Lung Cancer and Homelessness: A Hidden Health Crisis

In Hungary, a stark contrast exists in lung cancer rates and survival between those experiencing homelessness and the general public. The gap in healthcare use and outcomes is significant, yet often overlooked. This issue is particularly pressing within the country's universal healthcare system. The link between homelessness and lung cancer is clear. From 2015 to 2021, 11, 857 individuals were registered as homeless for at least a year. To understand the impact of homelessness, researchers created a "homelessness length index" (HLI). This index measures the proportion of time a person spent homeless during the study period. The index ranges from HLI 0 (no homelessness) to HLI 3 (more than two-thirds of the time homeless). The study focused on lung cancer patients. It compared 233 homeless individuals with 408 non-homeless controls, matched by age, sex, and region. The findings were striking. Lung cancer was nearly three times more prevalent among the homeless group (1. 97%) compared to the control group (0. 69%). Survival rates also differed greatly. The homeless group had lower average survival times. Additionally, the cost of lung cancer care was substantially lower for the homeless group. On average, the homeless group incurred 47% lower annual lung cancer-related healthcare costs. The duration of homelessness played a crucial role in survival rates. Those who were homeless for longer periods had a higher risk of mortality. This was evident in the Cox proportional hazards analysis, which showed that the degree of time spent in homelessness had a significant impact on survival, second only to the severity of the disease. Several factors contribute to this health crisis. Lifestyle choices, such as smoking, are often more prevalent among the homeless. However, the study could not delve deeper into these factors due to data limitations. The focus was on the direct impact of homelessness on lung cancer outcomes. The findings highlight a pressing need for targeted interventions. Addressing the unique healthcare needs of the homeless population could improve survival rates and reduce healthcare disparities. It is crucial to recognize that homelessness is not just a social issue but a significant health concern.