Online Program

Perspectives of cancer and cancer screening among homeless adults of New York City shelters: A qualitative approach

Tuesday, November 3, 2015

Ramin Asgary, MD, MPH, Dept of Medicine, Weill Cornell College of Medicine and New York University School of Medicine, New York, NY
Blanca Sckell, MD, MPH, Community Medicine Program, Lutheran Family Health Centers, Brooklyn, NY
Analena Alcabes, BS, Medicine, New York University School of Medicine, New York, NY
Ramesh Naderi, MD, NYU School of Medicine, New York
Gbenga Ogedegbe, MD, MS, MPH, FACP, Department of Population Health, New York University Langone Medical Center, New York, NY

Millions of homeless Americans have lower cancer screening and higher cancer mortality rates. We explored perspectives and perceptions regarding cancer and cancer screening among homeless.


Using random and criteria sampling, we conducted in-depth semi-structured interviews with 50 homeless adults from New York City’s (NYC) shelters and shelter-based clinics.


Mean age was 51.66 years with average 2.03 years of homelessness; 33/50 were older than 50. Only a small number of participants had their recommended cancer screening. Contrary to general assumptions and despite significant barriers, the homeless were concerned about cancer, believed their risk of cancer is higher compared to the general population, and generally considered screening a high priority during homelessness. While they acknowledged several individual and systems level barriers, they welcomed targeted measures to address their multi-levels barriers. Suggested strategies included active counseling by providers, health education or reminders via mHealth strategies or face-to-face in shelters, addressing potential providers’ prejudice and biases regarding their priorities, incentives, and patient navigators or coach to help navigating the complex cancer screening process.


There are gaps in effective cancer screening despite adequate attitude and perceptions among homeless. The health system needs to shift from addressing only basic care to a more equitable approach with accessible and acceptable opportunities for preventive cancer care for the homeless.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Program planning
Public health or related research
Social and behavioral sciences

Learning Objectives:
Evaluate the perspectives regarding cancer and cancer screening among homeless Discuss barriers of and potential strategies to improve screening among homeless

Keyword(s): Cancer, Health Disparities/Inequities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have extensive experience in working with and evaluating healthcare of vulnerable population including the homeless and evaluating their cancer health disparities. I designed and performed this study and analyzed data and prepared the abstract
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.