Current opinion in urology · 2026
Barriers and facilitators to accessing urologic cancer treatment for people experiencing homelessness: a systematic review.
СтатьяСистематический обзорНазвание и аннотация: Перевод в очереди
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Pfluger Sabrina, Fragner Tobias, Hama Honja, Grabovac Igor
Аннотация
PURPOSE OF REVIEW: People experiencing homelessness (PEH) remain an understudied and underserved population in cancer care, particularly regarding access to urologic cancer treatment. This review aims to examine barriers and facilitators PEH encounter when accessing treatment for urologic malignancies.
RECENT FINDINGS: PEH are found to have increased odds of delayed or disrupted urologic oncological treatment and experience deviations from guideline-based therapy. Problems arise in treatment coordination and organisation, with communication and logistical challenges posing major barriers. Comorbidities and disadvantaged insurance status further exacerbate disparities. The lack of documented reasons for treatment interruptions limits the ability to clarify individual patient needs. Person-centred therapy, housing provision, and additional resources act as facilitators.
SUMMARY: Among the five included studies, two assessed treatment adherence, one evaluated inpatient care delivery for hospitalised PEH, one explored links between housing status, diagnostic stage, and mortality after diagnosis, and one examined time-to-treatment. Present findings indicate an association between housing instability and insufficient care along the urologic cancer pathway. Delayed or distorted therapy, persisting bias and stigma, and personal problems contribute to inequities in the received care. Proposed facilitators range from housing interventions, multidisciplinary and person-led care, to treatment adaptations and participatory approaches in therapy and future research.
RECENT FINDINGS: PEH are found to have increased odds of delayed or disrupted urologic oncological treatment and experience deviations from guideline-based therapy. Problems arise in treatment coordination and organisation, with communication and logistical challenges posing major barriers. Comorbidities and disadvantaged insurance status further exacerbate disparities. The lack of documented reasons for treatment interruptions limits the ability to clarify individual patient needs. Person-centred therapy, housing provision, and additional resources act as facilitators.
SUMMARY: Among the five included studies, two assessed treatment adherence, one evaluated inpatient care delivery for hospitalised PEH, one explored links between housing status, diagnostic stage, and mortality after diagnosis, and one examined time-to-treatment. Present findings indicate an association between housing instability and insufficient care along the urologic cancer pathway. Delayed or distorted therapy, persisting bias and stigma, and personal problems contribute to inequities in the received care. Proposed facilitators range from housing interventions, multidisciplinary and person-led care, to treatment adaptations and participatory approaches in therapy and future research.