Real-world socioeconomic disparities in cancer outcomes: Insights from a federally qualified health center.

Abstract

e23099 Background: Despite advancements in cancer care, socioeconomic barriers continue to create significant disparities in patient outcomes. Factors such as language proficiency, insurance coverage, and income directly influence access to preventive screenings, early diagnoses, and advanced treatments. Non-English speaking and uninsured patients encounter compounded challenges, including delays in diagnosis and limited access to therapies such as immunotherapy and targeted treatments. These inequities are particularly evident in community health settings, where vulnerable populations are disproportionately affected. While numerous studies highlight disparities in cancer care, there is limited data on the specific barriers faced by patients at federally qualified health centers (FQHCs). This single-center retrospective study aims to evaluate the impact of language proficiency, insurance coverage, and access to preventive screenings on cancer outcomes in an underserved population. Methods: We established a cancer registry at Norwalk Community Health Center, a Federally Qualified Health Center (FQHC) in Connecticut, by extracting demographic, clinical, and socioeconomic data from the electronic medical records of patients diagnosed with cancer. The study included patients over the age of 18 who were registered at the clinic from 2021 to 2024. Cancer patients were identified using the International Classification of Diseases (ICD-10) codes for cancer diagnoses. Deceased patients were excluded from the study, and only those with complete medical records were included in the analysis. Results: Among cancer patients in our registry, 37.5% were non-English speaking, and 57% of these patients were uninsured and self-paying, compared to 17.1% of English-speaking cancer patients (p < 0.005). Additionally, 71.4% of non-English speakers were diagnosed based on symptoms, as opposed to 54.3% of English speakers, indicating limited access to preventive care and cancer screenings. Conclusions: Our findings highlight the urgent need to improve access to screenings, expand insurance coverage, and provide culturally and linguistically appropriate resources. Addressing these barriers is crucial to improving adherence, optimizing treatment outcomes, and reducing survival inequities in underserved populations. This registry serves as a foundation for implementing targeted interventions to achieve equity in cancer care at our community health center.