{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T11:34:20Z","timestamp":1792755260438,"version":"4.5.0"},"reference-count":15,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T00:00:00Z","timestamp":1742256000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["K07AG076401"],"award-info":[{"award-number":["K07AG076401"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["K12HD065987"],"award-info":[{"award-number":["K12HD065987"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["1K23MD019644"],"award-info":[{"award-number":["1K23MD019644"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Hosp Palliat Care"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Patients who experience homelessness manifest poor cancer outcomes, often because of treatment delays. Few studies have used mixed methods to learn what happens at the patient and health care staff level to explain these delays.\n                    <jats:bold>Methods:<\/jats:bold>\n                    This single-institution, multi-site study interrogated the entire medical record system (thousands of patients annually) for homelessness and cancer diagnoses from January 1, 2019, through October 10, 2023. Records were abstracted for relevant quantitative and qualitative data; rigorous methods were used to analyze, integrate, and report findings.\n                    <jats:bold>Results:<\/jats:bold>\n                    Forty-three patients with a median age of 58 years (range: 32, 73\u00a0years) and 34 (79%) assigned male sex at birth are the focus of this report. The most common cancers include hematologic (n = 8), gastrointestinal (n = 8), and genitourinary (n = 8). Thirty-five patients (81%) initiated cancer therapy, and 27 (63%) manifested treatment delay (&gt;4\u00a0weeks post-diagnosis). The median time to cancer therapy was 9 weeks (95% confidence interval: 4.6, 12\u00a0weeks). Qualitative themes that explain delays are as follows: (1) logistical challenges in communication between the patient and health care team (\u201clack of a cell phone\u201d); (2) patient reluctance to receive care (\u201cpatient elected to leave Against Medical Advice\u201d); and (3) medical challenges in providing care (\u201che was hospitalized after being found down and hypotensive\u201d).\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    This study confirms that initiation of cancer therapy is often delayed in patients who experience homelessness. It sheds light on reasons for delay \u2013 for example, lack of phone access, an observation which suggests that perhaps provision of a burner phone might help some patients.\n                  <\/jats:p>","DOI":"10.1177\/10499091251325231","type":"journal-article","created":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T06:08:16Z","timestamp":1742278096000},"page":"179-187","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Homelessness and Cancer: A Multi-Site, Mixed Methods Study of Delayed or No Cancer Therapy"],"prefix":"10.1177","volume":"43","author":[{"given":"Robert J.","family":"Haemmerle","sequence":"first","affiliation":[{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelliann","family":"Fee-Schroeder","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynn","family":"Phelan","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1081-189X","authenticated-orcid":false,"given":"Aminah","family":"Jatoi","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3532-4913","authenticated-orcid":false,"given":"Elizabeth","family":"Cathcart-Rake","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,3,18]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.49143"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-023-14713-8"},{"key":"e_1_3_4_4_2","unstructured":"Homelessness among acute care patients within a large health care system in northern California. https:\/\/www.npr.org\/homelessness-affordable-housing-crisis-rent-assistance"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1089\/pop.2023.0190"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.3389\/frhs.2023.1288329"},{"key":"e_1_3_4_7_2","unstructured":"Homelessness among acute care patients within a large health care system in northern California. https:\/\/endhomelessness.org\/homelessness-in-america\/homelessness-statistics\/state-of-homelessness\/"},{"key":"e_1_3_4_8_2","unstructured":"Homelessness among acute care patients within a large health care system in northern California. https:\/\/endhomelessness.org\/homelessness-in-america\/homelessness-statistics\/state-of-homelessness\/#homelessness-trends-over-time"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph16152677"},{"key":"e_1_3_4_10_2","unstructured":"Homelessness among acute care patients within a large health care system in northern California. https:\/\/www.cancer.org\/research\/acs-research-news\/facts-and-figures-2020.html"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m4087"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-08-764712"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2022.3697"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2023.01.034"},{"key":"e_1_3_4_15_2","unstructured":"Homelessness among acute care patients within a large health care system in northern California. https:\/\/www.wilder.org\/mnhomeless\/results\/detailed-data"},{"key":"e_1_3_4_16_2","unstructured":"Homelessness among acute care patients within a large health care system in northern California. 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