Abstract
We aimed to describe the negative and positive impacts of changes in cancer care delivery due to COVID-19 pandemic for adolescents and young adults (AYAs) in Canada, as well as the correlates of negative impact and their perspectives on optimization of cancer care. We conducted an online, self-administered survey of AYAs with cancer living in Canada between January and February 2021. Multiple logistic regression was used to identify factors associated with a negative impact on cancer care. Of the 805 participants, 173 (21.5%) experienced a negative impact on their cancer care including delays in diagnostic tests (11.9%), cancer treatment (11.4%), and appointments (11.1%). A prior diagnosis of mental or chronic physical health condition, an annual income of <20,000 CAD, ongoing cancer treatment, and province of residence were independently associated with a negative cancer care impact (p-value < 0.05). The majority (n = 767, 95.2%) stated a positive impact of the changes to cancer care delivery, including the implementation of virtual healthcare visits (n = 601, 74.6%). Pandemic-related changes in cancer care delivery have unfavorably and favorably influenced AYAs with cancer. Interventions to support AYAs who are more vulnerable to the adverse effects of the pandemic, and the thoughtful integration of virtual care into cancer care delivery models is essential.
Highlights
COVID-19 is responsible for one of the largest global pandemics experienced in almost a century [1]
Most participants were less than five years from the time of cancer diagnosis (n = 667, 82.8%), and one-third were receiving some form of cancer treatment (n = 265, 33.0%)
Our cross-sectional study highlighted both negative and positive aspects of how the COVID-19 pandemic modified cancer care delivery to AYAs with cancer in Canada. This is the first Canadian study to assess in detail how the pandemic has impacted multiple aspects of cancer care of AYAs with cancer and to identify factors that place certain AYAs with cancer at greater risk for experiencing the negative impact of this pandemic
Summary
COVID-19 is responsible for one of the largest global pandemics experienced in almost a century [1]. Individuals of all ages with a cancer diagnosis are vulnerable to experiencing a multitude of adverse impacts secondary to the pandemic [2,3]. Alterations in cancer treatment protocols and access to clinical trials, medications, and physical or psychological support services have raised concerns about the quality of cancer care during this pandemic [6,8,9]. It has become more challenging for patients to cope with their cancer given the personal disconnect they feel from healthcare providers and their social support system [5,6]
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