Association of Cancer History with COVID-19 Risk and Outcomes Among Older Postmenopausal Women: Results from the Women's Health Initiative.

Abstract

Background: Several studies early in the COVID-19 pandemic suggested those with a cancer history had higher risk of COVID-19 infections and complications. However, few prospective studies evaluated the association of cancer with COVID-19 in older women. We aimed to examine the association of cancer history with risk of COVID-19 and various COVID-19 outcomes among older women.

Methods: The Women's Health Initiative (WHI) is an ongoing cohort study that recruited 161,808 postmenopausal women aged 50-79 from 1993-1998. Those who completed the COVID-19 survey (2021-2022) were included (n=35,623). Multivariable linear and logistic regression were used to examine COVID-19 positivity, symptoms severity, long COVID, and COVID concerns/anxiety outcomes.

Results: 28% (n=9,901) of participants had a history of cancer. Cancer history was not significantly associated with COVID-19 positivity (OR: 0.94, 95% CI: 0.81-1.08), COVID-19 hospitalization (OR: 1.21, 95% CI: 0.85-1.72), number of symptoms (LS Mean: 0.33, 95% CI: -0.20, 0.85), and long COVID (OR: 1.18, 95% CI: 0.88-1.58).

Conclusions: History of cancer was not associated with most COVID-19 outcomes. Future studies should continue to examine physiological mechanisms contributing to differences within cancer survivors and prioritize the inclusion of underserved populations to identify strategies to address the impact of COVID-19.

Impact: These findings may assure cancer survivors their diagnosis alone does not increase their risk of COVID-19 and suggests older women with a history of cancer may have similar risk of COVID-19 outcomes compared to their non-cancer counterparts.