Bridging the cancer evidence gap for people experiencing homelessness

People experiencing homelessness face unique health challenges, including a higher risk of cancer, yet little is known about the barriers they face in receiving appropriate cancer care and timely treatment.

A team of researchers led by Dr Matthew Tuson, Dr Jocelyn Tan and Professor Lisa Wood from the University of Notre Dame Australia has been successful in securing a Cancer Research Project Grant, co-funded by the Future Health Research and Innovation (FHRI) Fund and Cancer Council WA, to capture this data for the first time.

The team will draw on a unique linked dataset containing information about people experiencing homelessness in WA and conduct interviews with people with lived experience of homelessness and health professionals who work directly with this population. Importantly, this information will help to identify current gaps, and how challenges related to cancer prevention, screening, diagnosis and treatment might be overcome.

The research aims to understand how cancer symptoms are first identified among people experiencing homelessness, how they seek support, and their cancer-related experiences within the healthcare system. The team hope that this will ultimately improve outcomes and increase cancer survival for this vulnerable population.

We know we need to do better, but we don’t have the data to guide that yet

Dr Tan

Homelessness can create significant challenges for cancer prevention, detection and treatment, including:

• Higher exposure to risk factors, such as smoking and sun exposure
• Barriers to screening programs, including not receiving screening kits, reminders and positive result notifications
• Barriers to receiving and adhering to cancer treatment
• Challenges in managing symptoms and treatment, including palliative care

Delays in cancer detection and treatment may contribute to higher rates of early death, in a population who may also be at higher risk of developing cancer.

A system that isn’t set up for people without an address

Cancer screening rates among people experiencing homelessness are extremely low, and by the time medical treatment is received, cancers are often at an advanced stage.

“It’s not that people who experience homelessness don’t want to access screening – it’s that the services aren’t designed to accommodate them. Many cancer screening kits never reach people living with homelessness because they may not have a stable address, and follow-up care is nearly impossible without reliable contact information” says Dr Tan.

She adds, “There’s also an assumption that people experiencing homelessness don’t care about their health, but our research shows they do. If services were accessible in a way that worked for them, there would be more engagement.”

The findings from this research will hopefully give guidance to health services and screening programs to better support people experiencing homelessness.

Next steps and community impact

The research is still in the early stages, with the research team currently applying for ethics approvals, data collection, and setting up an advisory group, which will include people with lived experience of homelessness, service providers, and healthcare workers. This will ensure the research process is collaborative and that the findings translate into real action and don’t just ‘sit on a shelf’.

“If we can highlight the unique health challenges and inequities that people experiencing homelessness face, we can prioritise this population group in screening programs and strategies and then funding can be directed to the services which help this population directly”, Dr Tan shares.

Research projects such as this would not be possible without funding from community donations. If you’d like to make a difference, please donate today.