ABSTRACT
Background@#The COVID-19 pandemic has caused a global public health emergency. High levels of fear and limited access to cancer treatment may jeopardize the delivery of optimal oncologic care, potentially influencing treatment outcomes. This study aimed to identify patients’ and their caregivers’ perception of safety and accessibility of cancer care during the COVID-19 pandemic. @*Methods@#A cross-sectional survey of patients and caregivers at the Benavides Cancer Institute, University of Santo Tomas Hospital was performed from August to October 2020 using a 20-item investigator-developed questionnaire. @*Results@#A total of 207 participants answered the survey. Frequency of hospital visits varied from none to more than ten times in the previous month; but having multiple postponements were uncommon. Eighty-two percent, 77%, 62%, and 55% of participants reported being afraid of contracting COVID-19 from other patients, hospital surroundings, hospital staff, and doctors, respectively. Twenty-six percent and 12% had difficulty finding transportation and passing through checkpoints, respectively. Twenty-eight percent strongly expressed financial limitations in prioritizing cancer care. Participants were amenable to the use of telemedicine and stringent protocols to reduce in-hospital transmission risk, but had some reluctance to spend out of their pockets for screening tests. @*Conclusion@#The perceived safety of cancer care was influenced by fears of contracting COVID-19; and accessibility was influenced by limited transportation and financial constraints. Despite these, multiple postponements and cancelled hospital visits were uncommon. Institutional approaches targeting these concerns will be crucial to ensure safe and timely delivery of cancer care during the COVID-19 pandemic and further mitigate its impact on oncologic outcomes.
Subject(s)
COVID-19 , Pandemics , SafetyABSTRACT
@#<p style="text-align: justify;"><strong>Objectives.</strong> Several studies have demonstrated that genetic variants of certain DNA repair genes such as the RAD51 and XRCC1 increase cancer risk substantially. The results were also observed to be race- and tumor site specific. Hence, this study aimed to determine the possible association of XRCC1 Arg399Gln and RAD51 135G>C polymorphisms combined with risk factors of colorectal cancer (CRC) among selected Filipinos.</p><p style="text-align: justify;"><strong>Methods.</strong> Genomic DNA isolated from peripheral blood samples of histologically confirmed CRC patients (n=70) and their age- and sex-matched clinically healthy controls (n=70) were analyzed for polymorphisms of XRCC1 and RAD51 genes by polymerase chain reaction.</p><p style="text-align: justify;"><strong>Results.</strong> The genotypic distribution pattern of RAD51 135G>C (p?0.05) was not significantly different between the CRC cases and controls. Significantly higher incidence (p=0.016) of the XRCC1 GG genotype was noted among the cases (n=34, 49%) compared with controls (n= 20, 29%). Individuals carrying the XRCC1 AG genotype have a lower risk of developing CRC (OR=0.42, 95% CI=0.21-0.85) than the XRCC1 GG genotype. XRCC1 AG genotype combined with alcohol drinking, smoking, or family history of cancer also showed a lower risk of developing CRC. There was no significant association between the genetic variants of RAD51 135G>C and CRC risk. Carriers of both XRCC1 GG and RAD51 CC genotypes showed a 5x higher risk (OR=5.02; 95%; CI=1.0429-24.1283) compared to those carrying other genotype combinations (p=0.028).</p><p style="text-align: justify;"><strong>Conclusions. </strong>XRCC1 Arg399Gln but not RAD51 135G>C may be associated with CRC development among Filipinos. Individuals who drink alcohol, smoke tobacco and have a family history of cancer have a lower risk of developing CRC when they are also carrying the XRCC1 AG genotype. The findings may have significant impli cations in designing personalized methods for screening, diagnosing, and treating CRC.</p>