ASSOCIATION OF SOCIAL DETERMINANTS OF HEALTH WITH RARE CANCER BURDEN IN THE UNITED STATES: A MEPS-BASED ANALYSIS
Author(s)
Harshit Dixit, MBA1, Navneet Kumar, PhD2, Jatinder Kumar, MPharm2, Coby Martin, MSc3, Sabrina Gaiazov, MPH4, Ankur Goyal, MBBS2.
1Axtria India Pvt Ltd, Noida, India, 2Axtria India Pvt Ltd, Gurugram, India, 3Axtria Inc, Toronto, ON, Canada, 4Axtria Inc, Berkeley Heights, NJ, USA.
1Axtria India Pvt Ltd, Noida, India, 2Axtria India Pvt Ltd, Gurugram, India, 3Axtria Inc, Toronto, ON, Canada, 4Axtria Inc, Berkeley Heights, NJ, USA.
OBJECTIVES: Rare cancers contribute substantially to cancer-related morbidity in the US, yet the role of social determinants of health (SDoH) in rare cancer burden remains inadequately understood. This study assessed the association between SDoH and rare cancer burden among US adults using data from the Medical Expenditure Panel Survey (MEPS).
METHODS: We conducted a cross-sectional analysis using MEPS data (2018-2022). Rare cancers were identified using the MEPS CAOTHER variable, which captures cancer diagnoses occurring in fewer than 20 observations or classified as clinically rare by the National Institutes of Health. SDoH were examined across economic stability, health care access, health behaviors, and nativity domains. Survey-weighted descriptive analyses and logistic regression were used to assess associations between SDoH and rare cancer burden.
RESULTS: A weighted sample covering 1,646,572,515 US patient-years from 2018-2022 was identified, of which 1.59% (26,105,886) had a rare cancer diagnosis. In logistic regression analyses, multiple SDoH parameters were associated with rare cancer burden. Within the economic stability domain, compared with high income, low (OR=1.44; p<0.001) and middle income (OR=1.29; p=0.002) were associated with higher odds of rare cancer. Within health care access and quality, compared with private insurance, public insurance was associated with higher odds (OR=1.69; p<0.001), whereas Medicare was associated with lower odds (OR=0.53; p<0.001); lack of medication affordability was also associated with higher odds (OR=1.68; p<0.001) of rare cancer. Within health behaviors, smoking (OR=1.40; p=0.003) and physical inactivity (OR=1.16; p=0.04) were associated with higher odds. Within the nativity domain, non-US born individuals had higher odds of rare cancer (OR=1.49; p=0.001).
CONCLUSIONS: Multiple social determinants of health, including economic stability, health care access, medication affordability, health behaviors, and nativity, were significantly associated with rare cancer burden. Planned analyses will next compare rare and general cancer cohorts to help further contextualize these SDoH associations.
METHODS: We conducted a cross-sectional analysis using MEPS data (2018-2022). Rare cancers were identified using the MEPS CAOTHER variable, which captures cancer diagnoses occurring in fewer than 20 observations or classified as clinically rare by the National Institutes of Health. SDoH were examined across economic stability, health care access, health behaviors, and nativity domains. Survey-weighted descriptive analyses and logistic regression were used to assess associations between SDoH and rare cancer burden.
RESULTS: A weighted sample covering 1,646,572,515 US patient-years from 2018-2022 was identified, of which 1.59% (26,105,886) had a rare cancer diagnosis. In logistic regression analyses, multiple SDoH parameters were associated with rare cancer burden. Within the economic stability domain, compared with high income, low (OR=1.44; p<0.001) and middle income (OR=1.29; p=0.002) were associated with higher odds of rare cancer. Within health care access and quality, compared with private insurance, public insurance was associated with higher odds (OR=1.69; p<0.001), whereas Medicare was associated with lower odds (OR=0.53; p<0.001); lack of medication affordability was also associated with higher odds (OR=1.68; p<0.001) of rare cancer. Within health behaviors, smoking (OR=1.40; p=0.003) and physical inactivity (OR=1.16; p=0.04) were associated with higher odds. Within the nativity domain, non-US born individuals had higher odds of rare cancer (OR=1.49; p=0.001).
CONCLUSIONS: Multiple social determinants of health, including economic stability, health care access, medication affordability, health behaviors, and nativity, were significantly associated with rare cancer burden. Planned analyses will next compare rare and general cancer cohorts to help further contextualize these SDoH associations.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
PCR184
Topic
Patient-Centered Research
Topic Subcategory
Adherence, Persistence, & Compliance, Patient-reported Outcomes & Quality of Life Outcomes
Disease
SDC: Oncology, SDC: Rare & Orphan Diseases