Department of Biomedical & Health Information Sciences, University of Illinois at Chicago, 1919 W. Taylor St., Chicago, IL, 60612, USA.
University of Illinois Cancer Center, University of Illinois at Chicago, 818 S. Wolcott Ave., Chicago, IL, 60612, USA.
Breast Cancer Res Treat. 2020 Nov;184(1):249-254. doi: 10.1007/s10549-020-05828-7. Epub 2020 Aug 9.
The coronavirus disease (COVID-19) pandemic has had a profound impact on cancer care in the US Guidelines focused on the management of COVID-19, rather than healthcare needs of breast cancer patients requiring access to crucial services. This US survey of breast cancer survivors characterizes treatment delays early period in the pandemic.
We developed a survey and administered it to 609 adult breast cancer survivors in the US. We used snowball sampling with invitations distributed via social media. We used logistic regression to select a model of delay from a pool of independent variables including race, cancer stage, site of care, health insurance, and age. We used descriptive statistics to characterize delay types.
Forty-four percent of participants reported cancer care treatment delays during the pandemic. Delays in all aspects of cancer care and treatment were reported. The only variable which had a significant effect was age (97 (.95, 99), p < 0.001) with younger respondents (M = 45.94, SD = 10.31) reporting a higher incidence of delays than older respondents (M = 48.98, SD = 11.10). There was no significant effect for race, insurance, site of care, or cancer stage.
Our findings reveal a pervasive impact of COVID-19 on breast cancer care and a gap in disaster preparedness that leaves cancer survivors at risk for poor outcomes. Delays are critical to capture and characterize to help cancer providers and healthcare systems develop effective and patient-tailored processes and strategies to manage cases during the current pandemic wave, subsequent waves, and future disasters.
冠状病毒病(COVID-19)大流行对美国的癌症护理产生了深远影响。指南侧重于 COVID-19 的管理,而不是需要获得关键服务的乳腺癌患者的医疗保健需求。这项针对美国乳腺癌幸存者的调查描述了大流行早期的治疗延迟情况。
我们开发了一项调查,并在美国 609 名成年乳腺癌幸存者中进行了调查。我们使用滚雪球抽样法,通过社交媒体分发邀请。我们使用逻辑回归从包括种族、癌症分期、护理地点、健康保险和年龄在内的多个独立变量中选择一个延迟模型。我们使用描述性统计来描述延迟类型。
44%的参与者报告在大流行期间癌症治疗出现延迟。报告了癌症护理和治疗各个方面的延迟。唯一具有显著影响的变量是年龄(97(.95,99),p<0.001),年轻的受访者(M=45.94,SD=10.31)报告的延迟发生率高于年长的受访者(M=48.98,SD=11.10)。种族、保险、护理地点或癌症分期没有显著影响。
我们的研究结果表明,COVID-19 对乳腺癌护理产生了普遍影响,并且在灾难准备方面存在差距,这使癌症幸存者面临不良结局的风险。延迟是需要捕捉和描述的关键,以帮助癌症提供者和医疗保健系统在当前大流行浪潮、后续浪潮和未来灾难期间制定有效的、针对患者的流程和策略来管理病例。