Breast Cancer Survivors Experience Significant Delays in Care Due to COVID-19

A survey of breast cancer survivors in the US revealed the coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on breast cancer care and created a gap in disaster preparedness that leaves cancer survivors at risk for poor outcomes.¹

More specifically, the survey results, published in Breast Cancer Research and Treatment, indicated that nearly half of the survey respondents experienced delays in care during the early weeks of the COVID-19 pandemic.

“We expected the usual racial difference we see in health care, with Black patients being disproportionately affected, but our results showed that patients were universally affected by COVID in terms of delays in breast cancer care, likely because in those early weeks, hospitals and health care facilities were postponing visits and procedures across the board as they took on the growing burden of dealing with COVID-19,” co-author Tamara Hamlish, PhD, a research scientist in the cancer survivorship program at the University of Illinois Cancer Center, said in a press release.²

In total, the survey was administered to 609 adult breast cancer survivors in the US. Snowball sampling was utilized to distribute the survey, with invitations distributed via social media. Of note, 63% of respondents were currently receiving care at the time of survey distribution.

Overall, 44% of respondents reported treatment delays in their cancer care during the pandemic. Moreover, delays in all aspects of cancer care and treatment were reported.

The highest rate of delays was reported for routine or follow-up clinic appointments (79%), followed by surgical breast reconstruction (66%), diagnostic imaging (60%), and lab testing (50%). The lowest rate of delays was seen in genetic counseling and testing (11%) and oral therapies (13%). Further, approximately 30% of respondents reported delays in hospital or clinic-based cancer therapies, including radiation (30%), infusion therapies (32%), and surgical tumor removal (26%)

Notably, the only variable which had a significant effect on delays was age (97 years; P < .001), with younger respondents (M = 45.94, SD = 10.31) reporting a higher incidence of delays than older respondents (M = 48.98, SD = 11.10). There was no significant effect observed for race, insurance, site of care, or cancer stage.

“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,” co-author Elizabeth Lerner Papautsky, PhD, assistant professor of biomedical and health information sciences at the University of Illinois Chicago College of Applied Health Sciences, said in the release.

Importantly, in a section of the questionnaire reserved for general comments, many respondents indicated that their treatment may have been modified instead of totally canceled. One example noted by the researchers was that hormone therapies may have been spaced out more to reduce the number of clinic visits.

“Overall, we see that there is a serious gap in disaster preparedness when it comes to providing critical, and often time-sensitive care for breast cancer patients,” Hamlish concluded.

References:

1. Papautsky EL, Hamlish T. Patient‑reported treatment delays in breast cancer care during the COVID‑19 pandemic. Breast Cancer Research and Treatment. doi: 10.1007/s10549-020-05828-7

2. Half of breast cancer survivors had delays in care due to COVID-19 [news release]. University of Illinois at Chicago. Published August 18, 2020. Accessed August 19, 2020. https://www.newswise.com/coronavirus/half-of-breast-cancer-survivors-had-delays-in-care-due-to-covid-19/?article_id=736547&sc=dwhr&xy=10019792