The results of an online questionnaire of 609 breast cancer survivors in the Unites States suggest that almost 50% experienced delays in care during the early weeks of the COVID-19 pandemic. The research was published online on August 9, 2020, in the journal Breast Cancer Research and Treatment (Papautsky EL, et al. Breast Cancer Res Treat. 2020 Aug 9. Epub ahead of print).
Researchers at the University of Illinois, Chicago, developed a 50-item online survey to determine how the COVID-19 pandemic had affected breast cancer care. The questionnaire sought to identify what types of care were delayed: chemotherapy, radiation, cancer surgery, hormonal therapy, or routine follow-up appointments. The questionnaire also included questions regarding race, age, and stage of cancer. The investigators distributed the questionnaire to US breast cancer survivor groups on social media and via email. Between April 2 and April 27, 2020, 609 individuals responded to the survey.
Of those who responded, 608 were women, the average age was approximately 48 years, the average age at breast cancer diagnosis was 43 years, and 46% of respondents were within 5 years of their most recent diagnosis. Respondents were racially diverse; 78% were white, 17% were black, and 3% were Asian. Most were non-Hispanic (95%). The top 3 states of residence were Illinois (15%), California (9%), and Texas (8%). More than 50% of respondents said they were currently receiving cancer treatment (63%) and had employer‐sponsored health insurance (67%). The locations of cancer care included academic medical centers (45%), physician’s offices (26%), and community hospitals (21%).
Overall, 44% of the respondents reported a delay in care. The most frequently reported delay was for routine follow-up visits (79%). Other delays involved breast reconstruction surgery (66%), diagnostic imaging (60%) and laboratory testing (50%). Approximately 30% reported delays in hospital- or clinic-based cancer therapies, including radiation (30%), infusion therapies (32%), and surgical tumor removal (26%).
The questionnaire also had a section for general comments, and several respondents noted that their treatment may have been modified instead of totally canceled. For example, hormone treatments were spaced out more to reduce the number of clinic visits.
“Our study results point to the pervasive impact of COVID-19 on cancer care, and a critical gap in disaster preparedness that leaves vulnerable cancer survivors at even greater risk for poor cancer outcomes, including not only clinical outcomes, but factors such as mental health, pain, and quality of life,” noted the investigators. “As strategies emerge to address the backlog of patients whose care has been delayed, it is critical to recognize the differential impact of delays across the healthcare system, evidenced in part in the documented disparities in both breast cancer and COVID-19 mortality,” they added.