The trajectory of racial/ethnic disparities in the use of cancer screening before and during the COVID-19 pandemic: A large U.S. academic center analysis

Marcondes, Felippe O.; Cheng, David; Warner, Erica T.; Kamran, Sophia C.; Haas, Jennifer S.

doi:10.1016/j.ypmed.2021.106640

Cited by 34 publications

(32 citation statements)

References 27 publications

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“… 14 Another study by Marcondes et al found no significant improvement or worsening of racial and ethnic disparities for any cancer screening after the hiatus was lifted. 15 Our data show similar findings and suggest a trend toward a mitigation of these disparities.…”

Section: Discussionsupporting

confidence: 82%

Impact of the COVID-19 breast cancer screening hiatus on clinical stage and racial disparities in New York City

Fasano¹,

Bayard²,

Tamimi³

et al. 2022

The American Journal of Surgery

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Section: Discussionsupporting

confidence: 82%

Impact of the COVID-19 breast cancer screening hiatus on clinical stage and racial disparities in New York City

Fasano¹,

Bayard²,

Tamimi³

et al. 2022

The American Journal of Surgery

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“…A prioritisation model for CRC screening and colonoscopy follow-up was essential during this time and has also been alluded to by others 18 35 44 50 51. The need for this type of prioritisation protocol is likely to extend to other crises and may also be useful in addressing the lingering backlog in screening and diagnosis resulting from the pandemic 43 52. For example, Kadakuntla et al 35 suggest additional stratification risk factors than what the participants in our study mentioned, including obesity, race/ethnicity, personal medical history, lifestyle and dietary factors.…”

Section: Discussionmentioning

confidence: 58%

Nimble Approach: fast, adapting, calculating and ethically mindful approach to managing colorectal cancer screening programmes during a pandemic

Baxter

Facey

Ruco

et al. 2022

BMJ Open Gastroenterol

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ObjectiveTo describe a conceptual framework that provides understanding of the challenges encountered and the adaptive approaches taken by organised colorectal cancer (CRC) screening programmes during the initial phase of the COVID-19 pandemic.DesignThis was a qualitative case study of international CRC screening programmes. Semi-structured interviews were conducted with programme managers/leaders and programme experts, researchers and clinical leaders of large, population-based screening programmes. Data analysis, using elements of grounded theory, as well as cross-cases analysis was conducted by two experienced qualitative researchers.Results19 participants were interviewed from seven programmes in North America, Europe and Australasia. A conceptual framework (‘Nimble Approach’) was the key outcome of the analysis. Four concepts constitute this approach to managing CRC screening programmes during COVID-19: Fast (meeting the need to make decisions and communicate quickly), Adapting (flexibly and creatively managing testing/colonoscopy capacity, access and backlogs), Calculating (modelling and actively monitoring programmes to inform decision-making and support programme quality) and Ethically Mindful (considering ethical conundrums emerging from programme responses). Highly integrated programmes, those with highly integrated communication networks, and that managed greater portions of the screening process seemed best positioned to respond to the crisis.ConclusionsThe Nimble Approach has potentially broad applications; it can be deployed to effectively respond to programme-specific challenges or manage CRC programmes during future pandemics, other health crises or emergencies.

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“…Longer delays across multiple needed treatments are also associated with greater mortality [ 36 ]. Moreover, as we observed greater delays among individuals with Medicaid insurance, and others have found disparities in COVID-19-related changes in cancer screening among racial/ethnic minorities [ 37 ], the impact could be unevenly distributed and be more severe in vulnerable populations including patients with lower socioeconomic status. COVID-19-related delays could further exacerbate pre-existing racial and socioeconomic disparities in breast cancer early detection, diagnosis, and treatment [ 38 , 39 ].…”

Section: Discussionmentioning

confidence: 61%

Patient-Reported Experiences of Breast Cancer Screening, Diagnosis, and Treatment Delay, and Telemedicine Adoption during COVID-19

Du¹,

Carfang²,

Restrepo

et al. 2022

Current Oncology

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Purpose: To evaluate and quantify potential sociodemographic disparities in breast cancer screening, diagnosis, and treatment due to the COVID-19 pandemic, and the use of telemedicine. Methods: We fielded a 52-item web-based questionnaire from 14 May 2020 to 1 July 2020 in partnership with several U.S.-based breast cancer advocacy groups. Individuals aged 18 or older were eligible for this study if they: (1) received routine breast cancer screening; OR (2) were undergoing diagnostic evaluation for breast cancer; OR (3) had ever been diagnosed with breast cancer. We used descriptive statistics to understand the extent of cancer care delay and telemedicine adoption and used multivariable logistic regression models to estimate the association of sociodemographic factors with odds of COVID-19-related delays in care and telemedicine use. Results: Of 554 eligible survey participants, 493 provided complete data on demographic and socioeconomic factors and were included in the analysis. Approximately half (n = 248, 50.3%) had a personal history of breast cancer. Overall, 188 (38.1%) participants had experienced any COVID-19-related delay in care including screening, diagnosis, or treatment, and 339 (68.8) reported having at least one virtual appointment during the study period. Compared to other insurance types, participants with Medicaid insurance were 2.58 times more likely to report a COVID-19-related delay in care (OR 2.58, 95% Cl: 1.05, 6.32; p = 0.039). Compared to participants with a household income of less than USD 50,000, those with a household income of USD 150,000 or more were 2.38 (OR 2.38, 95% Cl: 1.09, 5.17; p = 0.029) times more likely to adopt virtual appointments. Self-insured participants were 70% less likely to use virtual appointment compared to those in other insurance categories (OR 0.28, 95% Cl: 0.11, 0.73; p = 0.009). Conclusions: The COVID-19 pandemic has had a significant impact on breast cancer screening, diagnosis, and treatment, and accelerated the delivery of virtual care. Lower-income groups and patients with certain insurance categories such as Medicaid or self-insured could be more likely to experience care delay or less likely to use telemedicine. Careful attention must be paid to vulnerable groups to insure equity in breast cancer-related service utilization and telemedicine access during and beyond the COVID-19 pandemic.

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The trajectory of racial/ethnic disparities in the use of cancer screening before and during the COVID-19 pandemic: A large U.S. academic center analysis

Cited by 34 publications

References 27 publications

Impact of the COVID-19 breast cancer screening hiatus on clinical stage and racial disparities in New York City

Impact of the COVID-19 breast cancer screening hiatus on clinical stage and racial disparities in New York City

Nimble Approach: fast, adapting, calculating and ethically mindful approach to managing colorectal cancer screening programmes during a pandemic

Patient-Reported Experiences of Breast Cancer Screening, Diagnosis, and Treatment Delay, and Telemedicine Adoption during COVID-19

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