Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, New York.
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, New York.
Cancer. 2021 Jul 15;127(14):2399-2408. doi: 10.1002/cncr.33537. Epub 2021 Apr 26.
New York City (NYC) emerged as an epicenter of the COVID-19 pandemic, and marginalized populations were affected at disproportionate rates. The authors sought to determine the impact of COVID-19 on cancer treatment, anxiety, and financial distress among low-income patients with gynecologic cancer during the peak of the NYC pandemic.
Medicaid-insured women who were receiving gynecologic oncology care at 2 affiliated centers were contacted by telephone interviews between March 15 and April 15, 2020. Demographics and clinical characteristics were obtained through self-report and retrospective chart review. Financial toxicity, anxiety, and cancer worry were assessed using modified, validated surveys.
In total, 100 patients completed the telephone interview. The median age was 60 years (range, 19-86 years), and 71% had an annual income <$40,000. A change in employment status and early stage cancer (stage I and II) were associated with an increase in financial distress (P < .001 and P = .008, respectively). Early stage cancer and telehealth participation were significantly associated with increased worry about future finances (P = .017 and P = .04, respectively). Lower annual income (<$40,000) was associated with increased cancer worry and anxiety compared with higher annual income (>$40,000; P = .036 and P = .017, respectively). When controlling for telehealth participation, income, primary language, and residence in a high COVID-19 prevalence area, a delay in medical care resulted in a 4-fold increased rate of anxiety (P = .023, 95% CI, 1.278-14.50). Race was not significantly associated with increased financial distress, cancer worry, or anxiety.
Low socioeconomic status was the most common risk factor for increased financial distress, cancer worry, and anxiety. Interventions aimed at improving access to timely oncology care should be implemented during this ongoing pandemic.
纽约市（NYC）成为 COVID-19 大流行的中心，边缘化人群受到的影响不成比例。作者试图确定 COVID-19 对在 NYC 大流行高峰期接受妇科癌症治疗的低收入患者的癌症治疗、焦虑和经济困境的影响。
通过电话访谈，于 2020 年 3 月 15 日至 4 月 15 日联系在 2 家附属中心接受妇科肿瘤学护理的医疗补助保险妇女。通过自我报告和回顾性图表审查获得人口统计学和临床特征。使用经过修改的验证后的调查评估财务毒性、焦虑和癌症担忧。
共有 100 名患者完成了电话访谈。中位年龄为 60 岁（范围 19-86 岁），71%的患者年收入<40000 美元。就业状况的改变和早期癌症（I 期和 II 期）与财务困境的增加相关（P<0.001 和 P=0.008）。早期癌症和远程医疗参与与对未来财务状况的担忧增加显著相关（P=0.017 和 P=0.04）。与高年收入（>$40000 美元）相比，较低的年收入（<$40000 美元）与癌症担忧和焦虑增加相关（P=0.036 和 P=0.017）。当控制远程医疗参与、收入、主要语言和居住在高 COVID-19 流行地区时，医疗护理的延迟导致焦虑的发生率增加 4 倍（P=0.023，95%CI，1.278-14.50）。种族与财务困境、癌症担忧或焦虑无显著相关性。
低社会经济地位是财务困境、癌症担忧和焦虑增加的最常见危险因素。在此持续大流行期间，应实施旨在改善及时肿瘤学护理获取机会的干预措施。
