Cancer health disparities in the state of Georgia: African American oncology care.

Abstract

1546 Background: Approximately 58,970 new cancer diagnoses are projected for 2022 in Georgia (GA), contributing to 18,750 deaths. African Americans (AA) make up about one-third of Georgia’s population compared to 14% of the national population. Cancer survival rates are lower for AA than non-AA for almost all cancer types. Biological factors do not account for all these differences. We explore the impact of racial disparities on cancer care in Georgia. Methods: We used 2020 behavioral risk factor surveillance system (BRFSS) data to capture patient-reported data on various demographic and health coverage variables. Oncology patients in the stage of Georgia were selected for our analysis. We evaluated the effect of racial disparities on clinical services received. Results: In the state of GA, 9,090 participants responded to the 2020-BRFSS, of which 400 partcipants had a history of cancer diagnosis other than skin cancer. Males and females comprised 37% and 63%, respectively. AA represented 15.8% of the respondents. The majority of the oncology respondents reported having health care coverage (96%) and having insurance coverage for all cancer treatments (96.8%) despite having 81.9% of the participants unemployed. Compared to non-AA, AA participants reported lower rates of health insurance payment for cancer treatment (84% v 99.3%, P = 0.0022) and lower levels of annual incomes (percentage of annual income <50,000$/year was 72.3% vs 51.5%, P = 0.0151). AA participants were four times less likely to have full coverage for cancer-related treatment than non-AA (odds ratio=4.31). There was no statistically significant difference in secondary education rates, health care coverage, the inability to see a physician due to cost, receipt of summary of treatment or written instructions, denial of insurance coverage due to cancer, and clinical trial participation. Participants with at least secondary education were more likely to have full insurance coverage for all cancer treatment expenses (P = 0.0206). Conclusions: Among cancer patients in Georgia, income rates were lower in AA than in non-AA. They were also less likely to have full coverage for cancer-related treatment. Analysis suggests secondary education increases the likelihood of having full insurance coverage. Education and income disparity may have a bearing on the accessibility and quality of cancer care. Addressing these inequities on a societal level will be key in ensuring high-quality oncology care for all. [Table: see text]