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Cited by 53COVID-19 and healthcare impactsGlobal Cancer Incidence and ScreeningHealth disparities and outcomes

Racial and Ethnic Disparities in Cancer Care During the COVID-19 Pandemic

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Patel, Manali I., Ferguson, Jacqueline M., Castro, Eida, Pereira-Estremera, Cristina D., Armaiz-Peña, Guillermo N., Duron, Ysabel, Hlubocky, Fay, Infantado, Analynn +6 more·2022·JAMA Network Open
DOI 10.1001/jamanetworkopen.2022.22009PMC PMC9284331
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Abstract

Importance: The full effect of the COVID-19 pandemic on cancer care disparities, particularly by race and ethnicity, remains unknown. Objectives: 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. Design, Setting, and Participants: 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. Exposures: The COVID-19 pandemic. Main Outcomes and Measures: 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. Results: 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. Conclusions and Relevance: 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.

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  • Disparities in oncology outcomes, including differences in individual-level socioeconomic factors during the COVID-19 pandemic, have fueled an interest in the documentation of individual-level SDOH.

    “More recently, disparities in oncology outcomes, including differences in individual-level socioeconomic factors during the COVID-19 pandemic, have fueled an interest in the documentation of individual-level social determinants of health (SDOH)8,9.”

    From Documentation of individual-level social determinants of health among adults diagnosed with cancer in the United States (2025) · cites this paper as [9]

    The Results (Experiences and Concerns Regarding Adverse Social and Economic Effects; page unavailable) report racial and ethnic differences in patient-reported job loss, food insecurity, and childcare loss during the pandemic. The Methods (page unavailable) show that the study collected individual-level socioeconomic information. The paper does not say that these disparities fueled interest in documenting individual-level SDOH. (LLM, conf=0.82)

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  • Awareness of the impacts of SDOH on health outcomes is evident from the oncology literature, largely due to the persistent disparities, substantial barriers to treatment, and the financial toxicity commonly associated with cancer care.

    “Awareness of the impacts of SDOH on health outcomes is evident from the oncology literature, largely due to the persistent disparities, substantial barriers to treatment, and the financial toxicity commonly associated with cancer care1,2,8,9,18.”

    From Documentation of individual-level social determinants of health among adults diagnosed with cancer in the United States (2025) · cites this paper as [9]

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Cited by

Sorted by citations

Authors
Patel, M. I., Ferguson, J. M., Castro, E., Pereira-Estremera, C. D., Armaiz-Peña, G. N., Duron, Y., Hlubocky, F., Infantado, A., Nuqui, B., Julian, D., Nortey, N., Steck, A., Bondy, M., & Maingi, S.
Affiliations
  • VA Palo Alto Health Care System (US)
  • Ponce Health Sciences University (PR)
  • Battle Creek VA Medical Center (US)
  • The Latino Cancer Institute, San Jose, California
  • University of Chicago (US)
  • St Peter's Hospital (US)
  • Stanford University (US)
  • Dana-Farber Cancer Institute (US)
Corresponding author
Patel, Manali I.
ORCID
Venue
JAMA Network Open
Publisher
American Medical Association (AMA)
Published
2022-07-14
Volume
5
Issue
7
Pages
e2222009
ISSN
2574-3805 (ISSN-L)
DOI
10.1001/jamanetworkopen.2022.22009
PMC
PMC9284331
OpenAlex
W4285387472
Cited by
53
References
3
Citations by year
2026: 8 · 2025: 13 · 2024: 13 · 2023: 18 · 2022: 1
FWCI
4.71
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • JAMA Network Open (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Knowledge@UChicago (University of Chicago) (submittedVersion)
  • University of Chicago (cc-by)
Funders
  • National Institutes of Health
  • National Institute on Minority Health and Health Disparities (R21MD013674, K23MD013474)
  • State of California
Topics
  • Health Sciences › Medicine › Oncology › COVID-19 and healthcare impacts
  • Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
  • Social Sciences › Health › Health disparities and outcomes
Keywords
racial and ethnic disparities, cancer care, COVID-19 pandemic, treatment delay, Black patients, Latinx patients, social determinants of health, economic hardship, social isolation, trust in health information, health misinformation, cancer survivorship, health equity, health insurance status
MeSH terms
COVID-19, Adult, Black or African American, Ethnicity, Female, Hispanic or Latino, Humans, Middle Aged, Neoplasms, Pandemics

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