Department of Surgery, Public Health Sciences, School of Medicine, Washington University in St. Louis, St Louis, United States.
Brown School, Washington University in St. Louis, St Louis, United States.
Elife. 2023 Aug 10;12:e85024. doi: 10.7554/eLife.85024.
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.
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.
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.
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.
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.
本研究旨在了解 COVID-19 如何以及为何扰乱癌症护理，以了解癌症预防和控制连续体中癌症健康差异的可能性。
在这项横断面研究中，年龄在 30 岁及以上的参与者居住在密苏里州和伊利诺伊州的 82 个县，于 2020 年 6 月至 8 月期间完成了在线调查。分别对所有变量和按护理中断状态进行描述性统计。进行逻辑回归模型分析以确定护理中断的相关因素。
参与者（N=680）报告称，2020 年 3 月至 2020 年底，21%至 57%的癌症筛查或治疗预约被取消/推迟。大约 34%的居民表示，他们需要知道医生办公室是否采取了适当的 COVID 相关安全措施才能恢复治疗。较高的教育程度（OR=1.26，95%CI：1.11-1.43）、女性身份（OR=1.60，95%CI：1.12-2.30）、在医疗保健环境中经历更多歧视（OR=1.40，95%CI：1.13-1.72）以及安排远程医疗预约（OR=1.51，95%CI：1.07-2.15）与更高的护理中断几率相关。与护理中断相关的因素在不同种族之间并不一致。白人居民护理中断的几率较高与较高的教育程度、女性身份、较年长和安排远程医疗预约有关，而黑人居民护理中断的几率较高仅与较高的教育程度有关。
本研究提供了对与癌症护理中断相关的因素以及患者需要返回护理的了解。研究结果可以为减少延迟的癌症筛查和鼓励返回癌症护理提供信息，以制定外展和参与策略。
本研究得到了美国国立卫生研究院的 P30 癌症中心支持拨款的行政补充（P30CA091842-18S2 和 P30CA091842-19S4）的支持。Kia L. Davis、Lisa Klesges、Sarah Humble 和 Bettina Drake 得到了美国国立癌症研究所 P50CA244431 的支持，Kia L. Davis 还得到了乳腺癌研究基金会的支持。Callie Walsh-Bailey 得到了 NIMHD T37 MD014218 的支持。内容不一定代表这些资助机构的官方观点，完全由作者负责。
