Risk Factors and COVID-19 Survival Among Cancer Survivors in New Jersey: A Population-based study

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Abstract

Background: People diagnosed with cancer are more susceptible to COVID-19-related mortality. Other than race, age, and sex, less is known about other factors associated with a higher risk of death after COVID-19 diagnosis among cancer survivors. Objective: The goal was to examine factors associated with survival time in cancer survivors following a COVID-19 diagnosis, focusing on sociodemographic and clinical factors in a population-based cohort of New Jersey residents. Methods : Cancer cases identified using the New Jersey State Cancer Registry (NJSCR) were linked with COVID-19 cases from Communicable Disease Reporting and Surveillance System (CDRSS) diagnosed in 2020-21, creating an analytic dataset 63,330 people. Area Deprivation Index incorporated environmental and structural factors related to neighborhood disadvantage. Competing risk regression analyses were used to identify factors associated with survival. Results: People diagnosed with cancer were more likely to die from COVID-19 than die from cancer within the first five months following their COVID-19 diagnosis. Cumulative incidence rate of cancer-specific deaths surpassed that of COVID-19-specific deaths ( P <0.001), after three years. After adjusting for other covariates, females had a lower risk of dying from COVID-19 than males (HR=0.63, 95% CI= 0.58-0.65, P<0.001). Relative to whites, Blacks were 47% more likely (HR=1.47, 95% CI= 1.35-1.60, P<0.001) to die from COVID-19. Older age, API race, Hispanic ethnicity, those living in more socioeconomically disadvantaged areas of New Jersey, diagnosed with hematological cancers, or diagnosed later stage also had a significantly higher risk of dying from COVID-19 ( P <0.001). Conclusions . This study of cancer survivors illustrates that males, Black, API, or Hispanic individuals, as well as those living in more socioeconomically disadvantaged areas of New Jersey, diagnosed with a hematologic cancer or at late-stage tumor had increased risks of COVID-19-related death. Targeting more aggressive interventions to this vulnerable cancer population (e.g., access to vaccines or early treatments) may reduce morbidity and mortality.

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