Understanding disruptions in cancer care to reduce increased cancer burden
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eLife assessment
The study presents patterns of cancer care disruption in southern Illinois and eastern Missouri in the summer of 2020. Survey results show factors that impact cancer care during the COVID-19 pandemic, including group differences by race. The important findings provide solid evidence about variation in cancer care disruptions and opportunities to improve return to care.
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Abstract
This study seeks to understand how and for whom COVID-19 disrupted cancer care to understand the potential for cancer health disparities across the cancer prevention and control continuum.
Methods:
In this cross-sectional study, participants age 30+residing in an 82-county region in Missouri and Illinois completed an online survey from June-August 2020. Descriptive statistics were calculated for all variables separately and by care disruption status. Logistic regression modeling was conducted to determine the correlates of care disruption.
Results:
Participants (N=680) reported 21% to 57% of cancer screening or treatment appointments were canceled/postponed from March 2020 through the end of 2020. Approximately 34% of residents stated they would need to know if their doctor’s office is taking the appropriate COVID-related safety precautions to return to care. Higher education (OR = 1.26, 95% CI:1.11–1.43), identifying as female (OR = 1.60, 95% CI:1.12–2.30), experiencing more discrimination in healthcare settings (OR = 1.40, 95% CI:1.13–1.72), and having scheduled a telehealth appointment (OR = 1.51, 95% CI:1.07–2.15) were associated with higher odds of care disruption. Factors associated with care disruption were not consistent across races. Higher odds of care disruption for White residents were associated with higher education, female identity, older age, and having scheduled a telehealth appointment, while higher odds of care disruption for Black residents were associated only with higher education.
Conclusions:
This study provides an understanding of the factors associated with cancer care disruption and what patients need to return to care. Results may inform outreach and engagement strategies to reduce delayed cancer screenings and encourage returning to cancer care.
Funding:
This study was supported by the National Cancer Institute’s Administrative Supplements for P30 Cancer Center Support Grants (P30CA091842-18S2 and P30CA091842-19S4). Kia L. Davis, Lisa Klesges, Sarah Humble, and Bettina Drake were supported by the National Cancer Institute’s P50CA244431 and Kia L. Davis was also supported by the Breast Cancer Research Foundation. Callie Walsh-Bailey was supported by NIMHD T37 MD014218. The content does not necessarily represent the official view of these funding agencies and is solely the responsibility of the authors.
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eLife assessment
The study presents patterns of cancer care disruption in southern Illinois and eastern Missouri in the summer of 2020. Survey results show factors that impact cancer care during the COVID-19 pandemic, including group differences by race. The important findings provide solid evidence about variation in cancer care disruptions and opportunities to improve return to care.
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Reviewer #1 (Public Review):
This cross-sectional study examined the results of a survey about cancer treatment disruption during June-August 2020 in 82 counties located in Missouri and Illinois in the U.S. The main outcome was disruption in cancer care. Authors reported that higher education, being a female, experiencing more discrimination in healthcare settings, and having scheduled a telehealth appointment were associated with higher odds of care disruption. Lack of a research focus, lack of following any conceptual framework, the cross-sectional nature of the study, and the small sample size were the noted shortcomings of the manuscript.
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