and in housing and transportation with an SVI of 0.97. African American patients were most vulnerable in household composition and disability with an SVI of 0.78. Three of the four theme ranking variables showed significant differences based on race/ethnicity, with the exception of housing and transportation (p = 0.2). We identified a clear discrepancy in social vulnerability among minority patients with cervical cancer. Further investigation of the factors contributing to disparities among cervical cancer patients will help appropriately allocate resources and ensure that these patients receive optimal treatment leading to improved outcomes.
Citation Format: Lindsey A. McAlarnen, Melanie Sona, Kristin Tischer, Christina Small, Meena Bedi, Beth Erickson, Elizabeth E. Hopp. Exploring social vulnerability in locally advanced cervical cancer patients undergoing brachytherapy irradiation [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-231.