Racial and ethnic minority groups more likely to delay cancer treatment after COVID-19 infection

A recent study found that non-Hispanic black and Hispanic patients were more likely than non-Hispanic white patients to delay or discontinue cancer treatment and pharmacology after COVID-19 infection.

The COVID-19 pandemic has led to greater urbanization, living in low-income multifamily housing, the overrepresentation of racial and ethnic minority groups in essential jobs, their increased use, and public It highlights inequalities among many cancer patients that increase the risk of infection, including risks related to hygiene. Transportation, and the increased likelihood of living in multigenerational housing, are putting older people at risk.

Community-level social determinants of health (SDOH), such as geography, proportion of residents without health insurance, low levels of education, and low median household income, all contribute to discrimination and access to health care. can lead to a lack of The study found that these determinants also corresponded to treatment delays of at least 14 days.

“Treatment patterns during the COVID-19 pandemic support high rates of initiation, discontinuation, and non-adherence to adjuvant endocrine therapy in cancer patients from racial and ethnic minority groups,” study authors said. teeth, JAMA network opened.

Historically, black and Hispanic populations have had worse cancer outcomes, and these communities have also been disproportionately affected by the pandemic. Cancer treatment delays are associated with high cancer-related morbidity and mortality, and experts say survival inequalities could be impacted for years due to COVID-19. pointed out that there is

Researchers found that racial and ethnic minority groups in low-income areas experienced delayed or discontinued treatment after COVID-19 infection compared with white patients in areas of high socioeconomic status (SES). I hypothesized that it is likely that They conducted a study evaluating patient-level factors, area-level SDOH, and treatment delay or discontinuation after SARS-CoV-2 infection.

The team identified 4,768 racially diverse patients aged 70 years and older to participate in a retrospective registry-based cohort study. The study population included 630 Hispanic patients, 196 non-Hispanic Asian American or Pacific Islander patients, 568 non-Hispanic black patients, and 3173 non-Hispanic white patients. and was registered with the American Society of Clinical Oncology (ASCO) COVID-19 registry.

Black patients appeared to be most affected, being 37% more likely to delay or discontinue treatment and pharmacology. The findings also show that Hispanic patients are 17% more likely to delay or discontinue than non-Hispanic whites.

Results further suggest that geographic and regional levels of SDOH are associated with treatment delay or discontinuation.

This is “consistent with the understanding that residents of socio-economically disadvantaged areas are more likely to experience various forms of health inequalities, independent of the individual-level factors associated with those outcomes.” ,” the authors of the study said in their paper.

This study includes limitations. First, exclude deceased patients. The registry-based style fails to account for patients who have not undergone laboratory testing for COVID-19 and may also contribute to selection bias. Moreover, passive data collection may increase the likelihood of confounding variables, especially as they relate to her SDOH at the regional level.

“These data will contribute to the development and implementation of multi-level interventions targeting micro- and macro-level determinants of delayed oncology among vulnerable patient populations during public health emergencies. We hope to reduce the chances,” the study’s authors said in the article.

reference

Llanos A, Ashrafi A, Ghosh N, et al. Assessment of inequity in delaying or stopping cancer treatment after SARS-CoV-2 infection. Accessed 16 January 2023. JAMA net opened. 2023;6(1):e2251165.doi:10.1001/jamanetworkopen.2022.51165