Aisha Lofters|Andrée Schuler|Morgan Slater|Nancy N. Baxter|Navindra Persaud|Andrew D. Pinto|Ed Kucharski|Sam Davie|Rosane Nisenbaum|Tara Kiran
Using self-reported data on the social determinants of health in primary care to identify cancer screening disparities: opportunities and challenges
St. Michael's Hospital|St. Michael's Hospital|St. Michael's Hospital|University of Toronto|St. Michael's Hospital|St. Michael's Hospital|Cancer Care Ontario|St. Michael's Hospital|St. Michael's Hospital|University of Toronto
data social determinants health help primary care practices target improvement efforts yet relevant data rarely available family practice located toronto ontario routinely collects patientlevel sociodemographic data via pilottested survey developed multiorganizational steering committee sought use data assess relationship social determinants colorectal cervical breast cancer screening describe opportunities challenges using data social determinants selfadministered patient surveypatients family practice eligible least one three cancer screening types based age screening guidelines june 30 2015 answered least one question sociodemographic survey included study linked selfreported data sociodemographic survey conducted waiting room patients electronic medical record data cancer screening records created individuallevel income variable lowincome cutoff defined poverty threshold took household size account sociodemographic characteristics patients overdue screening compared uptodate screening cancer type using chisquared testswe analysed data 5766 patients survey data survey participants significantly higher screening rates 729 787 744 colorectal cervical breast cancer screening respectively 13 036 patients survey data 592 653 589 respectively foreignborn patients significantly likely uptodate colorectal screening canadianborn peers showed significant differences breast cervical cancer screening found significant association lowincome cutoff variable cancer screening neighbourhood income quintile significantly associated cancer screening housing status also significantly associated colorectal cervical breast cancer screening large amount missing data lowincome cutoff variable approximately 25 across three cohortswhile able show neighbourhood income might underestimate incomerelated disparities screening individuallevel income also challenging variable collect future work area target income disparity cancer screening simultaneously explore best collect measures poverty