ASPO Abstracts
Impact of the COVID-19 Pandemic on the Quality of Breast Cancer Survivorship Care
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2023
Abstract Body:
Background: The COVID-19 pandemic has significantly disrupted many aspects of cancer care. However, the extent to which it has disrupted survivorship care and its impact on disparities in the receipt of guideline-concordant survivorship care is unclear. Methods: The iCanCare study is a population-based, longitudinal study of women diagnosed with breast cancer in 2014-15 identified in the Los Angeles and Georgia SEER registries. Women were surveyed during initial treatment and again approximately 6 years later in survivorship (2021-2022) (Expected final N=1430, 60% current response rate). An impact of the COVID-19 pandemic scale was created by averaging participant responses to 5 questions which asked whether the following were worse or better during the pandemic (5 pt. Likert type scales): Ability to get general preventive care, breast cancer follow-up care, fill/re-fill medications, and communicate with primary care and oncology providers. The scale was then categorized as high (>3) vs. low impact (<=3). Guideline-concordant surveillance mammography and preventive care (flu vaccine, colorectal and cervical cancer screenings) were defined as participant-reported receipt in the last 2 years among those eligible based on guidelines and screening history. The associations between the impact of COVID-19 and race/ethnicity on receipt of guideline-concordant surveillance and preventive care were evaluated using multivariable logistic regression. Results: In this preliminary sample of 1252 women, 40% reported the COVID-19 pandemic had a high impact on their survivorship care. A greater proportion of Latina and Asian women reported a high impact compared to white women (p<0.001). Women who reported a greater impact of COVID-19 were less likely to receive colorectal cancer screening (aOR: 0.7, 95% CI: 0.5-0.9). Latina women were less likely to receive mammography (aOR: 0.2, 0.1-0.6). Black women were less likely to receive flu vaccines and cervical cancer screening (flu vaccine aOR: 0.5, 0.3-0.8; cervical cancer screening aOR: 0.1, 0.03-0.4). Conclusions: Additional strategies to ensure breast cancer survivors receive guideline-concordant survivorship care are likely necessary to mitigate the negative effects of the pandemic, particularly for women of color.
Keywords: breast cancer, survivorship care, disparities, COVID-19 pandemic