Care Delivery Impact of the COVID-19 Pandemic on Breast Cancer Care
- 1 August 2021
- journal article
- research article
- Published by American Society of Clinical Oncology (ASCO) in JCO Oncology Practice
- Vol. 17 (8), e1215-e1224
- https://doi.org/10.1200/op.20.01062
Abstract
COVID-19 has altered healthcare delivery. Previous work has focused on patients with cancer and COVID-19, but little has been reported on healthcare system changes among patients without COVID-19. We performed a retrospective study of patients with breast cancer (BC) in New York City between February 1, 2020, and April 30, 2020. New patients were included as were patients scheduled to receive intravenous or injectable therapy. Patients with COVID-19 were excluded. Demographic and treatment information were obtained by chart review. Delays and/or changes in systemic therapy, surgery, radiation, and radiology related to the pandemic were tracked, along with the reasons for delay and/or change. Univariate and multivariable analysis were used to identify factors associated with delay and/or change. We identified 350 eligible patients, of whom 149 (42.6%) experienced a delay and/or change, and practice reduction (51.0%) was the most common reason. The patients who identified as Black or African American, Asian, or Other races were more likely to experience a delay and/or change compared with White patients (Black, 44.4%; Asian, 47.1%; Other, 55.6%; White, 31.4%; P = .001). In multivariable analysis, Medicaid compared with commercial insurance (odds ratio [OR], 3.04; 95% CI, 1.32 to 7.27) was associated with increased odds of a delay and/or change, whereas stage II or III BC compared with stage I (OR, 0.38; 95% CI, 0.15 to 0.95; and OR, 0.28; 95% CI, 0.08 to 0.092, respectively) was associated with decreased odds of a delay and/or change. Almost half of the patients with BC without COVID-19 had a delay and/or change. We found racial and socioeconomic disparities in the likelihood of a delay and/or change. Further studies are needed to determine the impact these care alterations have on BC outcomes.Keywords
This publication has 29 references indexed in Scilit:
- Clinical Characteristics and Outcomes of COVID-19–Infected Cancer Patients: A Systematic Review and Meta-AnalysisJNCI Journal of the National Cancer Institute, 2020
- Clinical characteristics of COVID-19-infected cancer patients: a retrospective case study in three hospitals within Wuhan, ChinaAnnals of Oncology, 2020
- Cancer and COVID-19: what do we really know?The Lancet, 2020
- Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort studyThe Lancet, 2020
- Oncology Practice During the COVID-19 PandemicJAMA, 2020
- Active and Effective Measures for the Care of Patients With Cancer During the COVID-19 Spread in ChinaJAMA Oncology, 2020
- A Practical Approach to the Management of Cancer Patients During the Novel Coronavirus Disease 2019 (COVID-19) Pandemic: An International Collaborative GroupThe Oncologist, 2020
- COVID-19: impact on cancer workforce and delivery of carePublished by Elsevier BV ,2020
- Triage of Scarce Critical Care Resources in COVID-19 An Implementation Guide for Regional AllocationSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2020
- Cancer patients in SARS-CoV-2 infection: a nationwide analysis in ChinaThe Lancet Oncology, 2020