University at Buffalo Study: Patient Pathways to Cancer Treatment Varies by Education and Income

Published January 8, 2015

When it comes to cancer treatment, both education and income levels can influence a patient’s pathways to care at a National Cancer Institute (NCI)-designated cancer center (NCI-CCC) according to a recent study by researchers from the University at Buffalo and Roswell Park Cancer Institute.

Within the field of oncology, increasing access to high quality care has been identified as a priority to reduce cancer disparities. Previous research has also revealed that the facilities where patients receive their cancer care have implications for cancer outcomes. However, there had been little understanding of how patients decide where to seek cancer care.

“For this study, we wanted to focus on understanding how sociodemographic factors influence patient selection of where they received cancer care,” said Elizabeth Gage-Bouchard, PhD, assistant professor in the University at Buffalo’s School of Public Health and Health Professions, Department of Community Health and Health Behavior.”

Published in the international and peer-reviewed journal PLOS ONE, the study conducted in-depth interviews and administered questionnaires to a random sample of 124 patients at one NCI-CCC in the Northeast US.  In-depth interview data was then analyzed qualitatively to identify themes and patterns in patients’ pathways to receive their cancer care at an NCI-CCC location.  Logistic Regression was used to examine if these pathways varied by patient race, income, and education.

From the study, two qualitative themes emerged: following the recommendation of a physician and following advice from social network members. Quantitative data analysis shows that patient pathways to care at an NCI-CCC varied by education and income. Patients with lower income and education most commonly sought their cancer care at an NCI-CCC due to the recommendation of a physician. Patients with higher income and education most commonly cited referral by a specialist physician or the advice of a social network member.

“Our findings show that most patients relied on physician recommendations or advice from a social network member in deciding to seek their cancer care at an NCI-CCC,” said Gage-Bouchard. “Due to the role of physicians in shaping patients’ pathways to the NCI-CCC, initiatives that strengthen partnerships between NCI-CCCs and community physicians who serve underserved communities may improve access to NCI-CCCs.”

In addition to Gage-Bouchard, co-authors of the study include several researchers from Roswell Park Cancer Institute in Buffalo, NY, including: Elisa M. Rodriquez, PhD, assistant professor of oncology, Department of Cancer Prevention and Population Sciences; Ms. Frances G. Saad-Harfouche, Department of Cancer Prevention and Population Sciences; Austin Miller, PhD, assistant professor of oncology, Department of Biostatistics and Bioinformatics; Deborah Erwin,PhD, director, Office of Cancer Health Disparities Research, Division of Cancer Prevention and Population Sciences.