TAMPA, Fla. — A groundbreaking new study led by researchers at the Moffitt Cancer Center reveals profound disparities in cancer treatment access among people living with HIV, linked closely to the socioeconomic fabric of their communities. This comprehensive analysis scrutinized cancer care delivery across the United States, emphasizing how neighborhood income levels and educational attainment act as critical determinants influencing whether patients receive potentially lifesaving first-line cancer therapies. The findings illuminate a pressing public health concern, exposing structural inequities that transcend biological factors and medical complexity.
The research team undertook an extensive review of medical records for over 31,000 adults diagnosed with HIV who subsequently developed one of fourteen common cancers between 2004 and 2020. Utilizing advanced data statistical techniques, the investigators identified that a significant proportion — approximately 16.5% — did not receive the recommended curative cancer treatments. Importantly, this treatment gap was not random but rather showed a striking correlation with area-level socioeconomic indicators, suggesting that social determinants deeply impact clinical outcomes.
Crucially, patients residing in ZIP codes characterized by lower educational achievement were found to be 27% less likely to receive standard curative cancer interventions compared to those in the most educated regions. Similar trends were observed for income, where individuals living in the lowest income brackets encountered a 27% reduced likelihood of treatment. These disparities prevailed even after controlling for demographic and clinical variables such as age, gender, cancer type, disease stage at diagnosis, and the type of treatment facility, underscoring the systemic nature of these inequities.
The study’s lead author, Dr. Jessica Islam, an assistant member in the Cancer Epidemiology Program at Moffitt, emphasizes that these findings shift the dialogue from purely biomedical explanations to a broader view of health determinants. “Our data suggest that economic and educational environments shape access to cancer treatment more than previously appreciated,” Dr. Islam notes. “It’s not merely proximity to treatment centers; it’s about how larger societal structures influence healthcare delivery and patient engagement.”
Geographically, a majority of the patients analyzed hailed from the Southern United States, accounting for 39% of the cohort, with most subjects being male (68%) and aged 60 or older (43%). Among the cancers most frequently diagnosed within this group were lung cancer, lymphoma, colorectal cancer, and prostate cancer. These malignancies, which have established guidelines for curative intervention, served as a robust framework to evaluate disparities in treatment application across diverse populations.
Co-author Dr. Amir Alishahi Tabriz, assistant member in the Health Outcomes and Behavior Program at Moffitt, highlights the broader implications of the findings. “This study unearths how structural inequality — not just individual patient factors or disease biology — drives the divergence in cancer care outcomes for people living with HIV,” he explains. “It compels us to develop multifaceted interventions targeting social determinants to ensure equitable, life-saving treatment access.”
The observed association between socioeconomic variables and care gaps likely represents the compounded effects of various systemic barriers. Patients in disadvantaged communities may face limited transportation options, fragmented healthcare networks, reduced health literacy, and financial hardships. These factors can result in delays in diagnosis, treatment initiation, and adherence to prescribed therapies, ultimately diminishing survival prospects.
From a methodological perspective, the researchers harnessed national cancer registries integrated with HIV surveillance data to enable a granular assessment of treatment disparities over a sixteen-year period. Sophisticated statistical models were applied to adjust for confounders and isolate the independent effect of area-level education and income. This rigorous approach enhances the validity of conclusions, positioning the study as a pivotal reference for public health policy.
Importantly, this investigation illuminates an urgent need for health systems and policymakers to incorporate social determinants into cancer care delivery frameworks, especially for vulnerable populations such as those living with HIV. Solutions may involve community-based outreach programs, education campaigns tailored to increase awareness and health navigation skills, and structural reforms to expand economic opportunities and healthcare accessibility within underserved neighborhoods.
This expansive evaluation aligns with a growing body of evidence demonstrating that beyond biological factors, health outcomes are profoundly shaped by socioeconomic contexts. Addressing these root causes through targeted, multidisciplinary strategies is essential to closing the treatment gap and improving survival rates among people with HIV who develop cancer.
The study was supported by funding from the American Cancer Society and published in the journal Cancer on April 30, 2025. It represents a novel contribution to oncological and epidemiological research, intersecting infectious disease and cancer care with social sciences. Future research is encouraged to explore intervention efficacy in mitigating these disparities and to expand inquiry into other populations facing similar structural barriers.
As the landscape of cancer treatment evolves with precision medicine and novel therapies, the findings underscore that equitable access must remain a core priority. Without deliberate actions to dismantle socioeconomic barriers, advances in cancer care risk amplifying health inequities rather than alleviating them.
Moffitt Cancer Center, recognized as a National Cancer Institute-designated Comprehensive Cancer Center, continues to spearhead research efforts addressing these complex intersections of social determinants and health outcomes. The leadership emphasized a commitment to multidisciplinary collaboration aimed at translating research insights into actionable policies and community programs.
These revelations call for a paradigm shift in how healthcare systems conceive of and deliver cancer care—one that integrates social context as an indispensable element of treatment planning. Only through such an inclusive lens can the medical community hope to eradicate inequities and foster health equity for people living with HIV and beyond.
Subject of Research: People
Article Title: Investigating structural inequities in area-level socioeconomic and health care access measures among people with HIV and cancer (2004–2020)
News Publication Date: May 5, 2025
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- DOI: 10.1002/cncr.35881
Keywords: Cancer research
