Abstract 5859: Impact of adverse SDOH on cancer knowledge and beliefs: Analysis of a NCI-designated cancer center’s catchment area survey
Authors: Smith Alexandria P. , Ali Ayesha , Shimada Ayako , Smith Brittany C. , Okere Samantha , Hines Kamryn , Leader Amy , Simone Nicole L. 
Published: June 2022

Abstract
Background: Social determinants of health (SDOH) are social barriers that stratify health status. Specifically, socioeconomic status, education level, minority and immigration status correlate with higher risk of onset and severity of chronic disease. We sought to understand how SDOH affect a patient’s belief regarding autonomy over cancer risk and outcomes.
Methods: Data from the Sidney Kimmel Cancer Center catchment area including Delaware, Montgomery, and Philadelphia Counties in Pennsylvania; Camden and Burlington Counties in New Jersey were queried and analyzed. The survey included six cancer belief statements. Demographic characteristics of survey participants, as well as data related to cancer risk factors and beliefs were all calculated using unweighted data.
Results: 1,557 adults responded to this survey. Survey participants ranged in age from 18 to 88 years old, with 49.6% of participants 40 years old and younger. 64% of respondents identified as female vs 36% male. Poverty classification was based on ASPE 2020 Poverty Guidelines given family size and income information. Based on these parameters, 21.3% of respondents were considered impoverished. Additional demographics included housing security, food security, and health literacy. Results demonstrated, impoverished respondents were more likely to disagree that behavior/lifestyle causes cancer (63.3% vs 53.3%, p&lt;0.001). Housing insecure respondents were more likely to disagree that behavior/lifestyle causes cancer (62.8% vs 54.8% p&lt;0.001). Respondents who are more food insecure were more likely to disagree that behavior/lifestyle causes cancer than those who are food secure (food last: 57.9% vs 54.5%, p&lt;0.001). Respondents who are more food insecure were more likely to agree that everything causes cancer (food last: 67.8% vs 59.2%, p&lt;0.001).
Discussion: Adverse SDOH such as poverty, food insecurity, housing insecurity, and health literacy affect cancer beliefs. Overall, results demonstrated that respondents with adverse SDOH were more likely to disagree that behavior/lifestyle can cause cancer and more likely to agree that everything causes cancer. Patients with adverse SDOH may be less likely to actively engage in preventive health measures and screenings, clinical trials, and other factors known to positively impact cancer outcomes. SDOH should be evaluated on patient intake and patients should be provided with appropriate support and targeted education with broad cancer beliefs in mind.
Citation Format: Alexandria P. Smith, Ayesha Ali, Ayako Shimada, Brittany C. Smith, Samantha Okere, Kamryn Hines, Amy Leader, Nicole L. Simone. Impact of adverse SDOH on cancer knowledge and beliefs: Analysis of a NCI-designated cancer center’s catchment area survey [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5859.