Abstract A27: Addressing cancer disparities through use of a novel community-based oncology program

Abstract

Purpose: This study evaluates a novel approach to address cancer disparities by incorporating a comprehensive clinical oncology outreach facility within the context of a primary care setting in Boston. We hypothesize that this unique oncology program will improve access to care for underserved populations, and may serve as a model system for other health disparity initiatives. Methods: The Whittier Street Health Clinic (WSHC) is a Federally Qualified Health Center, that provides comprehensive primary health care and support services for vulnerable communities. In 2012, the Dana-Farber Cancer Institute's Cancer Care Equity Program partnered with WSHC to develop an initiative aimed at streamlining cancer care and services to address cancer disparities in the underserved population Whittier serves. A retrospective chart review was performed to evaluate the impact of the program on patient outcomes, specifically timeliness of care/time to resolution and time to initiation of treatment. We have identified a cohort of patients (N = 50) who have been provided cancer-related services through this initiative from December 2012 to July 2013. All patients were ≥ 18 years old. Timeliness of care/time to resolution is defined as the amount of time elapsed between patient presentation until their reason for visit to the oncology facility has been resolved. Time to initiation of treatment was measured only for patients with newly diagnosed cancer; it is defined as the amount of time elapsed between patient presentation at the oncology facility to the start of treatment. T-tests and one-way ANOVA were carried out to determine if there were any statistically significant differences in the timeliness of care/time to resolution for different demographic subgroups. Results: In this cohort, 48% of patients self-identify as Black/African-American, 48% Hispanic, and 2% other. Forty-eight percent are men; 52% are women. Although the majority of patients are English-speaking (58%), a large proportion (38%) speaks Spanish. The average time to resolution for subjects was 29 days and 19 days for imaging and clinical evaluation respectively. This presents an overall reduction compared to baseline data (N = 38) from WSHC, which had an average of 67.7 days for time to resolution, which was mainly diagnostic resolution. A similar trend was also observed in time to initiation of treatment (52.5 days vs. baseline of 67.6 days). There is no statistically significant difference in the timeliness of care/time to resolution between different demographic subgroups served by the oncology program (e.g. English speakers vs. Spanish speakers, p = 0.336). Conclusion: The data supports our hypothesis that employing the use of a comprehensive oncology program within the context of an established community center improves access to specialized oncologic care for vulnerable populations. This unique model improves timeliness of care by reducing time to diagnostic resolution, which may ultimately help improve cancer outcomes. Citation Format: Ann Oluloro, Ann Oluloro, Karen M. Winkfield, Ludmila Svoboda, Laura Tesler Waldman, Christopher S. Lathan. Addressing cancer disparities through use of a novel community-based oncology program. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr A27. doi:10.1158/1538-7755.DISP13-A27