COVID-19 Pandemic Led to Breast Cancer Treatment Delays for Nearly Half of Patients, According to Survey

Almost half of breast cancer patients experienced delays in cancer care and treatment as a result of the COVID-19 pandemic, according to a survey.

“The motivation for the study came from widespread reports of cancer care being delayed or procedures being canceled in the beginning of the pandemic, and we wanted to get a better handle on what was happening,” said study author Elizabeth Papautsky, assistant professor of biomedical and health information sciences at the University of Illinois at Chicago College of Applied Health Sciences, in a press release.

A total of 609 breast cancer survivors completed a 50-item survey; one patient was male. The average age of respondents 47.76 years, and the average age at diagnosis was 43 years. Nearly half of patients (46%) were within five years of their most recent diagnosis. The cohort was 78% white, 17% black, and 3% Asian; 95% of respondents were non-Hispanic. Close to two-thirds of patients (63%) are currently receiving cancer treatment, and a similar proportion (67%) have employer-sponsored health insurance. Most cancer care was provided at academic medical centers (45%).

When asked, “Has any aspect of your cancer care been delayed or interrupted due to the COVID-19 pandemic?,” 44% of patients responded, “Yes.” Race, insurance, site of care, and cancer stage were not significantly correlated with delays in treatment and care. Delayed care was slightly more prevalent among white (46%) and Asian (50%) patients than black patients (36%). Medicare and Medicaid insurance patients had a slightly lower rate of delayed care (36%) than patients with employer-sponsored health (46%) or private (47%) insurance. There were no significant differences in delays among patients with stage 0 (44%), 1 (46%), 2 (46%), 3 (44%), and 4 (42%) cancer. Only age was significantly correlated with delayed care; younger patients were more likely than older patients to experience delays.

“We were surprised to see that younger women were more likely to experience delays, and we think that has to do with cancellations of hormone therapy for ovarian suppression that is given to women with certain types of breast cancer, and those women tend to be younger in general,” said Dr. Papautsky.

In their conclusion the study authors wrote, “As strategies emerge to address the backlog of patients whose care has been delayed, it is critical to recognize the differential impact of delays across the healthcare system, evidenced in part in the documented disparities in both breast cancer and COVID-19 mortality. The factors underlying these disparities must be recognized and addressed in the development of systems and processes to deliver high quality cancer care to those whose care has been delayed to reduce the risk of exacerbating existing health inequities and ensure access to high quality cancer care for all breast cancer survivors.”

The study was published in Breast Cancer Research and Treatment.