Abstract 72: Socioeconomic Disparities Across the Cancer Care Continuum in Saint Lucia: A Community-Based Study

Abstract

Abstract Purpose: Low socioeconomic status could contribute to insufficient access to care and the high cancer mortality in small developing island states (SIDS). However, disparities in care among cancer survivors are rarely studied in SIDS. We investigated for the first time the socioeconomic disparities across the cancer care continuum in Saint Lucia. Methods: We used purposive and snowball sampling to recruit adult cancer survivors residing in Saint Lucia. Trained field investigators interviewed survivors face-to-face with a structured questionnaire ascertaining their care experience and health services accessed. We used univariate logistic regressions to estimate odds-ratios (OR) and their 95% confidence intervals (CI) measuring the association between socioeconomic status and cancer care. Socioeconomic status was modelled as binary outcome variables: educational level, private medical insurance and hot water at home (a proxy for income in Saint Lucia). Results: We included 50 survivors (13 men, 37 women). The majority of survivors were black, and diagnosed with breast and prostate cancer. Survivors who were satisfied with the information provided during their diagnosis announcement were more likely to have hot water (OR=5.0, 95% CI=1.3-19.0). Concerning, sources of funds for treatment, private medical insurance and hot water were associated respectively with less financial contributions from family/friends (OR=0.2, 95% CI=0.1-0.9) and greater use of their own funds (OR=3.3, 95% CI=0.9-15.0). Patients who were provided with doctor’s contact information in case of concerns were more likely to have more than primary education (OR=6.3, 95% CI=1.3-31.1) and private medical insurance (OR=12.3, 95% CI=1.4-111.6). Overseas travel for cancer treatment was significantly associated with having private health insurance (OR=3.4, 95% CI=0.9-12.7) and hot water (OR=4.5, 95% CI=1.2-16.8). Having more than primary school education was associated with better perceived care experience (OR=13.5, 95% CI=2.2-84.0). Having private medical insurance was associated with greater access to supportive care services such as psychologists and physiotherapists (OR=3.6, 95% CI=0.9-14.5). Conclusion: Despite our small sample size and potential confounding, we showed some evidence of socioeconomic disparities across the cancer care continuum in Saint Lucia. Low socioeconomic status should be taken into account when considering interventions to reduce of cancer mortality in SIDS. Citation Format: Aviane Auguste, Dorothy Phillip, Owen Gabriel, James St. Catherine, Carlene Radix. Socioeconomic Disparities Across the Cancer Care Continuum in Saint Lucia: A Community-Based Study [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 72.