Publication-only abstracts (abstract number preceded by an "e"), published in conjunction with the 2019 ASCO Annual Meeting but not presented at the Meeting, can be found online only.
Homeless outcomes in non-small cell lung cancer: A county hospital experience.
Metastatic Non-Small Cell Lung Cancer
Lung Cancer—Non-Small Cell Metastatic
2019 ASCO Annual Meeting
J Clin Oncol 37, 2019 (suppl; abstr e20582)
Author(s): Kyle Concannon, John Henry Thayer, Vicky Wu, Isaac Jenkins, Christina S Baik, Hannah M. Linden; University of Washington, Seattle, WA; Fred Hutchinson Cancer Research Center, Seattle, WA; University of Washington/Fred Hutchinson Cancer Research Center, Seattle, WA; University of Washington Medical Center, Seattle Cancer Care Alliance, Seattle, WA
Background: Vulnerable populations such as homeless with non-small cell lung cancer (NSCLC) likely have higher mortality rates compared to the general population due to inadequate care, but their outcomes have not been described. We hypothesize that homeless patients with NSCLC experience greater mortality, shorter time from diagnosis to last known contact, delays in biopsy after imaging and treatment after biopsy, and greater rates of missed appointments following diagnosis. Methods: We conducted a retrospective review of all non-small cell lung cancer patients (N = 133) with appointments made between 9/2012 and 9/2018 at an academic county hospital with a dedication to the underserved in a major US city. Data were collected from electronic medical records manually and analyzed using ANOVA for continuous variables or Pearson's Chi-squared for categorical data. Results: Of the 133 patients diagnosed with non-small cell lung cancer, 21 (15.8%) were homeless at the time of their diagnosis. The mean time from diagnosis to last known contact was 1.4 vs 4.2 years (p = 0.0002) in localized disease and 1.41 vs 1.43 years (p = 0.95) in advanced disease for homeless vs housed patients. Kaplan Meier curve in advanced disease shows median survival time is 6.9 months (95% CI: 4.6 to N/A) for homeless (n = 13) vs 14.4 months (95% CI: 11.0 to 35.8) for housed (n = 67) patients (p = 0.51).The time from radiographic finding to biopsy, biopsy to intervention, and percentage of missed appointments in the year following diagnosis for homeless vs housed NSCLC with localized disease was 248 vs 116 days (p = 0.37), 20.1 vs 49.7 days (p = 0.19), and 21% vs 11% (p = 0.17) respectively; 35 vs 46 days (P = 0.64), 50 vs 58 days (p = 0.75), and 26% vs 16% (p = 0.034) among those with advanced disease. Conclusions: In this retrospective analysis, homeless with localized NSCLC experienced a significantly shorter time from diagnosis to last known contact. Homeless patients with advanced NSCLC had shorter median survival time compared to housed patients, although this was not statistically significant. Homeless patients with both localized and advanced disease had increased rates of missed appointments without significant delays in treatment. Further research is needed to improve outcomes.