Diverging paths: Identifying barriers to and increasing accessibility of a survivorship program in a socio-economically diverse community.

Abstract

e13877 Background: The importance of survivorship programs for enhancing the lives of cancer survivors is well documented in the literature. To maximize engagement across the diverse patient population of Smilow Cancer Hosptial, the Survivorship program offers both telemedicine and in-person visits at four different care centers in Connecticut. Our goal was to identify gaps in accessing this important care among our cancer patients. Methods: A retrospective review of 280 scheduled patient visits across four survivorship clinic sites between January 2024 and January 2025 was conducted using Electronic Medical records. Demographic data including gender, race, ethnicity, area of residence, distance from home address to referred clinic, and median household income by patient zip code was collected. The patients were divided based on whether or not they attended their scheduled visit, either in person or telemedicine, a show group (SG) and a no-show group (NSG). The data was then compared between the two groups to identify differences between the demographics of patients who did attend as compared to those that did not. Results: Among the patients that did attend the survivorship clinic visit, 91% were female and 9% were male. Among those that did not attend their scheduled appointment, 77% were female and 23% were male. Regarding race: in the SG, 77% were white, 11% Black or African American, 1% Asian, 2% Native American or Pacific Islander and 8% did not see their race represented. Among the NSG: 42% were white, 31% black, 4% Asian and 23% did not see their race represented. In the SG: 13% identified their ethnicity as Hispanic/Latino, 2% identified as other, and 84% identified their ethnicity as Not Hispanic/Latino. In the NSG: 31% identified as Hispanic/Latino and 69% identified as Not Hispanic/Latino. The average age among the SG was 58 compared to 56 in the NSG. 22% of the SG was enrolled in Medicaid, Medicare or other state-based insurance, compared to 42% of the NSG. The average median household income by zip code for the SG was $105,141 compared to $77,296 for the NSG. In the SG, 62% lived under 30 minutes from their referred clinic site, 32% lived between 30 to 60 minutes and 6% lived over 60 minutes away. In the NSG, 92% lived within 30 minutes from their referred clinic site and 8% lived between 30 to 60 minutes away. Conclusions: Attendance to a survivorship program varied based upon the socio-economic diversity of our patient population. Our no-show group was comprised of more patients of racial and ethnic minorities and from areas associated with lower median household income as compared to our group of patients who did attend. Of note, distance from referred clinic site did not impact the patient’s ability to attend their visit. These results warrant further investigation with a qualitative study to address barriers in accessing this care and broadening access across all diverse patient groups.