Race and ethnicity are associated with delayed or discontinued cancer treatment after COVID-19, according to research published in JAMA Network Open.

The study showed that, compared with non-Hispanic White patients, non-Hispanic Black patients were 35% more likely to experience delays or discontinuations of cancer treatment, and Hispanic patients were 14% more likely to do so.

The study included data from 4768 cancer patients who had COVID-19 from April 2020 to September 2022. Racial/ethnic groups included non-Hispanic American Indian or Alaska Native (3.7%), non-Hispanic Asian American or Pacific Islander (4.1%), non-Hispanic Black (11.9%), Hispanic (13.2%), and non-Hispanic White (66.5%).  


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A multivariable analysis revealed that non-Hispanic Black patients were more likely than non-Hispanic White patients to experience delays or discontinuations of at least 14 days for any cancer treatment (risk ratio [RR], 1.35; 95% CI, 1.22-1.49; P <.001) or pharmacotherapy only (RR, 1.37; 95% CI, 1.23-1.52; P <.001).

Likewise, Hispanic patients were more likely than non-Hispanic White patients to experience delays or discontinuations of any cancer treatment (RR, 1.14; 95% CI, 1.00-1.28; P =.04) or pharmacotherapy only (RR, 1.17; 95% CI, 1.03-1.33; P =.02).

The time to restart pharmacotherapy was significantly longer for non-Hispanic Black patients than for non-Hispanic White patients (HR, 0.81; 95% CI, 0.67-0.97; P =.03), but there were no significant differences for Hispanic patients or non-Hispanic Asian American or Pacific Islander patients (vs non-Hispanic White patients).

Race and ethnicity were not associated with delays or discontinuation of radiotherapy or surgery. Sex and age were not associated with any treatment delay or discontinuation. Similarly, area-level social determinants of health, which included education levels, lower median household income, and proportion of residents without health insurance, were not significantly associated with treatment delays or discontinuation.

“This study’s findings on at-risk patients can be used by oncology clinicians and public health professionals to inform plans to improve care across the cancer continuum and among patients with cancer undergoing active treatment,” the researchers concluded.

Disclosures: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Reference

Llanos AAM, Ashrafi A, Ghosh N, et al. Evaluation of inequities in cancer treatment delay or discontinuation following SARS-CoV-2 infection. JAMA Netw Open. Published online January 13, 2023. doi:10.1001/jamanetworkopen.2022.51165