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Perspectives of cancer and cancer screening among homeless adults of New York City shelter-based clinics: a qualitative approach

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Abstract

Purpose

Millions of homeless Americans have lower cancer screening and higher cancer mortality rates. We explored perspectives and perceptions regarding cancer and cancer screening among homeless.

Methods

Using random and criteria sampling, we conducted in-depth semi-structured interviews with 50 homeless adults from New York City’s (NYC) shelters and shelter-based clinics.

Results

Mean age was 51.66 years with average 2.03 years of homelessness; 33/50 were older than 50. Only a small number of participants had their recommended cancer screening. Contrary to general assumptions and despite significant barriers, the homeless were concerned about cancer, believed their risk of cancer is higher compared to the general population, and generally considered screening a high priority during homelessness. While they acknowledged several individual- and systems-level barriers, they welcomed targeted measures to address their multi-level barriers. Suggested strategies included active counseling by providers, health education or reminders via mHealth strategies or face-to-face in shelters, addressing potential providers’ prejudice and biases regarding their priorities, incentives, and patient navigators or coach to help navigating the complex cancer screening process.

Conclusions

There are gaps in effective cancer screening despite adequate attitude and perceptions among homeless. The health system needs to shift from addressing only basic care to a more equitable approach with accessible and acceptable opportunities for preventive cancer care for the homeless.

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Acknowledgments

Authors thank the staff and supervisors at the NYU Lutheran Family Health Centers’ Community Medicine Program as well as New York City shelters where the study took place for their invaluable support for this project.

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Authors and Affiliations

  1. Department of Population Health, New York University School of Medicine, 227 E30th Street, Translational Research Building, 6th floor, Room 639, New York, NY, 10016, USA

    Ramin Asgary, Ramesh Naderi & Gbenga Ogedegbe

  2. Department of Medicine, New York University School of Medicine, 227 E30th Street, Translational Research Building 6th floor, Room 639, New York, NY, 10016, USA

    Ramin Asgary & Gbenga Ogedegbe

  3. Community Medicine Program, NYU Lutheran Family Health Centers, 317 Bowery Street, New York, NY, 10003, USA

    Blanca Sckell & Analena Alcabes

Authors
  1. Ramin Asgary
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  2. Blanca Sckell
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  3. Analena Alcabes
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  4. Ramesh Naderi
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  5. Gbenga Ogedegbe
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Corresponding author

Correspondence to Ramin Asgary.

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The authors declare that there are no conflicts of interest. There is no funding source to report.

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Asgary, R., Sckell, B., Alcabes, A. et al. Perspectives of cancer and cancer screening among homeless adults of New York City shelter-based clinics: a qualitative approach. Cancer Causes Control 26, 1429–1438 (2015). https://doi.org/10.1007/s10552-015-0634-0

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  • DOI: https://doi.org/10.1007/s10552-015-0634-0

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