ABSTRACT
During the first year of the coronavirus disease 2019 (COVID-19) pandemic, prevention measures included quarantining and facility closures. Because cancer screening is dependent on interventions in facilities, the extent of the COVID-19 impact on screening was questioned. A claims registry from a large health system was queried for colorectal and prostate cancer screening. A screening gap and screening loss ratio were calculated by comparing 2020 screening to historical reference years. All cancer screenings decreased in the first four months of the pandemic. Colorectal cancer screening returned to baseline in the latter six months of 2020. Prostate cancer screening exceeded baseline in the latter six months, but with a lesser gain than previous years. Populations disproportionately affected by decreased cancer screening included men and black people. To catch-up after the initial deficit in screening, it is estimated that the rate of colorectal cancer screening needs to increase by 50%.
ABSTRACT
(1) Background: Vaccine hesitancy and rejection are major threats to controlling coronavirus disease 2019 (COVID-19). There is a paucity of information about the attitudes of cancer patients towards vaccinations and the role of clinical oncologists in influencing vaccination acceptance. (2) Methods: Cancer patients and caregivers were invited to participate in a webinar and two surveys (pre- and post-webinar) assessing intention and thought processes associated with receiving COVID-19 vaccines. (3) Results: Two hundred and sixty-four participants participated in the webinar and registered to take at least one survey. Participants reported receiving most of their COVID-19 vaccine information from their doctor, clinic, or hospital. Before the webinar, 71% of participants reported the intention to receive a COVID-19 vaccine, 24% were unsure, and 5% had no intention of receiving a vaccine. The strongest predictors of vaccine enthusiasm were (a) planning to encourage the vaccination of family, friends, co-workers, and community, and (b) physician recommendation. The chief reason for vaccine hesitancy was a fear of side effects. After the webinar, 82.5% reported the intention to receive a vaccine, 15.4% were still unsure, and 2% stated that they had no intention of receiving a vaccine. The webinar shifted the attitude towards vaccine enthusiasm, despite an already vaccine-enthusiastic population. Communicating about vaccines using positive framing is associated with greater vaccine enthusiasm. (4) Conclusions: Patient education programs co-hosted by multiple stakeholders and delivered by oncologists can increase cancer patient enthusiasm for COVID-19 vaccination.
ABSTRACT
Since the Coronavirus Disease 2019 (COVID-19) was identified as a global pandemic, health systems have been severely strained, particularly affecting vulnerable populations such as patients with cancer. In response to the COVID-19 pandemic, a variety of oncology specialty societies are making recommendations for standards of care. These diverse standards and gaps in standards can lead to inconsistent and heterogeneous care among governments, cancer centers, and even among oncologists within the same practice. These challenges highlight the need for a common nomenclature and crisis guidelines. For times of increased scarcity of resources, the National Academy of Medicine developed Crisis Standards of Care, defined as fairness, duty to care, duty to steward resources, transparency, consistency, proportionality, and accountability. However, we believe there is an urgent need to develop cancer-specific guidelines by convening a panel of experts from multiple specialties. These would be Crisis Oncology Standards of Care (COSCs) that are sensitive to both the individual cancer patient and to the broader health system in times of scarce resources, such as pandemic, natural disaster, or supply chain disruptions.