ASPO Abstracts
Sociodemographic characteristics associated with COVID-19 related delays in cancer screenings and decreased trust in the healthcare system among an urban cancer center"s catchment area population
Category: Cancer Health Disparities
Conference Year: 2022
Abstract Body:
Purpose: COVID-19 caused disruptions to cancer screening and contributed to declining trust in the healthcare system. These factors will disproportionately impact those already experiencing health inequities and may lead to adverse cancer outcomes. We examined associations between sociodemographics and COVID-19 related cancer screening delays and decreased trust in the healthcare system. Methods: A community health needs assessment (CHNA) was conducted in English and Spanish in an urban cancer center's catchment area during 12 community events between July-Sept. 2021. Eligibility criteria included >18 years of age and ability to verbally consent. The CHNA had 28 items about sociodemographics, the pandemic, cancer screening, and trust in the healthcare system. We examined associations between sociodemographics and COVID-19 related delays in cancer screenings and decreased trust in the healthcare system. Results: Most of the 385 respondents were female (78%), Hispanic (62%) or non-Hispanic Black (29%), and had a mean age of 48 years. 22% of respondents were uninsured, 28% had public, and 50% reported private or another insurance source, and 21% reported no primary care provider (PCP). Related to COVID-19, 25% of respondents reported delaying screenings and 25% reported a decreased trust in the healthcare system. In bivariate analyses, Hispanics, when compared to non-Hispanic Blacks, were more likely to report a delay (30% v 11%, p=.0003) and decreased trust (29% v 16%, p=.047). Those with no insurance, compared to private, were more likely to report a delay (34% v 20%, p=.032) and decreased trust (33% v 16%, p=.011). Finally, those without a PCP, compared to those with, were more likely to report a delay (37% v 21%, p=.008) and decreased trust (37% v 22%, p=.016). Conclusion: These findings highlight specific populations (Hispanic, uninsured, and without a PCP) within an urban cancer center's catchment area who may be especially reluctant to re-enter the healthcare space to engage in cancer screenings. Intentional outreach efforts to re-engage these populations, who already experience a disproportionate burden of cancer disparities, will be necessary to address the impact of COVID-19 on cancer outcomes.
Keywords: COVID-19, cancer screening, disparities, community health needs assessment