Lessons From COVID-19: Addressing Health Equity in Cancer Care

Siker, Malika L.; Deville, Curtiland; Suneja, Gita; Winkfield, Karen M.

doi:10.1016/j.ijrobp.2020.06.042

Cited by 9 publications

(7 citation statements)

References 16 publications

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“…Despite growing evidence that supports adverse consequences of COVID-19 on clinical and psychosocial outcomes of cancer patients, a limited number of studies have investigated cancer care disruption and patient-reported outcomes among racial and ethnic minoritized women diagnosed with breast cancer. Given the disproportionate burden of the disease, assessing the impact of the pandemic and associated SDoH among a tri-racial and ethnic sample is critical to inform best-practices for future models of care delivery and to improve care transitions [ 169 , 170 , 171 , 172 ]. Specifically, these data will provide the necessary evidence to inform whether a subsequent, multilevel intervention addressing these factors is warranted to improve quality of care delivery during and after the COVID-19 pandemic.…”

Section: Discussionmentioning

confidence: 99%

The Impact of the COVID-19 Pandemic on Cancer Care and Health-Related Quality of Life of Non-Hispanic Black/African American, Hispanic/Latina and Non-Hispanic White Women Diagnosed with Breast Cancer in the U.S.: A Mixed-Methods Study Protocol

Acquati

Chen

Leal

et al. 2021

IJERPH

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The COVID-19 pandemic has had critical consequences for cancer care delivery, including altered treatment protocols and delayed services that may affect patients’ quality of life and long-term survival. Breast cancer patients from minoritized racial and ethnic groups already experience worse outcomes, which may have been exacerbated by treatment delays and social determinants of health (SDoH). This protocol details a mixed-methods study aimed at comparing cancer care disruption among a diverse sample of women (non-Hispanic White, non-Hispanic Black/African American, and Hispanic/Latina) and assessing how proximal, intermediate, and distal SDoH differentially contribute to care continuity and health-related quality of life. An embedded mixed-methods design will be implemented. Eligible participants will complete an online survey, followed by a semi-structured interview (with a subset of participants) to further understand factors that influence continuity of care, treatment decision-making, and self-reported engagement. The study will identify potentially modifiable factors to inform future models of care delivery and improve care transitions. These data will provide the necessary evidence to inform whether a subsequent, multilevel intervention is warranted to improve quality of care delivery in the COVID-19 aftermath. Additionally, results can be used to identify ways to leverage existing social resources to help manage and support patients’ outcomes.

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Section: Discussionmentioning

confidence: 99%

The Impact of the COVID-19 Pandemic on Cancer Care and Health-Related Quality of Life of Non-Hispanic Black/African American, Hispanic/Latina and Non-Hispanic White Women Diagnosed with Breast Cancer in the U.S.: A Mixed-Methods Study Protocol

Acquati

Chen

Leal

et al. 2021

IJERPH

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“…The burden of these additional deaths is likely to be unevenly and unfairly distributed: for example, Indigenous and other minority and/or marginalised populations are likely to bear a disproportionate impact in comparison with those already privileged by economic, social and health system structures. [13] Measuring and monitoring these inequities allows restorative and preventative actions to be established.…”

Section: Introductionmentioning

confidence: 99%

The impact of the COVID-19 pandemic on cancer diagnosis and service access in New Zealand–a country pursuing COVID-19 elimination

Gurney

Millar

Dunn

et al. 2021

The Lancet Regional Health - Western Pacific

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Background:The COVID-19 pandemic has disrupted cancer services globally. New Zealand has pursued an elimination strategy to COVID-19, reducing (but not eliminating) this disruption. Early in the pandemic, our national Cancer Control Agency ( Te Aho o Te Kahu ) began monitoring and reporting on service access to inform national and regional decision-making. In this manuscript we use high-quality, nationallevel data to describe changes in cancer registrations, diagnosis and treatment over the course of New Zealand's response to COVID-19. Methods: Data were sourced (2018-2020) from national collections, including cancer registrations, inpatient hospitalisations and outpatient events. Cancer registrations, diagnostic testing (gastrointestinal endoscopy), surgery (colorectal, lung and prostate surgeries), medical oncology access (first specialist appointments [FSAs] and intravenous chemotherapy attendances) and radiation oncology access (FSAs and megavoltage attendances) were extracted. Descriptive analyses of count data were performed, stratified by ethnicity (Indigenous M āori, Pacific Island, non-M āori/non-Pacific). Findings: Compared to 2018-2019, there was a 40% decline in cancer registrations during New Zealand's national shutdown in March-April 2020, increasing back to pre-shutdown levels over subsequent months. While there was a sharp decline in endoscopies, pre-shutdown volumes were achieved again by August. The impact on cancer surgery and medical oncology has been minimal, but there has been an 8% year-todate decrease in radiation therapy attendances. With the exception of lung cancer, there is no evidence that existing inequities in service access between ethnic groups have been exacerbated by COVID-19. Interpretation: The impact of COVID-19 on cancer care in New Zealand has been largely mitigated. The New Zealand experience may provide other agencies or organisations with a sense of the impact of the COVID-19 pandemic on cancer services within a country that has actively pursued elimination of COVID-19. Funding: Data were provided by New Zealand's Ministry of Health, and analyses completed by Te Aho o Te Kahu staff.

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“…On March 11 2020, the World Health Organization (WHO) declared the COVID-19 a global pandemic 2 . During the COVID-19 pandemic, delivery of cancer treatment 3,4 , cancer care 5,6 , and cancer screening 7,8 has become challenging. Many cancer patients suffer from interruption or delay of cancer treatment due to the pandemic crisis, and while this may reduce the risk of COVID-19 infection and death, it may also increase cancer-speci c mortality 9 .…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Anxiety and Depression Among Cancer Patients During the COVID-19 Pandemic: a Systematic Review and Meta-analysis

Zhou

et al. 2020

Preprint

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Background: The COVID-19 pandemic has significantly affected patients’ access to healthcare. Patients with malignant tumors have experienced treatment interruptions and difficulties in seeking medical attention, and these have affected their mental health. The objective of this review is to evaluate the current evidence on the prevalence of depression and anxiety in cancer patients during the COVID-19 pandemic.Methods: We searched the EMBASE, PubMed, WHO COVID-19 database, Cochrane Library, Web of Science, CBM, CNKI, Wanfangdata, CQVIP, and CBM electronic databases for relevant studies published from the first available day to June 30, 2020. Two researchers independently screened the literature based on predetermined criteria and assessed the risk of bias in each study. Random-effects meta-analyses was used to estimate the pooled prevalence of anxiety and depression among patients with malignant tumors. The review protocol has been registered in PROSPERO (CRD42020196421).Results: Nine eligible studies on 2,335 patients with malignant tumors were included, all of which were cross-sectional studies. The pooled prevalence of anxiety was 52.94% (95% CI: 36.98%-68.91%, I2=98.6%) in 9 studies, and the pooled prevalence of depression was 43.25% (95% CI: 25.85%-60.85%, I2=98.8%) in 6 studies.Conclusions: Evidence shows that a considerable proportion of patients with malignant tumors suffered from emotional distress during the COVID-19 pandemic. It is important to solve the problem of interruption or delay of treatment and strengthen psychological interventions for patients with malignant tumors during the pandemic.

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Lessons From COVID-19: Addressing Health Equity in Cancer Care

Cited by 9 publications

References 16 publications

The Impact of the COVID-19 Pandemic on Cancer Care and Health-Related Quality of Life of Non-Hispanic Black/African American, Hispanic/Latina and Non-Hispanic White Women Diagnosed with Breast Cancer in the U.S.: A Mixed-Methods Study Protocol

The Impact of the COVID-19 Pandemic on Cancer Care and Health-Related Quality of Life of Non-Hispanic Black/African American, Hispanic/Latina and Non-Hispanic White Women Diagnosed with Breast Cancer in the U.S.: A Mixed-Methods Study Protocol

The impact of the COVID-19 pandemic on cancer diagnosis and service access in New Zealand–a country pursuing COVID-19 elimination

Prevalence of Anxiety and Depression Among Cancer Patients During the COVID-19 Pandemic: a Systematic Review and Meta-analysis

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