Within Canada, the homeless have four times the cancer rates of the general population, lower rates of screening, later stage diagnosis, and poorer outcomes. In the United States, disparities in cancer burden also exist between the homeless and the housed. For example, lung cancer deaths occur at double the rate for the homeless compared with the housed. Cancer care is complex and requires many high-order health literacy skills to obtain and understand the information needed to make informed decisions about cancer care. A scoping review was conducted to summarize what is known about, the homeless, cancer and health literacy. Th e literature search yielded 1,124 articles. Of these, 33 articles met eligibility criteria. Results suggest that low health literacy may have a signifi cant eff ect on access to cancer screening and care among the homeless population.

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Patient education (PE) is vital in reducing anxiety, increasing satisfaction with treatment, helping with self-management, and creating a sense of control for cancer patients. Patients access much of their material from health care providers through in-person visits, patient libraries, and in-person classes. Due to reductions in in-person visits throughout the pandemic, we sought to understand how PE programs responded under varying levels of COVID-19 restrictions to meet the information needs of patients and families. A cross-sectional survey was distributed to members of the Cancer Patient Education Network (CPEN) and the Health Care Education Association (HCEA) via the respective listservs. The survey consisted of five sections that included closed and opened questions. Participants were asked questions to describe their PE programs and how their duties were affected during the pandemic. Forty-two CPEN members completed the survey ( N = 42, 66%) with a 35% response rate and a 55% completion rate, and 19 HCEA members completed the survey ( N = 19, 30%) with a 5% response rate and 16% completion rate. The majority of staff surveyed were not furloughed ( N = 57/64, 89%). Just under half reported a change in daily PE program activities ( N = 23/52, 44%) and most reported a change in developing PE materials (e.g., pamphlets) ( N = 10/26, 63%), finding information for patients/families ( N = 11/19, 58%), and delivering classes ( N = 12/21, 57%). COVID-19 has ushered in a new era in the delivery of PE with the rapid deployment of digital cancer patient education. Results can inform future directions for the delivery of PE post-pandemic.

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