How did states in the United States adapt their cancer control plan in response to the COVID-19 pandemic?

The COVID-19 pandemic upended the delivery of cancer services across the care continuum. By outlining specific strategies for addressing cancer in the state, cancer control plans serve a critical role during a public health emergency. This policy analysis aims to understand how states updated their cancer control plan as a response to COVID-19. All plans from 50 states and the District of Columbia were reviewed for language related to "COVID." Among the 51 cancer plans analyzed, 7 plans met the inclusion criteria (Illinois [IL], Iowa [IA], Maine [ME], Nevada [NV], North Carolina [NC], Utah [UT], and Vermont [VT]). These seven plans adapted their cancer control plan in response to the COVID-19 pandemic across three main themes: (1) improving care across the cancer care continuum, from prevention to screening and treatment; (2) improving cancer care service delivery by expanding telehealth, addressing workforce shortages, and investing in public health systems; and (3) achieving population health equity by addressing social determinants of health. Two states only adapted their plans by prioritizing future monitoring and evaluation activities as related to the COVID-19 pandemic (ME and VT). The other five states all took different approaches to improve cancer care by adapting their service delivery and addressing social determinants of health. IL prioritized access to cancer screenings through expanding equity informed telehealth models. IA also prioritized equitable screenings as well as clinical trial participation, by addressing workforce shortages. NV focused on prevention, leveraging telehealth and specifically targeted food security and job loss resulting from the pandemic. NC-directed cancer treatment efforts by addressing workforce shortages. UT integrated telehealth and equity initiatives to combat barriers like food insecurity and social disparities. Continued policy surveillance is needed to ensure that patients receive timely, appropriate cancer care during future public health emergencies. Research evaluating whether these plan adaptations improved outcomes or advanced equity remains warranted.