Nearly half of breast cancer survivors experienced treatment delays due to COVID-19

CHICAGO — Over the course of this pandemic many have feared that countless Americans aren’t receiving the medical attention they need. Now, an unsettling new study seemingly confirms those concerns, at least regarding breast cancer. Researchers from the University of Illinois Chicago say that nearly half of surveyed U.S. breast cancer survivors had to deal with delays in care during the onset of the pandemic earlier this year.

In all, 609 breast cancer survivors participated in this study.

“The motivation for the study came from widespread reports of cancer care being delayed or procedures being canceled in the beginning of the pandemic, and we wanted to get a better handle on what was happening,” says Elizabeth Papautsky, assistant professor of biomedical and health information sciences at the UIC College of Applied Health Sciences, in a release.

The survey, specially designed to ask about any healthcare delays during the pandemic, was sent out to a number of U.S. breast cancer survivor groups via both social media and email. Then, between April 2nd and 27th, 609 survivors completed and returned the questionnaire.

More specifically, the survey asks which kind of care had been delayed: chemotherapy, surgery, radiation, hormonal treatment, or routine follow-ups. Respondents were also asked about their race, age, and diagnosed cancer stage.

Among the 209 responses, 63% were undergoing cancer treatment at the time they filled out the survey. The average respondent age was 47 years old, and 78% identified themselves as Caucasian, 17% were African American, and 3% were Asian American.

Breast cancer patient ‘universally affected’

In total, 44% of all respondents report dealing with a delay in care or treatment. The most common delay is getting a follow-up appointment (77%). That’s followed by delays in breast reconstruction surgery (66%), diagnostic imaging (60%) and lab testing (50%).

Additionally, another 30% cite delays for hospital or other clinical cancer therapies. Such therapies include: radiation (30%), infusion therapy (32%), and surgery to remove a tumor (26%).

“We expected the usual racial difference we see in health care, with Black patients being disproportionately affected, but our results showed that patients were universally affected by COVID in terms of delays in breast cancer care, likely because in those early weeks, hospitals and health care facilities were postponing visits and procedures across the board as they took on the growing burden of dealing with COVID-19,” study co-author Tamara Hamlish, a research scientist in the cancer survivorship program at the University of Illinois Cancer Center, adds.

Differences by age

“We were surprised to see that younger women were more likely to experience delays, and we think that has to do with cancellations of hormone therapy for ovarian suppression that is given to women with certain types of breast cancer, and those women tend to be younger in general,” Papautsky comments.

In the study, the authors found that age was the only demographic variable that had an impact on the likelihood of a delay in care.

Each survey also included a section for “general comments.” Within this area, some respondents reported that sometimes their scheduled treatments had been “modified” due to the pandemic. For example, some hormone therapies took place less frequently to cut down on in-person visits made to medical facilities.

“Overall, we see that there is a serious gap in disaster preparedness when it comes to providing critical, and often time-sensitive care for breast cancer patients,” Hamlish concludes.

The study is published in Breast Cancer Research and Treatment.

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