New approaches to cancer care in a COVID-19 world

Butler, John; Finley, Christian; Norell, Charles; Harrison, Selena; Bryant, Heather; Achiam, Michael Patrick; Altman, Alon D.; Baxter, Nancy N.; Bentley, J.; Cohen, Paul A.; Chaudry, M. Asif; Dixon, Elijah; Farrell, Rhonda; Fegan, Scott; Hashmi, Satwat; Høgdall, Claus; Jenkins, John T.; Kwon, Janice S.; Mala, Tom; McNally, Orla; Merrett, Neil D.; Nelson, Gregg; Nordin, Andy; Park, Jason; Porter, Geoff; Reynolds, John V.; Schieman, Colin; Schnack, Tine Henrichsen; Spigelman, Allan D.; Svendsen, Lars Bo; Sykes, Peter; Thomas, Robert J. S.

doi:10.1016/s1470-2045(20)30340-5

Cited by 18 publications

(21 citation statements)

References 2 publications

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“…Emerging studies on cancer care delays during the pandemic have focused on the rate and type of delays [1,2], clinical responses and potential consequences [21][22][23], and risk of Covid-19 infection or mortality among cancer survivors [24][25][26][27]. Studies on psychological distress during the pandemic indicate that both women and those with existing health conditions are at greater risk for distress, but have not indicated racial differences or disparities [28,29].…”

Section: Discussionmentioning

confidence: 99%

Differences in Emotional Distress Among Black and White Breast Cancer Survivors During the Covid-19 Pandemic: a National Survey

Hamlish

Papautsky

2021

J. Racial and Ethnic Health Disparities

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The Covid-19 pandemic is straining US healthcare resources, causing significant disruptions in cancer care. Prior to the pandemic, Black cancer survivors experienced a disproportionate burden of delays in cancer treatment compared to White cancer survivors. As a result of the pandemic, disruptions in care are widespread and affect cancer survivors regardless of race. This shift presented an opportunity to investigate differences in how Black and White cancer survivors experience disruptions in cancer care due to the pandemic. We conducted a national survey of adult breast cancer survivors, distributed online from 4/2/20 to 4/27/20. We used t -tests to compare cancer and non-cancer-related worry during the Covid-19 pandemic between Black and White breast cancer survivors. Analysis of data from 570 respondents (106 Black and 464 White) indicated significantly higher levels of distress among White respondents compared to Black respondents. Our results point to the importance of assessing race differences in emotional response to disruptions in cancer care during the pandemic. We suggest that differences in emotional distress may reflect differences in previous experience of treatment delays and coping strategies between Black and White breast cancer survivors.

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Section: Discussionmentioning

confidence: 99%

Differences in Emotional Distress Among Black and White Breast Cancer Survivors During the Covid-19 Pandemic: a National Survey

Hamlish

Papautsky

2021

J. Racial and Ethnic Health Disparities

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“…2 , 8 , 9 The results suggest that there is an urgent need for interventions encouraging people to consult their physicians with symptoms suggestive of cancer and addressing the barriers that have become most pronounced during the pandemic situation, especially among women and older individuals. 9 , 13 …”

Section: Discussionmentioning

confidence: 99%

“…Experts recommended that efforts be made to encourage patients to seek help for potential cancer symptoms during the pandemic by addressing current delays and barriers to help-seeking and identifying groups at high risk of delays. 9 , 13 To better understand the changes that might have occurred after the first wave of the pandemic, the aim of the current study was to compare anticipated help-seeking for cancer symptoms and perceived barriers in the Spanish population before and after the pandemic.…”

Section: Introductionmentioning

confidence: 99%

Anticipated help-seeking for cancer symptoms before and after the coronavirus pandemic: results from the Onco-barometer population survey in Spain

et al. 2021

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Background The patient interval—the time patients wait before consulting their physician after noticing cancer symptoms—contributes to diagnostic delays. We compared anticipated help-seeking times for cancer symptoms and perceived barriers to help-seeking before and after the coronavirus pandemic. Methods Two waves (pre-Coronavirus: February 2020, N = 3269; and post-Coronavirus: August 2020, N = 1500) of the Spanish Onco-barometer population survey were compared. The international ABC instrument was administered. Pre–post comparisons were performed using multiple logistic and Poisson regression models. Results There was a consistent and significant increase in anticipated times to help-seeking for 12 of 13 cancer symptoms, with the largest increases for breast changes (OR = 1.54, 95% CI 1.22–1–96) and unexplained bleeding (OR = 1.50, 1.26–1.79). Respondents were more likely to report barriers to help-seeking in the post wave, most notably worry about what the doctor may find (OR = 1.58, 1.35–1.84) and worry about wasting the doctor’s time (OR = 1.48, 1.25–1.74). Women and older individuals were the most affected. Conclusions Participants reported longer waiting times to help-seeking for cancer symptoms after the pandemic. There is an urgent need for public interventions encouraging people to consult their physicians with symptoms suggestive of cancer and counteracting the main barriers perceived during the pandemic situation.

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“…It is essential for authorities and health care providers to identify patients who should be prioritized for the continuation of fertility care in a safe environment (27). Many guidelines or protocols are available to support prioritization in the field of obstetrics and gynecology (28,29), and they should be considered on the basis of local resources and planning (30). In our study, we did not find significant differences in the treatment of gynecological malignancies according to city categories, hospital levels or hospital natures, which reflected the attention paid to these critical diseases across the country.…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 Pandemic on the Clinical Activities in Obstetrics and Gynecology: A National Survey in China

Li¹,

Cao²,

Fan³

et al. 2021

Front. Med.

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Objective: Few studies have quantified the influence of coronavirus disease 2019 (COVID-19) pandemic on medical providers. This is the first national study to investigate the impact of the pandemic on physicians practicing obstetrics and gynecology in China.Methods: A two-stage, stratified, cluster sampling method was performed based on the city categories (category 1, fewer than 10,000 beds; category 2, 10,000–30,000; and category 3, more than 30,000) and public hospital levels (primary, secondary, and tertiary). Physicians practicing obstetrics and gynecology reported the relevant changes in their general clinical activities and changes in the management of specific diseases or conditions occurring during the periods that they were most strongly affected. These changes were compared by municipal and hospital characteristics.Results: Questionnaires were collected from a representative sample of 11,806 physicians actively practicing obstetrics and gynecology in 779 hospitals from 157 cities of 31 provinces. Except emergency visits and online consultations, category 3 cities, tertiary hospitals and general hospitals had greater reductions in overall clinical activities than category 1 cities, primary hospitals and specialized hospitals (all adjusted p < 0.05), respectively. The differences also existed in the management of specific diseases and conditions, especially for less urgent conditions, including cervical cancer screening, instructions regarding contraception and miscarriage, and assisted reproduction (all p < 0.05).Conclusions: During the COVID-19 pandemic, the clinical obstetrics and gynecology activities in China markedly decreased, with significant differences across municipal and hospital characteristics.Trial Registration: This study was registered with ClinicalTrials.gov on July 27, 2020 (NCT04491201).

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New approaches to cancer care in a COVID-19 world

Cited by 18 publications

References 2 publications

Differences in Emotional Distress Among Black and White Breast Cancer Survivors During the Covid-19 Pandemic: a National Survey

Differences in Emotional Distress Among Black and White Breast Cancer Survivors During the Covid-19 Pandemic: a National Survey

Anticipated help-seeking for cancer symptoms before and after the coronavirus pandemic: results from the Onco-barometer population survey in Spain

Impact of COVID-19 Pandemic on the Clinical Activities in Obstetrics and Gynecology: A National Survey in China

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