Abstract S11-02: Patient-reported impact of the COVID-19 pandemic on breast cancer screening, diagnosis, and treatment: A national survey

Abstract

Introduction: The COVID-19 pandemic has altered the health care delivery system. The purpose of this study was to determine the impact of the COVID-19 pandemic on breast cancer screening, diagnosis, and treatment. Methods: Potential survey respondents were identified through partnerships with breast cancer organizations including Dr. Susan Love Foundation for Breast Cancer Research, SHARE, Survivingbreastcancer.org, Sisters Network Inc., the African American Breast Cancer Alliance, and through ResearchMatch.org. Study information was shared via social media, websites, or email. Individuals were eligible for this study if they: 1) receive routine breast cancer screening, or 2) are undergoing diagnostic evaluation for breast cancer, or 3) had ever been diagnosed with breast cancer. Participants accessed and completed the 10-15-minute REDCap survey either by emailing the research team and receiving a private survey link or by clicking a public link. The survey collected information on respondent demographics; breast cancer screening and diagnosis; the extent to which screening, diagnosis, or treatment had been changed, delayed, or canceled because of COVID-19; personal protective practices; extent of worry about financial and health implications of COVID-19; and use of telemedicine. We used descriptive statistical analyses to better understand the impact of the COVID-19 pandemic on respondents. Results: There are currently 415 survey respondents, 404 of whom agreed to participate in the study. 46.8% (N=189) of respondents were white, 26.7% (N=108) Black, 6.7% (N=27) Asian, and 5.5% Hispanic or Latino (N=22). Most respondents were between the ages of 50 and 69 years (52.2%, N=211). 43.3% (N=175) of respondents had been diagnosed with breast cancer and, of those, 36% (N=63) were in active treatment. More than a quarter of participants (26.5%, N=107) reported delayed or canceled breast cancer care due to COVID-19; the most frequently affected care was screening mammogram, ultrasound, or MRI (97.2%, N=104). 20.6% (N=13) of women in active treatment reported delayed or canceled surgery, chemotherapy, or radiation visits. 22.3% (N=90) of respondents reported that an in-person visit was changed to a phone call or videoconference, and 39.1% (N=158) said they had discussed COVID-19 with a health care provider. 29.1% (N=51) of those with breast cancer were worried or very worried that the COVID-19 pandemic would make it harder for them to get cancer care; among those without breast cancer, 34.9% (N=80) were worried that COVID-19 would make it harder to obtain health care, including breast cancer screening and diagnosis. Conclusions: The COVID-19 pandemic continues to disrupt breast cancer-related care, primarily screening. Planning and coordination are necessary to ensure the timely return of these patients to care. Most participants agreed to be contacted for follow-up, allowing us to investigate the long-term effects of delayed breast cancer screening, diagnostic evaluation, and treatment on health outcomes. Citation Format: Erica T. Warner, Emily Restrepo, Christine Benjamin, Ricki Fairley, Laura Roudebush, Leah Eshraghi, Crystal Hertz, Simo Du, Laura Carfang. Patient-reported impact of the COVID-19 pandemic on breast cancer screening, diagnosis, and treatment: A national survey [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr S11-02.

Temporal Trends in Inpatient Oncology Census Before and During the COVID-19 Pandemic and Rates of Nosocomial COVID-19 Among Patients with Cancer at a Large Academic Center

“…A Turkish study found a significant drop in the number of new cancer diagnosis, use of interventional procedures, and receipt of palliative care services [13]. Several other studies have found a precipitous decline in screening for breast, prostate, and colorectal cancer during the peak of COVID-19 [14,15].…”

The Utilization and Benefits of Telehealth Services by Health Care Professionals Managing Breast Cancer Patients during the COVID-19 Pandemic

“…Globally, the COVID-19 pandemic has negatively impacted health care systems and the diagnosis and treatment of BCa patients [119]. A survey of 404 respondents (43.5% BCa patients) showed delays or cancelled diagnostic and screening tests such as mammogram, MRI and ultrasound as well as surgery, radiation and chemotherapy visits [120]. Therefore, there is a need for subsequent restructuring of clinical activities including fundamental changes in patient management and greater application of health technology [121].…”

Impact of COVID-19 on Cancer Care: How the Pandemic Is Delaying Cancer Diagnosis and Treatment for American Seniors

“…15 Patients with cancer have reported delays in receiving cancer care, including follow-up clinic appointments and cancer therapies, such as radiation, infusion therapies, and surgical tumor removal. 16,17 Although the stay-at-home orders were lifted across the country in May and June, the utilization of certain oncology services continues to lag behind 2019 levels, and the lasting impact on disease progression, cancer morbidity, and mortality remains unclear. The United Kingdom recently projected that delays in diagnosis and treatment may increase mortality from breast, colorectal, and lung cancers by as much as 9.6%, 16.6%, and 5.3%, respectively, after 5 years.…”

“… 15 Patients with cancer have reported delays in receiving cancer care, including follow-up clinic appointments and cancer therapies, such as radiation, infusion therapies, and surgical tumor removal. 16 , 17 …”