PO.PS01.10 · 人群科学
CARIBCARES研究中癌症幸存者在肿瘤诊疗中面临的内部、外部及结构性障碍
Internal, external and structural barriers in cancer care faced by survivors from the caribcares study
作者与单位 Authors & Affiliations
摘要 Abstract
中文摘要
引言。及时诊断是一项公共卫生优先事项。然而，很大一部分人群往往在疾病晚期或以急诊形式被确诊。本研究旨在探讨波多黎各一部分癌症幸存者中导致诊断延误及肿瘤诊疗不平等的相关因素。
方法。加勒比海环境与自然灾害癌症研究中心（CARIBCARES）自2025年8月20日起，招募过去12个月内正在或曾经接受积极治疗的癌症患者，以评估极端天气事件对该人群生活质量的影响。我们在CARIBCARES正在进行的研究项目参与者（n=135）中开展了一项横断面研究。经过培训的研究助理对符合条件的参与者进行访谈，参与者完成了一份60分钟的问卷调查。每位参与者获得20.00美元的激励报酬。
结果。参与者中位年龄为60岁，41%生活在贫困线以下。女性比男性更愿意参与，分别占样本的66.4%和33.6%。超过半数（53%）的参与者在癌症确诊时为局限期，而35%为区域性或远处扩散的癌症。约49.6%的参与者报告其诊断存在延误。报告最多的挑战是医疗保险问题（24%）、经济问题（20%）以及与医疗服务提供者缺乏沟通（14%）。较小比例的参与者受到缺乏确诊或基因检测的影响（4.4%），另有3%因极端天气事件对其住房或社区造成损坏而无法就医。
讨论。本研究突出了参与CARIBCARES研究的幸存者在癌症诊断和诊疗连续体中的关键障碍，揭示了对波多黎各人群造成不成比例影响的重要不平等。这些发现凸显了在医疗可及性和导航方面的系统性薄弱环节，必须加以解决，以改善早期发现和生存结局。
查看英文原文 English abstract
Introduction. Timely diagnosis is a public health priority. However, a great proportion of the population is often diagnosed with advanced disease or as an emergency. The study aimed at examining factors contributing to diagnostic delays and inequalities in cancer care among a subset of cancer survivors in Puerto Rico.
Methods. The Caribbean Cancer Research Center on Environmental and Natural Hazards (CARIBCARES) has been recruiting cancer patients who are or have been in active treatment over the past 12 months since August 20, 2025, to assess the impact of extreme weather events on the quality of life of this population. We conducted a cross-sectional study among participants (n=135) from the ongoing research project of CARIBCARES. Trained research assistants interviewed eligible participants who completed the 60-minute survey. A with a $20.00 incentive was provided to each participant.
Results. Participants' median age was 60 years, and 41% were living below poverty level. Females were willing to participate than males accounting for 66.4% and 33.6% of the sample, respectively. Over half (53%) of participants had a localized stage at cancer diagnosis, while 35% had regional or distant cancer. Around 49.6% of participants reported delays in their diagnosis. The top reported challenges were problems with their health insurance (24%), financial problems (20%) and Lack of communication with health care providers (14%). Smaller groups of participants were affected due to absence of confirmatory or genetic tests (4.4%), while 3% were unable to attend a medical appointment due to damage to their home or neighborhood caused by an extreme weather event.
Discussion. This study highlights critical barriers in the cancer diagnostic and care continuum among survivors participating in the CARIBCARES study, revealing important inequities that disproportionately affect populations in Puerto Rico. These findings underscore systemic weaknesses in healthcare access and navigation that must be addressed to improve early detection and survival outcomes.
利益披露 Disclosure
N. R. Cardona-Cordero, None..
C. Boneu, None.