In Older Adults, Federal Housing Assistance Is Linked to Stage of Cancer Diagnosis

In older cancer patients, receiving federal housing assistance is associated with earlier-stage diagnosis of breast cancer, colorectal cancer, and non-small cell lung cancer (NSCLC), according to research published in JAMA Network Open.

In this comparative cohort analysis, researchers used Surveillance, Epidemiology, and End Results (SEER) cancer registry-Medicare data linked to administrative records from the US Department of Housing and Urban Development (HUD).

Individuals included in the analysis were aged 66 to 95 years at the time of primary diagnosis of breast cancer, colorectal cancer, NSCLC, or prostate cancer, with the diagnosis having been received between 2017 and 2019. Analyses involved propensity score matching of individuals based on receipt of HUD assistance, compared with not receiving such assistance.

From a total cohort of 1,477,032 individuals, the study included 52,532 individuals who were receiving HUD assistance at the time of diagnosis and had been for at least 6 months. Among these individuals, the mean age at diagnosis was 76.3 years; 64.0% were women; 17,156 patients had NSCLC; 16,064 had breast cancer; 10,807 had colorectal cancer, and 8505 had prostate cancer. Most of the patients (72.7%) were enrolled in Medicaid, and 73.4% had Part D low-income cost sharing.

A diagnosis of distant breast cancer was less likely among individuals receiving housing assistance (n=1071) than among matched control individuals (n=3485; adjusted odds ratio [aOR], 0.85; 95% CI, 0.82-0.90; P <.001), with localized cancer at diagnosis serving as the reference in this comparison.

A diagnosis of regional breast cancer was also less likely in patients with housing assistance (n=3598) than in matched control patients (n=11,650; aOR, 0.86; 95% CI, 0.81-0.93; P <.001) compared to a localized diagnosis.

Distant colorectal cancer at diagnosis was less likely among individuals with housing assistance (n=2398) than among matched control individuals (n=7562; aOR, 0.90; 95% CI, 0.83-0.98; P =.01), compared with a diagnosis of localized colorectal cancer.

Similar results were obtained for NSCLC, with patients with HUD assistance (n=8810) being less likely to receive a diagnosis of distant cancer than patients without HUD assistance (n=27,901; aOR, 0.83; 95% CI, 0.79-0.86; P <.001), compared to a diagnosis of localized NSCLC.

No significant associations were observed between stage of diagnosis of prostate cancer and receipt of housing assistance.

Across cancer types, the association between housing assistance and stage at diagnosis did not appear to vary in analyses examining race or ethnicity, type of Medicare insurance, sex, neighborhood socioeconomic status, or year of diagnosis, the researchers reported.

However, variations in patterns of distant cancer diagnosis were reported in analyses involving the type of housing assistance received, such as multifamily housing, public housing, or the Housing Choice voucher program.

“Across all 3 types of housing assistance, there were lower odds of distant-stage NSCLC for assisted versus unassisted individuals. Individuals with Housing Choice vouchers and those living in multifamily housing also had significantly lower odds of distant-stage breast cancer compared with unassisted individuals,” the researchers noted.

“In this cohort study of older adults in the US with cancer, we found that receipt of housing assistance was associated with earlier-stage breast cancer, colorectal cancer, and NSCLC diagnoses,” the researchers concluded. “Given that only about 1 in 4 eligible individuals currently receive housing assistance, a potential benefit of extending housing assistance may be earlier-stage diagnoses of these cancers.”

Disclosures: This research was supported by National Cancer Institute, the California Department of Public Health, the Centers for Disease Control and Prevention’s National Program of Cancer Registries, and the National Cancer Institute’s Surveillance, Epidemiology and End Results Program. Some study authors disclosed conflicts of interest. Please see the original reference for complete disclosures.

This article originally appeared on Cancer Therapy Advisor