Changes in time to treatment initiation for patients diagnosed with breast, lung, colon, or rectal cancer during the 2020 COVID-19 pandemic in the US.

Abstract

e13516 Background: The COVID-19 pandemic resulted in substantial disruptions in health care and declines in cancer diagnoses in the US. We used nationwide data to examine changes in time to first treatment for patients newly diagnosed with cancer during 2020, the first year of the pandemic. Methods: Adults aged ≥18 years newly diagnosed with breast, non-small cell lung cancer (NSCLC), colon, or rectal cancer between January 2019 and November 2020 were identified from the National Cancer Database. Logistic regression was used to calculate crude and adjusted (by age and sex and diagnosis quarter) odds ratios (AOR) of initiating any treatment within 30 days of the diagnosis comparing 2020 vs. 2019 overall and by quarter. Results: A total of 668,229 adults newly diagnosed with cancer were identified, including 358,255 in 2019 and 309,974 in 2020. Individuals diagnosed in 2020 were more likely to initiate treatment ≤ 30 days of breast (AOR = 1.12, 95% confidence interval [95% CI] =1.11-1.14), NSCLC (AOR = 1.09, 95% CI =1.07-1.11), colon (AOR = 1.13, 95% CI =1.09-1.16) or rectal (AOR = 1.08, 95% CI =1.04-1.12) cancer diagnosis, compared to those diagnosed in 2019. Increases in treatment initiation ≤ 30 days were greatest in the second quarter of 2020 for all four cancers. Findings changed little after adjustment for quarter of diagnosis and AORs remained statistically significant. Conclusions: During 2020, there was an increase in treatment initiation within 30 days from diagnosis, especially in the second quarter. The lower volume of diagnoses and efforts by providers to prioritize cancer care may partly explain the observed improvements. Ongoing evaluation of these changes and cancer outcomes is warranted.[Table: see text]