Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jul 20:62:102095.
doi: 10.1016/j.eclinm.2023.102095. eCollection 2023 Aug.

Access to cancer preventive care and program considerations for people experiencing homelessness across four European countries: an exploratory qualitative study

Tobias Schiffler  1 , Christina Carmichael  2 , Lee Smith  2 , Ascensión Doñate-Martínez  3 , Tamara Alhambra-Borrás  3 , Miguel Rico Varadé  4 , Jaime Barrio Cortes  5 , Matina Kouvari  6 , Pania Karnaki  6 , Maria Moudatsou  7 , Ioanna Tabaki  7 , Alejandro Gil-Salmeron  8 , Igor Grabovac  1
Affiliations

Access to cancer preventive care and program considerations for people experiencing homelessness across four European countries: an exploratory qualitative study

Tobias Schiffler et al. EClinicalMedicine. .

Abstract

Background: People experiencing homelessness (PEH) have a higher prevalence of adverse health outcomes and premature mortality compared to the non-homeless population. These include a higher burden of cancer and cancer-specific morbidity and mortality-outcomes that may be a consequence of significant barriers to accessing primary and secondary prevention and community health services. This study aimed to better comprehend the health needs and barriers to accessing preventive cancer care for PEH across four European countries as well as necessary considerations for developing interventions around cancer prevention for this population.

Methods: In this exploratory qualitative study, 69 semi-structured interviews were conducted across Austria, Greece, Spain, and the UK, with a sample comprising 15 professionals working in homelessness support services, 19 health professionals, and 35 PEH. Interviews took place between August 1 and October 31, 2021, and data were analysed inductively and iteratively following a thematic approach.

Findings: Findings were organised into two overarching themes: (1) Experiences and understanding of cancer prevention and treatment and (2) Considerations for program interventions. While cancer was a significant worry among PEH across all settings, they generally had minimal knowledge and understanding of cancer symptoms and prevention. Specific programs for cancer prevention for PEH were described as almost non-existent. Health professionals in some settings indicated that cancer in PEH was often missed in the early stages and instead diagnosed when the severity of symptoms intensified.

Interpretation: Overall, our findings indicate many commonalities in the health needs of PEH and the barriers they face when they seek access to cancer-specific healthcare services in the European context.

Funding: This study received funding from the European Union's Horizon 2020 Research and Innovation Programme under GA 965351.

Keywords: Cancer; Healthcare disparities; Homeless persons; Neoplasms; Prevention; Qualitative study.

PubMed Disclaimer

Conflict of interest statement

This publication reflects the author's views. The European Commission is not responsible for any use that may be made of the information it contains.

Similar articles

See all similar articles

Cited by

References

    1. Fazel S., Geddes J.R., Kushel M. The health of homeless people in high-income countries: descriptive epidemiology, health consequences, and clinical and policy recommendations. Lancet. 2014;384:1529–1540. doi: 10.1016/S0140-6736(14)61132-6. - DOI - PMC - PubMed
    1. Thomson H., Thomas S., Sellstrom E., Petticrew M. Housing improvements for health and associated socio-economic outcomes. Cochrane Database Syst Rev. 2013 doi: 10.1002/14651858.CD008657.pub2. - DOI - PubMed
    1. Thomas B. Homelessness kills. An analysis of the mortality of homeless people in early twenty-first century England. https://www.crisis.org.uk/media/236799/crisis_homelessness_kills_es2012.pdf
    1. Ferlay J., Colombet M., Soerjomataram I., et al. Cancer incidence and mortality patterns in Europe: estimates for 40 countries and 25 major cancers in 2018. Eur J Cancer. 2018;103:356–387. doi: 10.1016/j.ejca.2018.07.005. - DOI - PubMed
    1. Asgary R. Cancer screening in the homeless population. Lancet Oncol. 2018;19:e344–e350. doi: 10.1016/s1470-2045(18)30200-6. - DOI - PubMed

LinkOut - more resources