Socio-economic disparities and accessibility to age-appropriate screening tools.

Abstract

1529 Background: Pervasive racial and ethnic health disparities continue to be reported throughout the U.S. population. An increasing number of studies have discussed racial disparities in cancer statistics as well as socio-economic differences. The purpose of this study is to investigate sociodemographic health care disparities and the prevalence of cancer diagnosis in the context of challenges in medical services accessibility due to financial burden. Methods: Analysis of pooled cross-sectional data using 2017 Behavioral Risk Factor Surveillance System (BRFSS). Differences between our comparison groups were computed using chi square test for categorical values and t-test for continuous variables. Demographic factors were analyzed through weighted regression for accessibility to cancer treatment and prior cancer screening. Results: We report data from a total of 436,198 respondents to the 2017 BRFSS survey, with cancer prevalence 9.8% and higher prevalence of cancer among females and elderly population (70 years and older). Racial disparities differed significantly between respondents with and without history of cancer, with higher prevalence in Hispanic and multiracial minorities, 19% and 14%, respectively. We also report, differences in annual income are significantly associated with increased cancer prevalence in lower socioeconomic populations. Nineteen percent of participants who had annual income less than 25k were diagnosed with cancer. Additionally, analyzing the association between delayed medical care due to financial burden and its correlation with accessibility to age-appropriate cancer screening tools. We report significant differences in receipt of cancer screening among respondents, with consistently lower probabilities of receiving age-appropriate screening tools among participants who experienced delays in medical care due to cost, that applies to all screening tools. Among respondents who did not receive screening mammograms, 17% reported delays in medical care due to medical cost. Twelve percent of participants who did not receive screening colonoscopy suffered delays in medical care due to cost. Also, among participants who did not receive screening for prostate cancer with PSA testing, 11% reported delays in medical care due to cost. Conclusions: Health care disparities in cancer screening continue to persist including differences in socioeconomic classes and access to medical services. In this study, we report that patients with delayed access to medical services due to cost are not adequately receiving age-appropriate screening for cancer. Given the deleterious effects of delayed diagnosis and treatment of cancer, it is important that public health and clinical professionals utilize tools to improve cancer screening accessibility to minorities with socio-economic disparities.