Racial and Ethnic Disparities in Cancer Care During the COVID-19 Pandemic.
Racial and Ethnic Disparities in Cancer Care During the COVID-19 Pandemic.
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DOI：
10.1001/jamanetworkopen.2022.22009
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发表时间：
2022-07-01
影响因子：
13.8
通讯作者：
Maingi, Shail
中科院分区：
文献类型：
--
作者：
Patel, Manali I.;Ferguson, Jacqueline M.;Castro, Eida;Pereira-Estremera, Cristina D.;Armaiz-Pena, Guillermo N.;Duron, Ysabel;Hlubocky, Fay;Infantado, Analynn;Nuqui, Bles;Julian, Donna;Nortey, Nii;Steck, Alexandra;Bondy, Melissa;Maingi, Shail
在新冠肺炎大流行期间，美国患有癌症的种族和少数民族成年人是否比白人成年人经历了更多的癌症护理延误和不利的社会和经济影响？在这项对1240名患有癌症的美国成年人的调查研究中，黑人和拉丁裔成年人报告说，他们经历了比白人成年人更高的延迟癌症治疗比率和更多的不利社会和经济影响。这项研究表明，新冠肺炎大流行与黑人和拉丁裔成年人在接受及时癌症治疗方面的差异有关。新冠肺炎大流行对癌症护理差异，特别是种族和族裔差异的全面影响尚不清楚。评估癌症患者的种族和族裔是否与癌症治疗延误、不良社会和经济影响以及新冠肺炎大流行期间的担忧方面的差异有关，并按种族和族裔评估新冠肺炎信息的可信来源。这项对美国成年癌症患者的全国性调查研究比较了2020年9月1日至2021年1月12日期间，不同种族和民族的治疗延误、不良社会和经济影响、担忧以及新冠肺炎信息的可信来源。新冠肺炎大流行。主要结果是癌症治疗因种族和民族而延迟。次要结果是延迟持续时间、不利的社会和经济影响、担忧以及新冠肺炎信息的可信来源。在1639名受邀受访者中，来自美国50个州、哥伦比亚特区和美国5个领地的1240名受访者(744名女性受访者[60.0%]；中位数年龄60岁[范围，24-92岁]；266名非裔美国人或黑人[以下简称黑人]受访者[21.5%]；186名亚裔受访者[15.0%]；232名西班牙裔或拉丁裔[以下称拉美裔]受访者[18.7%]；29名美国印第安人或阿拉斯加原住民、夏威夷原住民或多种族[以下简称其他]受访者[2.3%]；和527名白人受访者[42.5%])。与白人受访者相比，黑人受访者(优势比[OR]，6.13[95%CI，3.50-10.74])和拉丁裔受访者(OR，2.77[95%CI，1.49-5.14])发生非自愿治疗延误的几率更大，黑人受访者治疗延误超过4周的几率更高(OR，3.13[95%CI，1.11-8.81])。与白人受访者相比，黑人受访者(OR，4.32[95%CI，2.65-7.04])和拉丁裔受访者(OR，6.13[95%CI，3.57-10.53])发生粮食不安全和对粮食安全的担忧的几率更大(黑人受访者：OR，2.02[95%CI，1.34-3.04]；拉丁裔受访者：OR，2.94[95%CI，[1.86-4.66])，财务稳定性(OR，3.56[95%CI，1.79-7.08]；拉丁裔受访者：OR，4.29[95%CI，1.98-9.29])，以及癌症治疗的可负担性(黑人受访者：OR，4.27[95%CI，2.20-8.28]；拉丁裔受访者：OR，2.81[95%CI，1.48-5.36])。新冠肺炎信息的可信来源因种族和民族而异。在这项针对美国成年癌症患者的调查中，新冠肺炎大流行与黑人和拉丁裔成年人之间的治疗延误差距以及不利的社会和经济影响有关。与值得信赖的来源合作可能是克服这种差距的机会。这项调查研究评估了癌症患者的种族和民族是否与新冠肺炎大流行期间癌症治疗延迟以及不良社会和经济影响方面的差异有关。
Did racial and ethnic minority adults with cancer in the United States experience more cancer care delays and adverse social and economic effects than White adults during the COVID-19 pandemic? In this survey study of 1240 US adults with cancer, Black and Latinx adults reported experiencing higher rates of delayed cancer care and more adverse social and economic effects than White adults. This study suggests that the COVID-19 pandemic is associated with disparities in the receipt of timely cancer care among Black and Latinx adults. The full effect of the COVID-19 pandemic on cancer care disparities, particularly by race and ethnicity, remains unknown. To assess whether the race and ethnicity of patients with cancer was associated with disparities in cancer treatment delays, adverse social and economic effects, and concerns during the COVID-19 pandemic and to evaluate trusted sources of COVID-19 information by race and ethnicity. This national survey study of US adults with cancer compared treatment delays, adverse social and economic effects, concerns, and trusted sources of COVID-19 information by race and ethnicity from September 1, 2020, to January 12, 2021. The COVID-19 pandemic. The primary outcome was delay in cancer treatment by race and ethnicity. Secondary outcomes were duration of delay, adverse social and economic effects, concerns, and trusted sources of COVID-19 information. Of 1639 invited respondents, 1240 participated (75.7% response rate) from 50 US states, the District of Columbia, and 5 US territories (744 female respondents [60.0%]; median age, 60 years [range, 24-92 years]; 266 African American or Black [hereafter referred to as Black] respondents [21.5%]; 186 Asian respondents [15.0%]; 232 Hispanic or Latinx [hereafter referred to as Latinx] respondents [18.7%]; 29 American Indian or Alaska Native, Native Hawaiian, or multiple races [hereafter referred to as other] respondents [2.3%]; and 527 White respondents [42.5%]). Compared with White respondents, Black respondents (odds ratio [OR], 6.13 [95% CI, 3.50-10.74]) and Latinx respondents (OR, 2.77 [95% CI, 1.49-5.14]) had greater odds of involuntary treatment delays, and Black respondents had greater odds of treatment delays greater than 4 weeks (OR, 3.13 [95% CI, 1.11-8.81]). Compared with White respondents, Black respondents (OR, 4.32 [95% CI, 2.65-7.04]) and Latinx respondents (OR, 6.13 [95% CI, 3.57-10.53]) had greater odds of food insecurity and concerns regarding food security (Black respondents: OR, 2.02 [95% CI, 1.34-3.04]; Latinx respondents: OR, 2.94 [95% CI, [1.86-4.66]), financial stability (Black respondents: OR, 3.56 [95% CI, 1.79-7.08]; Latinx respondents: OR, 4.29 [95% CI, 1.98-9.29]), and affordability of cancer treatment (Black respondents: OR, 4.27 [95% CI, 2.20-8.28]; Latinx respondents: OR, 2.81 [95% CI, 1.48-5.36]). Trusted sources of COVID-19 information varied significantly by race and ethnicity. In this survey of US adults with cancer, the COVID-19 pandemic was associated with treatment delay disparities and adverse social and economic effects among Black and Latinx adults. Partnering with trusted sources may be an opportunity to overcome such disparities. This survey study assesses whether the race and ethnicity of patients with cancer was associated with disparities in cancer treatment delays and adverse social and economic effects during the COVID-19 pandemic.
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