Abstract 45: How Did States Adapt Their Cancer Control Plan During the COVID-19 Pandemic?

Abstract

Abstract Purpose: The COVID-19 pandemic upended the delivery of cancer services across the care continuum. In the United States, the federalist system of governance led to health policy changes by federal, state, and local jurisdictions. At the intersection of these levels of government are state cancer control plans. Funded by the federal government, state cancer control plans are developed by state health departments in collaboration with healthcare providers, public health agencies, and community organizations. By outlining specific strategies for addressing cancer in the state, these plans serve a critical role during a public health emergency. This policy analysis aims to understand how states updated their cancer control plan as a response to COVID-19. Methods: This qualitative policy analysis began by reviewing the cancer control plans of all 50 states and the District of Columbia. The inclusion criteria required that each plan be updated after March 2020 and included language related to “COVID”. These plans were then analyzed for COVID-19 related adaptations along three themes: 1) cancer care continuum, 2) service delivery, 2) population health and equity. Results: Among the 51 cancer plans analyzed, seven plans met the inclusion criteria (IL, IA, ME, NV, NC, UT, VT). Three states (IL, IA, ME) adapted their plans to increase cancer screenings, two plans to increase clinical trials (IA, ME), and one plan each targeted increased treatment (NC) and prevention activities (NV). Three states identified telehealth as a priority for service delivery (IL, NV, UT), but only two (IL, UT) identified telehealth equity as a barrier. Two states (IA, NC) prioritized addressing workforce shortage and disruptions caused by the pandemic. Health insurance loss and public health investments were also identified as service delivery concerns. Two states (IL, IA) acknowledged the role of social determinants of health exacerbating COVID-19 and cancer inequalities. Food insecurity (NV, UT) and job loss (ME, NV, UT) were also components of equity within these plans. Utah explicitly acknowledged the role of racism and gender as related to the disparate impact of COVID-19 on cancer care. Conclusion: This analysis highlighted how states adapted their cancer control plans in response to COVID-19 and may inform ongoing policy debate. Continued policy surveillance and evaluation could ensure that cancer patients receive timely, appropriate care during public health emergencies. Citation Format: Jason Semprini. How Did States Adapt Their Cancer Control Plan During the COVID-19 Pandemic? [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 45.