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Patient-Reported Experiences of Breast Cancer Screening, Diagnosis, and Treatment Delay, and Telemedicine Adoption during COVID-19.
Du, Simo; Carfang, Laura; Restrepo, Emily; Benjamin, Christine; Epstein, Mara M; Fairley, Ricki; Roudebush, Laura; Hertz, Crystal; Eshraghi, Leah; Warner, Erica T.
  • Du S; SurvivingBreastCancer.org, Boston, MA 02119, USA.
  • Carfang L; SurvivingBreastCancer.org, Boston, MA 02119, USA.
  • Restrepo E; Mongan Institute, Clinical Translational Epidemiology Unit, Massachusetts General Hospital, Boston, MA 02114, USA.
  • Benjamin C; SHARE Cancer Support, New York, NY 10036, USA.
  • Epstein MM; Meyers Health Care Institute, a Joint Endeavor of the University of Massachusetts Medical School, Fallon Health, and Reliant Medical Group, Worcester, MA 01605, USA.
  • Fairley R; Division of Geriatric Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA 01655, USA.
  • Roudebush L; TOUCH, The Black Brest Cancer Alliance, Annapolis, MD 21403, USA.
  • Hertz C; Dr. Susan Love Foundation for Breast Cancer Research, West Hollywood, CA 90069, USA.
  • Eshraghi L; Dr. Susan Love Foundation for Breast Cancer Research, West Hollywood, CA 90069, USA.
  • Warner ET; Dr. Susan Love Foundation for Breast Cancer Research, West Hollywood, CA 90069, USA.
Curr Oncol ; 29(8): 5919-5932, 2022 08 20.
Article in English | MEDLINE | ID: covidwho-1997533
ABSTRACT

PURPOSE:

To evaluate and quantify potential sociodemographic disparities in breast cancer screening, diagnosis, and treatment due to the COVID-19 pandemic, and the use of telemedicine.

METHODS:

We fielded a 52-item web-based questionnaire from 14 May 2020 to 1 July 2020 in partnership with several U.S.-based breast cancer advocacy groups. Individuals aged 18 or older were eligible for this study if they (1) received routine breast cancer screening; OR (2) were undergoing diagnostic evaluation for breast cancer; OR (3) had ever been diagnosed with breast cancer. We used descriptive statistics to understand the extent of cancer care delay and telemedicine adoption and used multivariable logistic regression models to estimate the association of sociodemographic factors with odds of COVID-19-related delays in care and telemedicine use.

RESULTS:

Of 554 eligible survey participants, 493 provided complete data on demographic and socioeconomic factors and were included in the analysis. Approximately half (n = 248, 50.3%) had a personal history of breast cancer. Overall, 188 (38.1%) participants had experienced any COVID-19-related delay in care including screening, diagnosis, or treatment, and 339 (68.8) reported having at least one virtual appointment during the study period. Compared to other insurance types, participants with Medicaid insurance were 2.58 times more likely to report a COVID-19-related delay in care (OR 2.58, 95% Cl 1.05, 6.32; p = 0.039). Compared to participants with a household income of less than USD 50,000, those with a household income of USD 150,000 or more were 2.38 (OR 2.38, 95% Cl 1.09, 5.17; p = 0.029) times more likely to adopt virtual appointments. Self-insured participants were 70% less likely to use virtual appointment compared to those in other insurance categories (OR 0.28, 95% Cl 0.11, 0.73; p = 0.009).

CONCLUSIONS:

The COVID-19 pandemic has had a significant impact on breast cancer screening, diagnosis, and treatment, and accelerated the delivery of virtual care. Lower-income groups and patients with certain insurance categories such as Medicaid or self-insured could be more likely to experience care delay or less likely to use telemedicine. Careful attention must be paid to vulnerable groups to insure equity in breast cancer-related service utilization and telemedicine access during and beyond the COVID-19 pandemic.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Breast Neoplasms / Telemedicine / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study / Qualitative research / Randomized controlled trials Limits: Female / Humans Country/Region as subject: North America Language: English Journal: Curr Oncol Year: 2022 Document Type: Article Affiliation country: Curroncol29080467

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Breast Neoplasms / Telemedicine / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study / Qualitative research / Randomized controlled trials Limits: Female / Humans Country/Region as subject: North America Language: English Journal: Curr Oncol Year: 2022 Document Type: Article Affiliation country: Curroncol29080467