21 Sep Minorities At Increased Risk of Cancer Care Disruption During COVID-19
MedicalResearch.com Interview with:
Dr. El Bakouny
Ziad Bakouny, MD, MSc
Post-doctoral research fellow
Lank Center for Genitourinary Oncology
Dana-Farber Cancer Institute
MedicalResearch.com: What is the background for this study?
Response: The COVID-19 pandemic has disproportionately affected patients with cancer, with these patients unfortunately having worse outcomes than the general population. In fact, a recent report by the COVID-19 and Cancer Consortium (CCC19) showed that the mortality rate in patients with cancer who develop COVID-19, at 30 days median follow-up, was 16%. Although the adverse outcomes of patients with cancer who develop COVID-19 has received much attention, few studies have thus far investigated the effects of the potential disruption to cancer care delivery caused by the pandemic.
Our aim in the COVID and Cancer Outcomes Study (CCOS) was therefore to evaluate this disruption to cancer care caused by the pandemic. This is a multicenter prospective cohort study that included patients seen in the outpatient setting at the Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai in New York City and the Dana-Farber Cancer Institute in Boston during one week in March (between March 2 and March 6 2020). Data was collected 3 months before this index week and 3 months prospectively (during the first peak of the pandemic in the Northeastern United States).
MedicalResearch.com: What are the main findings?
Response: Of 2365 patients with cancer that formed the analysis cohort, 51.6% had a decrease in the number of in-person outpatient oncology visits during the pandemic period (the 3 months after the pandemic) compared to the baseline period (the 3 months before the pandemic), whereas 32.2% of patients had an increase in the number of telehealth visits during the pandemic period compared to the baseline period. In addition, 128 patients had developed COVID-19, at 84 days median follow-up.
Compared to White patients, Black and Hispanic patients were less likely to utilize telehealth during the pandemic and were also at a disproportionately higher risk of developing COVID-19. In addition, Hispanic patients were more likely to experience treatment delays in cancer-directed treatment compared to White patients. These findings were based on models that were adjusted for cancer center, cancer status, receipt of systemic therapy, and tumor type.
MedicalResearch.com: What should readers take away from your report?
Response: Overall, significant disruptions to cancer care delivery were observed during the pandemic period compared to the baseline period. While such disruptions were expected, it is concerning that minorities appeared to be disproportionately at risk of disruptions to cancer care delivery and were also at higher risk of developing COVID-19.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Future research should identify and attempt to address the socioeconomic barriers that lead to greater disruption to cancer care delivery and increased risk of COVID-19 infection in patients with cancer who are part of racial and ethnic minority communities.
Any disclosures?
I have received research support from Bristol-Myers Squibb and Genentech/imCORE outside of the current study.
Citation:
Disparities in Cancer during the COVID-19 Pandemic: COVID-19 and Cancer Outcomes Study (CCOS)
Date: Sept. 20, 2020
Speaker: Deborah Doroshow, MD, PhD, Assistant Professor of Medicine (Hematology and Medical Oncology) at The Tisch Cancer Institute at Mount Sinai
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Last Updated on September 21, 2020 by Marie Benz MD FAAD