Disparities in the Care Disruption During COVID-19 and in its Impacts on the Mental and Physical Well-Being of Cancer Survivors.

Abstract

Purpose: Our study explores cancer care disruption among different demographic subgroups. It also investigates these disruptions' impacts on cancer survivors' mental and physical well-being.

Design: Pooled cross-sectional survey data.

Setting: Health Information Trends Survey for Surveillance Epidemiology and End Results, HINTS-SEER.

Participation: n = 1234 cancer survivors participated in the study and completed the survey.

Measures: Outcome variables were treatment disruption in cancer care, mental health and physical health perceptions, age, race, education, income, and sexual orientation.

Analysis: Multiple imputations were used to address missing data. Descriptive statistics were conducted to understand the perceptions of care disruption. Partial least squares structural equation models were employed for data analysis, adjusted for socio-demographics.

Results: COVID-19 impacted cancer treatment and follow-up appointments (69.45%), routine cancer screening (60.70%), and treatment plans (73.58%), especially among elderly patients. It changed the interactions with health care providers (HCP) for 28.03% of the participants. Older adults were 2.33 times more likely to experience treatment appointment disruptions. People who thought their contact with their doctors changed during COVID-19 were more likely to be older adults (65 or more) (OR = 3.85, P = .011), white (OR >1, P = .002), and with higher income (OR = 1.81, P = .002). The changes to cancer treatment and follow-up medical appointments negatively impacted the well-being of the patients (mental: β = -.006, P = .043; physical: β = -.001, P = .006), routine screening and preventative care visits (mental: β = -.029, P = .031; physical: β = -.003, P = .008), and cancer treatment plans (mental: β = -.044, P = .024; physical: β = -.021, P = .040).

Conclusions: Our findings underscore the crucial requirement for implementing focused interventions aimed at alleviating the discrepancies in the accessibility of cancer care across diverse demographic groups, particularly during times of emergency, in order to mitigate any potential disruptions in care.