Bridging the gender gap in cancer care at a resident-led federally qualified health center: Retrospective insights and strategies for improvement.

Abstract

e13841 Background: Federally Qualified Health Centers (FQHCs) are nonprofit organizations with federal funding which play a vital role in the United States health care system by providing affordable and accessible outpatient care, particularly to those facing socioeconomic, language, geographic and cultural barriers to healthcare. Prior studies have indicated differences in cancer screening participation based on gender and gender identity. This study aims to explore gender disparities in cancer care among FQHC patients. Methods: We conducted retrospective data analysis using a cancer registry at a FQHC in Connecticut. This registry was curated from March 2021 to March 2024 and included alive patients over the age of 18 with a diagnosis of cancer were included in this registry. Statistical analysis was performed with chi-squared test or Fisher’s exact test where applicable. Results: In the observed population, a trend was noted for men to present at more advanced stages of cancer (70.6% stages 0-III vs 29.4% stages III-IV) when compared to women (78.1% stages 0-III vs 21.9% stages III-IV). Regardless of whether screening occurred before or after their cancer diagnosis, 5.5% of female patients had not undergone age-appropriate cancer screening, compared to 41.9% of males. All unscreened females were uninsured, whereas the majority (53.8%) of unscreened male patients did have insurance. Interestingly, while women had slightly higher screening rates when they spoke English (100% vs 89.5%), there was no major difference in cancer screening rates based on language for male patients (57.9% English speakers vs 53.8% non-English speakers). Male cancer patients also exhibited a higher number of comorbidities (40% had 2 or less vs 60% had 3 or more comorbidities) than females (61.4% had 2 or less vs 38.6% had 3 or more comorbidities). Remarkably, male cancer patients were more likely to have undergone cancer screening if they had 3 or more comorbidities compared to 0-2 comorbidities (72.2% vs 27.8%) whereas for women there was no significant difference. Conclusions: Our findings suggest a gap in cancer care affecting males in medically underserved populations. Not only do male cancer patients face higher number of comorbidities complicating their treatment options, they also appear to have lower cancer screening rates and tend to present at later stages of disease. Subgroup analysis indicates that other variables beyond socioeconomic factors influence the disparities in cancer care for male compared to female patients in FQHCs. Efforts in improving cancer care in FQHCs should consider the influence of gender differences when devising new strategies.