nach oben

Current Breast Cancer Reports

Erschienen in:

30.08.2022 | COVID-19 | Breast Cancer Disparities (LA Newman, Section Editor)

Breast Cancer Disparities and the COVID-19 Pandemic

verfasst von: Genevieve A. Fasano, Solange Bayard, Vivian J. Bea

Erschienen in: Current Breast Cancer Reports | Ausgabe 4/2022

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

The COVID-19 pandemic has placed unprecedented challenges on breast cancer patients and health care providers. The impact of the pandemic on preexisting breast cancer disparities remains unknown but is projected to have adverse outcomes.

Recent Findings

Early work has demonstrated that pandemic-related temporary suspensions in breast cancer screening, interruption of clinical trials, and treatment delays have an adverse impact on breast cancer patient outcomes and may worsen disparities.

Summary

In this review, we highlight existing knowledge regarding breast cancer disparities and the impact of the COVID-19 pandemic. Strategies for mitigating disparities moving forward include targeted research evaluating race-specific outcomes, targeted education for providers regarding breast health disparities, improved access to telehealth, maintenance of patient navigation programs, and patient education regarding the safety and necessity of enrollment in clinical trials.

DeSantis CE, Ma J, Gaudet MM, Newman LA, Miller KD, Goding Sauer A, et al. Breast cancer statistics, 2019. CA Cancer J Clin. 2019;69:438–51. https://doi.org/10.3322/caac.21583.CrossRef

United States Census Bureau. Income and poverty in the United States: 2020. https://www.census.gov/library/publications/2021/demo/p60-273.html; Accessed Jan 31, 2022.

United States Census Bureau. Health Insurance Coverage in the United States: 2019. https://www.census.gov/content/dam/Census/library/publications/2020/demo/p60-271.pdf; Accessed Jan 31, 2022.

American Cancer Society. Breast cancer facts & figures 2019–2020. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/breast-cancer-facts-and-figures/breast-cancer-facts-and-figures-2019-2020.pdf; Accessed Jan 31, 2022.

Ahmed AT, Welch BT, Brinjikji W, Farah WH, Henrichsen TL, Murad MH, et al. Racial disparities in screening mammography in the United States: a systematic review and meta-analysis. J Am Coll Radiol. 2017;14:157-165.e9. https://doi.org/10.1016/j.jacr.2016.07.034.CrossRef

Churpek JE, Walsh T, Zheng Y, Moton Z, Thornton AM, Lee MK, et al. Inherited predisposition to breast cancer among African American women. Breast Cancer Res Treat. 2015;149:31–9. https://doi.org/10.1007/s10549-014-3195-0.CrossRef

Behrendt CE, Hurria A, Tumyan L, Niland JC, Mortimer JE. Socioeconomic and clinical factors are key to uncovering disparity in accrual onto therapeutic trials for breast cancer. J Natl Compr Canc Netw. 2014;12:1579–85. https://doi.org/10.6004/jnccn.2014.0158.CrossRef

Ajewole VB, Akindele O, Abajue U, Ndulue O, Marshall JJ, Mossi YT. Cancer disparities and Black American representation in clinical trials leading to the approval of oral chemotherapy drugs in the United States between 2009 and 2019. JCO Oncol Pract. 2021;17:e623–8. https://doi.org/10.1200/OP.20.01108.CrossRef

•• Newman LA, Winn RA, Carethers JM. Similarities in risk for COVID-19 and cancer disparities. Clin Cancer Res 2021;27:24–7. https://doi.org/10.1158/1078-0432.CCR-20-3421. Newman and colleagues provide a thorough overview of the similarities in risk for both COVID-19 and cancer that has led to a disproportionate impact on racial and ethnic minorities. Driven by not only genetic predisposition but also socioeconomic factors, racial and ethnic minority populations face an increased burden of acquiring and dying from both diseases. Additionally, in both scenarios, these populations are underrepresented in clinical trials which may lead to long-term disparities. This paper provides suggestions for collaborative strategies for addressing the root cause of these disparities.

10.

Kaiser Family Foundation. COVID-19 cases and deaths by race/ethnicity: current data and changes over time. https://www.kff.org/racial-equity-and-health-policy/issue-brief/covid-19-cases-and-deaths-by-race-ethnicity-current-data-and-changes-over-time/; Accessed Jan 31, 2022.

11.

Newman L, Fejerman L, Pal T, Mema E, McGinty G, Cheng A, et al. Breast cancer through the lens of the COVID-19 pandemic. Curr Breast Cancer Rep. 2021;6:1–3. https://doi.org/10.1007/s12609-021-00419-x.CrossRef

12.

Cavallo, J. How delays in screening and early cancer diagnosis amid the COVID-19 pandemic may result in increased cancer mortality. https://ascopost.com/issues/september-10-2020/how-delays-in-screening-and-early-cancer-diagnosis-amid-the-covid-19-pandemic-may-result-in-increased-cancer-mortality/; Accessed Feb 23, 2022.

13.

Balogun OD, Bea VJ, Phillips E. Disparities in cancer outcomes due to COVID-19-a tale of 2 cities. JAMA Oncol. 2020;6:1531–2. https://doi.org/10.1001/jamaoncol.2020.3327.CrossRef

14.

Carethers JM, Sengupta R, Blakey R, Ribas A, D’Souza G. Disparities in cancer prevention in the COVID-19 era. Cancer Prev Res (Phila). 2020;13:893–6. https://doi.org/10.1158/1940-6207.CAPR-20-0447.CrossRef

15.

Maringe C, Spicer J, Morris M, Purushotham A, Nolte E, Sullivan R, et al. The impact of the COVID-19 pandemic on cancer deaths due to delays in diagnosis in England, UK: a national, population-based, modelling study. Lancet Oncol. 2020;21:1023–34. https://doi.org/10.1016/S1470-2045(20)30388-0.CrossRef

16.

Amram O, Robison J, Amiri S, Pflugeisen B, Roll J, Monsivais P. Socioeconomic and racial inequities in breast cancer screening during the COVID-19 pandemic in Washington state. JAMA Netw Open. 2021;4:e2110946. https://doi.org/10.1001/jamanetworkopen.2021.10946.CrossRef

17.

Velazquez AI, Hayward JH, Gregory B, Dixit N. Trends in breast cancer screening in a safety-net hospital during the COVID-19 pandemic. JAMA Netw Open. 2021;4:e2119929. https://doi.org/10.1001/jamanetworkopen.2021.19929.CrossRef

18.

DeGroff A, Miller J, Sharma K, Sun J, Helsel W, Kammerer W, et al. COVID-19 impact on screening test volume through the National Breast and Cervical Cancer early detection program, January-June 2020, in the United States. Prev Med. 2021;151:106559. https://doi.org/10.1016/j.ypmed.2021.106559.CrossRef

19.

•• Chen RC, Haynes K, Du S, Barron J, Katz AJ. Association of cancer screening deficit in the United States with the COVID-19 pandemic. JAMA Oncol. 2021:7:878–884. https://doi.org/10.1001/jamaoncol.2021.0884. This large retrospective study quantifies the decrease in screening rates that occurred for breast, colorectal, and prostate cancer due to the COVID-19 pandemic in different geographic regions within the USA. While screening for breast, colorectal, and prostate cancers declined from March through May of 2020, the sharpest decline was observed for breast during April 2020 where the screening rate decreased by 90.8%. Additionally, geographic variation was observed such that the Northeast experienced the largest decline in screening. Importantly, when stratified by socioeconomic status, the largest screening decline was seen for patients within the largest socioeconomic index quartile suggesting that not all patient populations were affected equally.

20.

Li S, O’Brien S, Murphy C, Nabil C. Identifying patients at risk of delayed breast imaging due to the COVID-19 pandemic. Cureus. 2021;13:e17235. https://doi.org/10.7759/cureus.17235.CrossRef

21.

Miller MM, Meneveau MO, Rochman CM, Schroen AT, Lattimore CM, Gaspard PA, et al. Impact of the COVID-19 pandemic on breast cancer screening volumes and patient screening behaviors. Breast Cancer Res Treat. 2021;189:237–46. https://doi.org/10.1007/s10549-021-06252-1.CrossRef

22.

Newman LA, Roff NK, Weinberg AD. Cancer clinical trials accrual: missed opportunities to address disparities and missed opportunities to improve outcomes for all. Ann Surg Oncol. 2008;15:1818–9. https://doi.org/10.1245/s10434-008-9869-2.CrossRef

23.

Sheppard VB, Hurtado-de-Mendoza A, Talley CH, Zhang Y, Cabling ML, Makambi KH. Reducing racial disparities in breast cancer survivors’ ratings of quality cancer care: the enduring impact of trust. J Healthc Qual. 2016;38:143–63. https://doi.org/10.1097/JHQ’.0000000000000046.CrossRef

24.

Asaad M, Habibullah NK, Butler CE. The impact of COVID-19 on clinical trials. Ann Surg. 2020;272:e222–3. https://doi.org/10.1097/SLA.0000000000004113.CrossRef

25.

Bartlett DL, Howe JR, Chang G, Crago A, Hogg M, Karakousis G, et al. Management of cancer surgery cases during the COVID-19 pandemic: considerations. Ann Surg Oncol. 2020;27:1717–20. https://doi.org/10.1245/s10434-020-08461-2.CrossRef

26.

The American Society of Breast Surgeons. ASBrS resource guide to endocrine therapy in the COVID-19 pandemic. https://www.breastsurgeons.org/docs/statements/ASBrS-Resource-Guide-on-Endocrine-Therapy-in-the-COVID-19-Pandemic.pdf?v1; Accessed Jan 31, 2022.

27.

American College of Surgeons. COVID-19: elective case triage guidelines for surgical care. https://www.facs.org/covid-19/clinical-guidance/elective-case; Accessed Jan 31, 2022.

28.

Bachand J, Soulos PR, Herrin J, Pollack CE, Xu X, Ma X, et al. Physician peer group characteristics and timeliness of breast cancer surgery. Breast Cancer Res Treat. 2018;170:657–65. https://doi.org/10.1007/s10549-018-4789-8.CrossRef

29.

Benefield HC, Reeder-Hayes KE, Nichols HB, Calhoun BC, Love MI, Kirk EL, et al. Outcomes of hormone-receptor positive, HER2-negative breast cancers by race and tumor biological features. JNCI Cancer Spectr. 2020:5:pkaa072. https://doi.org/10.1093/jncics/pkaa072.

30.

Doe S, Petersen S, Buekers T, Swain M. Does a multidisciplinary approach to invasive breast cancer care improve time to treatment and patient compliance? J Natl Med Assoc. 2020;112:268–74. https://doi.org/10.1016/j.jnma.2020.03.010.CrossRef

31.

Emerson MA, Golightly YM, Aiello AE, Reeder-Hayes KE, Tan X, Maduekwe U, et al. Breast cancer treatment delays by socioeconomic and health care access latent classes in Black and White women. Cancer. 2020;126:4957–66. https://doi.org/10.1002/cncr.33121.CrossRef

32.

Hoppe EJ, Hussain LR, Grannan KJ, Dunki-Jacobs EM, Lee DY, Wexelman BA. Racial disparities in breast cancer persist despite early detection: analysis of treatment of stage 1 breast cancer and effect of insurance status on disparities. Breast Cancer Res Treat. 2019;173:597–602. https://doi.org/10.1007/s10549-018-5036-z.CrossRef

33.

Jackson DK, Li Y, Eskander MF, Tsung A, Oppong BA, Bhattacharyya O, et al. Racial disparities in low-value surgical care and time to surgery in high-volume hospitals. J Surg Oncol. 2021;123:676–86. https://doi.org/10.1002/jso.26320.CrossRef

34.

• Obeng-Gyasi S, Oppong B, Paskett ED, Lustberg M. Purposeful surgical delay and the coronavirus pandemic: how will black breast cancer patients fare? Breast Cancer Res Treat. 2020:182:527–530. https://doi.org/10.1007/s10549-020-05740-0. An important editorial that examines the possible implications of the pandemic-related surgical delays on black breast cancer patients and directions for future study to further elucidate the impact.

35.

• Satish T, Raghunathan R, Prigoff JG, Wright JD, Hillyer GA, et al. Care delivery impact of the COVID-19 pandemic on breast cancer care. JCO Oncol Pract. 2021:17:e1215-e1224. https://doi.org/10.1200/OP.20.01062. As one of the first studies to examine how breast cancer care in the USA was affected by the COVID-19 pandemic, this study found that among breast oncology patients, patients who identified as Black/African American, Asian, or other races were more likely to experience a delay or change in their treatment compared to Whites; additionally, they found that Medicaid compared with commercial insurance was associated with increased odds of a delay and/or change.

36.

• Escobar N, Crown A, Pocock B, Joseph K. The devastating impact of the COVID-19 pandemic on breast cancer care among medically underserved populations at two New York City public hospitals. Annals of Surgery 2020:2:1–6. https://doi.org/10.1097/AS9.0000000000000018. An important real-world account of the impact that the COVID-19 pandemic has had on two New York City hospitals that resulted in vastly different experiences among similar patient populations. This paper highlights how the breast services at Bellevue Hospital and Elmhurst Hospital reallocated hospital resources to care for medically underserved breast cancer patients. The experience of these two hospitals shows how COVID-19 has contributed to the widening of health care disparities.

37.

Rentscher KE, Zhou X, Small BJ, Cohen HJ, Dilawari AA, Patel SK, et al. Loneliness and mental health during the COVID-19 pandemic in older breast cancer survivors and noncancer controls. Cancer. 2021;127:3671–9. https://doi.org/10.1002/cncr.33687.CrossRef

38.

Pew Research Center. Internet/Broadband Fact Sheet. https://www.pewresearch.org/internet/fact-sheet/internet-broadband/?menuItem=3109350c-8dba-4b7f-ad52-a3e976ab8c8f; Accessed Feb 23, 2022.

Titel: Breast Cancer Disparities and the COVID-19 Pandemic
verfasst von: Genevieve A. Fasano
Solange Bayard
Vivian J. Bea
Publikationsdatum: 30.08.2022
Verlag: Springer US
Schlagwort: COVID-19
Erschienen in: Current Breast Cancer Reports / Ausgabe 4/2022
Print ISSN: 1943-4588
Elektronische ISSN: 1943-4596
DOI: https://doi.org/10.1007/s12609-022-00458-y

Neu im Fachgebiet Onkologie

Positiver FIT: Die Ursache liegt nicht immer im Dickdarm

27.05.2024 Blut im Stuhl Nachrichten

Immunchemischer Stuhltest positiv, Koloskopie negativ – in solchen Fällen kann die Blutungsquelle auch weiter proximal sitzen. Ein Forschungsteam hat nachgesehen, wie häufig und in welchen Lokalisationen das der Fall ist.

Mammakarzinom: Brustdichte beeinflusst rezidivfreies Überleben

26.05.2024 Mammakarzinom Nachrichten

Frauen, die zum Zeitpunkt der Brustkrebsdiagnose eine hohe mammografische Brustdichte aufweisen, haben ein erhöhtes Risiko für ein baldiges Rezidiv, legen neue Daten nahe.

Mehr Lebenszeit mit Abemaciclib bei fortgeschrittenem Brustkrebs?

24.05.2024 Mammakarzinom Nachrichten

In der MONARCHE-3-Studie lebten Frauen mit fortgeschrittenem Hormonrezeptor-positivem, HER2-negativem Brustkrebs länger, wenn sie zusätzlich zu einem nicht steroidalen Aromatasehemmer mit Abemaciclib behandelt wurden; allerdings verfehlte der numerische Zugewinn die statistische Signifikanz.

ADT zur Radiatio nach Prostatektomie: Wenn, dann wohl länger

24.05.2024 Prostatakarzinom Nachrichten

Welchen Nutzen es trägt, wenn die Strahlentherapie nach radikaler Prostatektomie um eine Androgendeprivation ergänzt wird, hat die RADICALS-HD-Studie untersucht. Nun liegen die Ergebnisse vor. Sie sprechen für länger dauernden Hormonentzug.

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Breast Cancer Disparities and the COVID-19 Pandemic