Abstract
Simple SummaryThere is limited evidence regarding the influence of socioeconomic factors on COVID-19 transmission, severity and outcomes in the overall population. Furthermore, there is an urgent need to identify and explore the most important socioeconomic risk factors associated with the COVID-19 disease among incident cancer patients, one of the most vulnerable groups of the population. Findings from this study provide invaluable evidence needed for risk classification and stratification among incident cancer patients, based on the information from the first pandemic wave in the UK. We identified the clinical and socio-demographic profile of cancer patients at increased risk of COVID-19 infection. The results from the study added knowledge on impact of the pandemic on the most vulnerable cancer patients in the UK, and can shed light on possible treatment and prevention strategies for COVID-19, including future vaccination prioritisation policy.We explored the role of socioeconomic inequalities in COVID-19 incidence among cancer patients during the first wave of the pandemic. We conducted a case-control study within the UK Biobank cohort linked to the COVID-19 tests results available from 16 March 2020 until 23 August 2020. The main exposure variable was socioeconomic status, assessed using the Townsend Deprivation Index. Among 18,917 participants with an incident malignancy in the UK Biobank cohort, 89 tested positive for COVID-19. The overall COVID-19 incidence was 4.7 cases per 1000 incident cancer patients (95%CI 3.8–5.8). Compared with the least deprived cancer patients, those living in the most deprived areas had an almost three times higher risk of testing positive (RR 2.6, 95%CI 1.1–5.8). Other independent risk factors were ethnic minority background, obesity, unemployment, smoking, and being diagnosed with a haematological cancer for less than five years. A consistent pattern of socioeconomic inequalities in COVID-19 among incident cancer patients in the UK highlights the need to prioritise the cancer patients living in the most deprived areas in vaccination planning. This socio-demographic profiling of vulnerable cancer patients at increased risk of infection can inform prevention strategies and policy improvements for the coming pandemic waves.
Highlights
The coronavirus disease 2019 (COVID-19), declared as a global pandemic by the World Health Organization (WHO) on 11 March 2020 [1], has introduced a huge strain on communities and health care systems worldwide
With the second or third pandemic wave many countries are finding it difficult to respond to increasing health care needs of people infected with COVID-19, especially if they are diagnosed with other chronic diseases
We aimed to identify and explore the most important socioeconomic risk factors associated with testing positive for COVID-19 among incident cancer patients in the UK Biobank cohort
Summary
The coronavirus disease 2019 (COVID-19), declared as a global pandemic by the World Health Organization (WHO) on 11 March 2020 [1], has introduced a huge strain on communities and health care systems worldwide. Cancer patients have a higher risk of COVID-19 infection [2], with an estimated 2-fold increased risk of having a positive COVID-19 test, in comparison with the general population [3]. They are more susceptible to severe COVID-19 infection, followed by higher morbidity and mortality, than people without cancer [2,4,5,6]. It is necessary to ensure early detection of coronavirus infection given that cancer patients have a high risk of unfavourable outcomes
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