Cancer Risk Behaviors and Screening Rates Among Homeless Adults in Los Angeles County

Published in: Cancer Epidemiology, Biomakers & Prevention, v. 11, no. 5, May 2002, p. 431-438

Posted on RAND.org on December 31, 2001

by Sara Chau, Melissa Chin, Jeannie Chang, Ann Luecha, Eric M. Cheng, Jennifer Schlesinger, Veena Rao, David T. Huang, Annette E. Maxwell, Richard Usatine, et al.

Read More

Access further information on this document at cebp.aacrjournals.org

This article was published outside of RAND. The full text of the article can be found at the link above.

The homeless encounter many barriers to health care and preventive services, while having an increased prevalence of most risk factors for cancer. A group of homeless adults (221) at nine different locations within Los Angeles County were surveyed during the summers of 1998 and 1999. A portion (71%) reported that they had had at least one rectal exam, 42% had a fecal occult blood test, 24% had a skin exam, and 23% had an endoscopy (flexible sigmoidoscopy or colonoscopy), and of the men aged 50+, only 19% had a prostate-specific antigen test in their lifetime. For women aged 40+, 55% had received a Pap smear, and 53% had a breast exam, but only 32% had a mammogram within the prior year. Among the sampled homeless population, 77% believed in the benefits of cancer screening, 79% were not fatalistic about cancer, 63% believed that early detection was efficacious, and 83% did not think it would be difficult to get screened. The majority of this population demonstrated accurate knowledge of cancer screening guidelines with the exception of endoscopy. Cancer screening rates of those surveyed were lower than the rates in California for endoscopy, prostate-specific antigen, mammography, and Pap smears. Given the lower cancer screening rates compounded by higher cancer risk factors, homeless populations need increased access to cancer screening tests, as well as education on the availability of free services. Additionally, facilities for the homeless and their staff should reinforce the purposes of cancer screening, provide more screening services, and implement institutional efforts, such as providing nutritious meals and sun protection products, to reduce high-risk behaviors and increase further access to cancer screening tests.

This report is part of the RAND Corporation External publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

Our mission to help improve policy and decisionmaking through research and analysis is enabled through our core values of quality and objectivity and our unwavering commitment to the highest level of integrity and ethical behavior. To help ensure our research and analysis are rigorous, objective, and nonpartisan, we subject our research publications to a robust and exacting quality-assurance process; avoid both the appearance and reality of financial and other conflicts of interest through staff training, project screening, and a policy of mandatory disclosure; and pursue transparency in our research engagements through our commitment to the open publication of our research findings and recommendations, disclosure of the source of funding of published research, and policies to ensure intellectual independence. For more information, visit www.rand.org/about/principles.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.