Evidence map›Paper›PMID 40011415›Full record

ArticleJournal of general internal medicine2025

Housing Status and Cancer Screening in US Veterans.

Hannah Decker, Laura Graham, Ashley Titan, Mary Hawn, Margot Kushel, Hemal K Kanzaria, Elizabeth Wick

Abstract read
In one paragraph

Article in Journal of general internal medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Hannah DeckerDepartment of Surgery, UCSF, San Francisco, USA. Hannah.decker@ucsf.edu.ORCID 0000-0003-0850-4134
Laura GrahamPalo Alto VA, Palo Alto, USA.
Ashley TitanDepartment of Surgery, Stanford, USA.
Mary HawnDepartment of Surgery, Stanford, USA.
Margot KushelDepartment of Medicine, UCSF, San Francisco, USA.
Hemal K KanzariaBenioff Homelessness and Housing Initiative, Zuckerburg San Francisco General Hospital, San Francisco, USA.
Elizabeth WickDepartment of Surgery, UCSF, San Francisco, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCancer is a leading cause of death in people experiencing homelessness, who are more commonly diagnosed with late-stage disease and have poorer survival after diagnosis than housed.

objectiveTo characterize the incidence and timeliness of colorectal and breast cancer screening in a national sample of Veterans.

designRetrospective, matched cohort study from 2011 to 2021 in a national sample of Veterans receiving care from the Veterans Health Administration (VA).

participantsEach Veteran experiencing homelessness was matched to three housed Veterans with the same age, gender, clinic location, and month and year of outpatient clinic appointment. EXPOSURE: We classified Veterans as homeless if they had any homeless indicator at the matched clinic visit or in the 12 months prior and all others as housed. MAIN MEASURES: Our primary outcomes were being up to date on screening, receiving a biopsy following a positive screen and timeliness of biopsy. We assessed the association between housing status and our outcomes using conditional Poisson regression models with generalized estimating equations, adjusting for race, ethnicity, marital status, Charlson Comorbidity Index, smoking status, and mental health comorbidities. KEY

resultsOur sample included 2,580,640 Veterans, with 1,935,480 housed and 645,160 experiencing homelessness. Patients experiencing homelessness had a 16% lower adjusted incidence rate ratio (aIRR) of being up to date with colorectal cancer screening when compared to housed (aIRR 0.84, 95%CI 0.83-0.84; p<0.001) and a 13% lower aIRR for breast cancer (aIRR 0.87, 95%CI 0.86-0.88; p<0.001). Following a positive stool-based test, patients experiencing homelessness had a 12% lower aIRR of undergoing diagnostic colonoscopy compared to housed (aIRR 0.88, 95%CI 0.84-0.92; p<0.001). Time to biopsy was similar between groups for both cancer types.

conclusionsVeterans experiencing homelessness were less commonly screened for cancer than a matched housed cohort. However, screening rates in this group were higher than in non-Veteran homeless populations. The VA system may offer insights into providing preventative care for this population.

Indexed as

Breast NeoplasmsColorectal NeoplasmsEarly Detection of CancerHousingIll-Housed PersonsVeteransAgedCohort StudiesFemaleHumansMaleMiddle AgedRetrospective StudiesUnited StatesUnited States Department of Veterans Affairscancer screeninghealth equityhomelessnesshousingpreventive care

Identifiers

PMID40011415
PMCPMC12045890

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.