Socioeconomic and demographic factors that predict where children receive cancer care in Florida

Socioeconomic and demographic factors associated with type of facility (cancer center vs non-cancer center) at which a child with cancer is seen were identified to suggest interventions to increase access to state-of-the-art care. The 2268 children with cancer in Florida (1981-1986) were classified as ever having been seen or not having been seen at a cancer center. Patients referred from one type of facility to another were compared to those not referred. Nineteen percent of children with cancer were never seen at a cancer center. These children were likely to be older (15-19 years of age), have Hodgkin's disease or a brain tumor, reside in a county without a cancer center, or have higher median income. Interventions extending state-of-the-art cancer care beyond cancer centers should target (1) physicians treating adolescent-aged children and (2) patients for whom private insurance may serve as a barrier to referral and protocol therapy.