Delays In Cancer Treatment Research Articles

Measuring vulnerability to childhood cancer treatment delays in low-income and middle-income countries

Measuring vulnerability to childhood cancer treatment delays in low-income and middle-income countries

3 QUESTIONS ON... Addressing Disparities in Breast Cancer Treatment Delays

3 QUESTIONS ON... Addressing Disparities in Breast Cancer Treatment Delays

Immune Checkpoint Inhibitors-Associated Thrombosis: Incidence, Risk Factors and Management.

Immune checkpoint inhibitors (ICIs) target programmed cell death (PD) 1 receptor and its ligand PD-L1, and have become an integral part of treatment regimens in many cancers including lung cancer, renal cell carcinoma, melanoma, and more. Cancer is associated with a significantly increased risk of venous thromboembolism compared to non-cancer patients, and the risks increase further with anticancer therapies including ICIs. Cancer-associated thrombosis can lead to hospitalizations, delayed cancer treatment, and mortality. While thrombosis was not reported as a major complication in initial clinical trials leading to the approval of ICIs, emerging evidence from post-marketing studies revealed concerning risks of thrombosis in patients receiving ICIs. However, results remained heterogenous given differences in study designs and populations. Recent studies also showed that C-reactive protein dynamics might be an easily accessible biomarker for thrombosis and disease response in this population. In addition, early findings indicated that a commonly used anticoagulant for cancer-associated thrombosis, factor Xa inhibitors, might have potential synergistic antitumor effects when combined with ICIs. Herein we will review the current literature on the incidence, risk factors, and management of thrombosis in patients with cancer receiving ICIs. We aim to provide valuable information for clinicians in managing these patients.

Oncoguía de trombosis venosa asociada a cáncer: profilaxis y tratamiento 2023

People with cancer are at increased risk of developing venous thrombosis and rethrombosis (despite treatment), as well as at an increased risk of bleeding. The causes of thrombosis and bleeding vary among patients, tumor types, and cancer treatments. Cancer-associated venous thrombosis (CAVT) causes morbidity, delays in cancer treatment, impairment of quality of life and of emotional state, and increased mortality. Approximately one in ten individuals with cancer die from pulmonary thromboembolism. Reducing the risk of thrombosis in surgery, hospitalization, and in outpatients with cancer is possible with targeted, risk-based thromboprophylaxis. Treatment of CAVT should be individualized in terms of type of anticoagulant, dose, duration of treatment, and modifications of anticoagulation during invasive procedures. These guidelines present a framework for the comprehensive management of patients with cancer and venous thrombosis.

Therapeutic delay in curative treatment of colorectal cancer, does it impact oncological outcome and survival?: a non-inferiority analysis

Therapeutic delay in curative treatment of colorectal cancer, does it impact oncological outcome and survival?: a non-inferiority analysis

Preliminary Recommendations on the Timing of Lung Surgery after Novel Coronavirus Infection in Patients with Pulmonary Nodules and Lung Cancer

In recent years, the corona virus disease 2019 (COVID-19) pandemic has had a huge impact on the global medical, political and economic fields. Since the beginning of the COVID-19 epidemic, our understanding of the impact of COVID-19 has grown exponentially. Recently, the COVID-19 epidemic has changed rapidly in China, and there has been controversy over how to carry out surgical operations for patients with lung neoplastic lesions. Some studies have shown that lung cancer patients undergoing surgery are more likely to experience respiratory failure and perioperative death after contracting COVID-19 than the general population, however, delays in cancer treatment are also associated with increased mortality among these patients. In particular, the novel coronavirus Omikron variant has a higher transmissibility and may escape the immunity obtained through the previous novel coronavirus infection and vaccination. In order to minimize the risk of novel coronavirus infection in surgical patients, it is necessary to develop new treatment guidelines, expert consensus and preventive measures. However, the current rapid change of the epidemic situation has led to insufficient time and evidence to develop guidelines and consensus. Therefore, thoracic surgeons need to evaluate specific patient populations at higher risk of severe complications before surgery and weigh the benefit of surgical treatment against the risk of novel coronavirus infection. We try to give some recommendations on lung surgery during the current domestic epidemic situation based on the guidelines and consensus of oncology and thoracic surgery organizations in different regions on lung surgery. .

Race, geography, and risk of breast cancer treatment delays: A population-based study 2004-2015.

Treatment delays affect breast cancer survival and constitute poor-quality care. Black patients experience more treatment delay, but the relationship of geography to these disparities is poorly understood. We studied a population-based, retrospective, observational cohort of patients with breast cancer in North Carolina between 2004 and 2017 from the Cancer Information and Population Health Resource, which links cancer registry and sociodemographic data to multipayer insurance claims. We included patients >18years with Stage I-III breast cancer who received surgery or chemotherapy as their first treatment. Delay was defined as >60days from diagnosis to first treatment. Counties were aggregated into nine Area Health Education Center regions. Race was dichotomized as Black versus non-Black. Among 32,626 patients, 6190 (19.0%) were Black. Black patients were more likely to experience treatment delay >60days (15.0% of Black vs. 8.0% of non-Black). Using race-stratified modified Poisson regression, age-adjusted relative risk of delay in the highest risk region was approximately twice that in the lowest risk region among Black (relative risk, 2.1; 95% CI, 1.6-2.6) and non-Black patients (relative risk, 1.9; 95% CI, 1.5-2.3). Adjustment for clinical and sociodemographic features only slightly attenuated interregion differences. The magnitude of the racial gap in treatment delay varied by region, from 0.0% to 9.4%. Geographic region was significantly associated with risk of treatment delays for both Black and non-Black patients. The magnitude of racial disparities in treatment delay varied markedly between regions. Future studies should consider both high-risk geographic regions and high-risk patient groups for intervention to prevent delays.

Healthcare providers' attitudes towards delay in cancer treatment during COVID-19 pandemic

IntroductionThe COVID-19 pandemic has created unprecedented obstacles leading to delays in treatment for older adults with cancer. Due to limited resources at the height of the pandemic, healthcare providers were constantly faced with ethical dilemmas regarding postponing or rescheduling care for their patients. Materials and MethodsTwo survey-based studies were conducted at different time-points during the pandemic looking at factors affecting oncology care providers' attitudes towards delay in treatment for older adults with cancer. Eligible participants were recruited by email sent through professional organizations' listservs, email blasts, and social media. Change in provider attitude over time was analyzed by comparing responses from the 2020 and 2021 surveys. Data analysis included descriptive statistics and chi-squares. ResultsIn 2020, 17.5% of respondents were strongly considering/considering postponing cancer treatment for younger patients (age 30 and below), while 46.2% were considering delaying treatment for patients aged >85. These responses were in stark contrast to the results of the 2021 survey, where only 1.4% of respondents strongly considered postponing treatment for younger patients, and 13.5% for patients aged >85. DiscussionAll recommendations to postpone treatment for older adults with cancer must be made after mutual discussion with the patient. Throughout the COVID-19 pandemic, oncology care providers had to consider multiple factors while treating patients, frequently making most decisions without appropriate institutional support.

Evaluation of Inequities in Cancer Treatment Delay or Discontinuation Following SARS-CoV-2 Infection

There is a disproportionately greater burden of COVID-19 among Hispanic and non-Hispanic Black individuals, who also experience poorer cancer outcomes. Understanding individual-level and area-level factors contributing to inequities at the intersection of COVID-19 and cancer is critical. To evaluate associations of individual-level and area-level social determinants of health (SDOH) with delayed or discontinued cancer treatment following SARS-CoV-2 infection. This retrospective, registry-based cohort study used data from 4768 patients receiving cancer care who had positive test results for SARS-CoV-2 and were enrolled in the American Society for Clinical Oncology COVID-19 Registry. Data were collected from April 1, 2020, to September 26, 2022. Race and ethnicity, sex, age, and area-level SDOH based on zip codes of residence at the time of cancer diagnosis. Delayed (≥14 days) or discontinued cancer treatment (any cancer treatment, surgery, pharmacotherapy, or radiotherapy) and time (in days) to restart pharmacotherapy. A total of 4768 patients (2756 women [57.8%]; 1558 [32.7%] aged ≥70 years at diagnosis) were included in the analysis. There were 630 Hispanic (13.2%), 196 non-Hispanic Asian American or Pacific Islander (4.1%), 568 non-Hispanic Black (11.9%), and 3173 non-Hispanic White individuals (66.5%). Compared with non-Hispanic White individuals, Hispanic and non-Hispanic Black individuals were more likely to experience a delay of at least 14 days or discontinuation of any treatment and drug-based treatment; only estimates for non-Hispanic Black individuals were statistically significant, with correction for multiple comparisons (risk ratios [RRs], 1.35 [95% CI, 1.22-1.49] and 1.37 [95% CI, 1.23-1.52], respectively). Area-level SDOH (eg, geography, proportion of residents without health insurance or with only a high school education, lower median household income) were associated with delayed or discontinued treatment. In multivariable Cox proportinal hazards regression models, estimates suggested that Hispanic (hazard ratio [HR], 0.87 [95% CI, 0.71-1.05]), non-Hispanic Asian American or Pacific Islander (HR, 0.79 [95% CI, 0.46-1.35]), and non-Hispanic Black individuals (HR, 0.81 [95% CI, 0.67-0.97]) experienced longer delays to restarting pharmacotherapy compared with non-Hispanic White individuals. The findings of this cohort study suggest that race and ethnicity and area-level SDOH were associated with delayed or discontinued cancer treatment and longer delays to the restart of drug-based therapies following SARS-CoV-2 infection. Such treatment delays could exacerbate persistent cancer survival inequities in the United States.

Faktor Keterlambatan Pada Pasien Kanker Payudara Yang Berobat Di Rsucm Aceh Utara Tahun 2020 - 2021

cancer is a malignant tumor that begins in the cells in the breast derived from normal cells in the breast can come from the mammary glands, milk ducts, or supporting tissues such as fat. Delay in cancer management can be caused by several things, namely patient delay, doctor or medical personnel's ignorance (doctor delay) and pre-hospital delay (pre-hospital delay). Hospital delay is also a cause of delay in treatment in breast cancer patients, namely the time from the patient's arrival to the point of care until the start of the prescribed medical therapy guidelines. From some of these causes, it can also be grouped the factors that cause cancer delay in the form of predisposing factors, precipitation factors and supporting factors. The purpose of this study was to determine how the factors of delay in breast cancer treatment were treated at the Cut Meutia General Hospital, Aceh Utara. This type of research is descriptive analytic with a retrospective approach. The population in this study were inpatients and outpatients for breast cancer totaling 85 respondents using the Lemeshow formula. The results of the study showed that the value of knowledge was 37 people (43.5%), there was fear as many as 56 people (65.9%), low socioeconomic conditions as many as 40 people (47.1%), affordable health facilities were 64 people (75.3%), had insurance. As many as 77 people (90.6%), had visited alternative medicine as many as 49 people (57.6%) and had family support as many as 65 people (76.5%). The conclusion of this research is the importance of BSE (Breast Self-Examination) education to the public.

Delay Determinants in Seeking Cervical Cancer Treatment and Economic Burden among Patients at Selected Facilities in Imo State

Background: Cervical cancer is an important public health problem worldwide. In Nigeria women seeking cancer treatment see cost of uptake as a challenge. The objective of this study is to determine the determinants of delay in seeking cervical cancer treatment and economic burden among patients at selected facilities in Imo state. Methods: A hospital based descriptive cross sectional study was employed and a probability based multi-stage simple random sampling procedure was employed for the study in recruiting a total of 302 patients who participated in the study. A pretested structured questionnaire was used and statistical package for social sciences version 23.0 was used in the analysis of the study. Results: 32.6% (98) of the respondents were between 56-60 years of age and 19.5% (59) earned between ₦31,000-₦60,000. 57.1% of the women accepted to uptake cervical cancer treatment and 62.8% of the respondents confirmed they can afford to uptake cervical cancer treatment options. The study revealed that 26.7% of the women were able to afford supportive palliative care as a form of cervical cancer treatment. There was a statistically significant relationship between age (χ2 =12, df=4, p= 0.0035), occupation (χ2 = 0.321, df=5, p=0.00275), income level (χ2 = 8.57, df=3, p=0.0092), education level (χ2 = 17, df=2, p=0.0327) and uptake of cervical cancer treatment. Also, financial constraints (p=0.0031), attitude of health providers (p=0.0074), distance to facility (p=0.0015) and lack of information (p= 0.0038) showed significant association with the economic cost towards seeking cervical cancer treatment. Conclusion: Several demographic and economic factors contribute to the determinants of delay in seeking cervical cancer treatment and economic burden among patients at selected facilities in Imo state. Awareness campaigns must provide accurate information so that women can make informed choices.

Delayed treatment initiation and its associated factors among cancer patients at Northwest Amhara referral hospital oncology units: A cross-sectional study

BackgroundCancer is one of the major non-communicable diseases that impose an enormous burden both in low and middle-income countries. A cancer patient’s chance of survival is mainly determined by the time to treatment initiation, and when it is delayed, there is a lower chance of survival. Therefore, the objective of this study was to assess the magnitude of delayed cancer treatment initiation and its associated factors among patients at the oncology units of Northwest Amhara referral hospitals. MethodsAn institution-based cross-sectional study was conducted among 423 cancer patients enrolled in treatment between April 3, 2018, and August 13, 2021, at Northwest Amhara referral hospital oncology units. A systematic random sampling technique was applied to select study participants. The data was analyzed with Stata 14.1. A binary logistic regression model was fitted to identify factors associated with delayed cancer treatment initiation at a p-value < 0.05. ResultsOut of 415 patients included in the analysis, 275 (66.3%) were females, and the median age was 46 years (IQR: 40–54 years). The magnitude of delayed cancer treatment initiation was nearly 43%, and associated with the lowest wealth index level (AOR = 2.26; 95% CI: 1.03–4.94), body mass index (BMI) ≥ 25 kg/m2 (AOR = 3.38; 95% CI: 1.11–10.31), presence of comorbid illness (AOR = 2.07; 95% CI: 1.33–3.22), and Eastern Cooperative Oncology Group (ECOG) performance score of two (AOR = 2.78; 95% CI: 1.29–5.94). ConclusionA significant proportion of cancer patients were delayed in starting treatment. But it could be addressed by providing information about the negative consequences of delay.

Frequência e fatores associados ao atraso para o tratamento do câncer de mama no Brasil, segundo dados do PAINEL-Oncologia, 2019-2020

to analyze treatment delay and the flow of care for women with breast cancer in Brazil in 2019 and 2020. this was a follow-up study of breast cancer cases available from the Oncology Panel; a chi-square test and multilevel logistic regression were performed in order to analyze the explanatory variables associated with delay (greater than 60 days) in starting treatment. 22,956 cases (54.5%) with delay in treatment were identified in 2019 and 17,722 (48.7%) in 2020; the Southeast region (54.6%) had the greatest proportion of delay; delay was greater when treatment was provided outside the municipality of residence and lower in 2020 compared to 2019; most outward flows were to the capital cities in the same Federative Units of residence. strategies to reduce cancer treatment delay and optimize health care networks in the Federative Units should be prioritized.

Oral Cancer and the Tragedy of Thinking Inside the Box

Analyzing The National Cancer Data Base, Fujiwara et al. (2016) concluded that oral cancer treatment delay significantly impacts overall survival [2]. On December 26th, 2022, the following statement could be identified on the website of the National Cancer Institute: “There is inadequate evidence to establish whether screening would result in a decrease in mortality from the oral cavity and nasopharyngeal cancers” [3]

Abstract B123: Prevalence of COVID-19 among hematology/oncology patients and providers of a community-facing county health system during the B1.1.529 (“Omicron”) SARS-CoV-2 variant wave

Abstract Introduction: The SARS-CoV-2 (COVID-19) pandemic continues in the United States, and patients actively receiving chemotherapy are known to be at enhanced risk for developing symptomatic disease. Our study evaluated the prevalence of COVID-19 among patients and providers of our community-facing county health system during the B1.1.529 (“Omicron”) COVID-19 variant wave. Methods: We retrospectively analyzed patients that received care and clinical providers whom worked at the Jackson Memorial Hospital Hematology/Oncology clinic in Miami, Florida from December 1st, 2021 through April 30th, 2022. After categorizing basic demographic factors for individuals whom tested positive for COVID-19 during the study timeframe, we analyzed additional risk factors leading to COVID-19 positivity including, but not limited to, vaccination status, previous COVID-19 positivity, and active receipt of chemotherapeutics. We then analyzed outcomes related to COVID-19, including treatment with advanced COVID-19 therapies such as oral or intravenous antivirals, monoclonal antibodies, convalescent plasma, steroids, or interleukin-6 inhibitors; interactions with inpatient services including emergency department (ED)/urgent care visits, inpatient and/or ICU admissions, and deaths from COVID-19. We finally assessed quality outcomes such as delay in cancer-directed therapy. This study was approved by the University of Miami IRB and Jackson Health System Clinical Trials Office. Results: 498 patients and 18 providers were retrospectively analyzed during the study timeframe. 49 patients tested positive for COVID-19 (9.84%), while 6 providers tested positive (33.3%) (p = 0.015). Patients whom tested positive were 51.0% female (n = 25), 26.5% Black (n = 13), 73.5% Hispanic/Latinx (n = 36), and 2.05% Asian (n = 1). Only 6.12% patients had tested positive for COVID-19 previously (n = 3), and 42.9% were considered unvaccinated (n = 21) while 14.3% were boosted (n = 7). 73.5% (n = 36) presented with symptomatic disease, 46.9% (n = 23) sought care at an ED/urgent care, 32.6% (n = 13) were admitted to the hospital, 6.12% were admitted to the ICU (n = 3), and 16.3% (n = 8) received advanced therapeutics. There were 2 (8.0%) COVID-19-related deaths (and another outside our study timeframe) among 23 non-COVID-19 related deaths in the patient population (p = 0.75). More than half of the patients whom tested positive experienced a cancer treatment delay (n = 27/49; 55.1%). Conclusions: The prevalence of COVID-19 positivity in our patient cohort during the initial Omicron wave mirrored local, state, and national trends, however a statistically significant greater proportion of our providers tested positive. COVID-19 positivity conferred appreciable disparities in the presentation of disease as well as receipt of cancer treatment. COVID-19 positivity was more likely to result in symptomatic disease and ED/urgent care visit in cancer patients without previous COVID infection and unvaccinated status. COVID-19 accounted for 8.0% of our clinic’s total mortality. Citation Format: Aliya Khan, Samuel A. Kareff, Priscila Barreto-Coelho, Sunil Iyer, Brian Pico, Michele Stanchina, Giselle Dutcher, José Monteiro de Oliveira Novaes, Aparna Nallagangula, Gilberto Lopes. Prevalence of COVID-19 among hematology/oncology patients and providers of a community-facing county health system during the B1.1.529 (“Omicron”) SARS-CoV-2 variant wave [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B123.

What Has Changed During the COVID-19 Pandemic? - The Effect on an Academic Breast Department in Portugal.

One year ago, Portugal entered its first lockdown because of the coronavirus disease-2019 (COVID-19) pandemic. The impact of this on delays in cancer diagnosis and treatment is a major concern, which may negatively affect the outcomes of these patients. This retrospective, single-center analysis compared the clinical and pathological characteristics of breast cancer (BC) patients referred to a medical oncology first appointment between March 2020 and 2021, with the same period in the previous year. Strikingly, there was a 40% reduction in the number of BC patients during lockdown. However, there was a statistically significant increase in the proportion of metastatic BC patients admitted for the first time for systemic therapy (13.6% vs. 28.9%, p = 0.003). Additionally, a statistically significant increase in the number of patients with bilateral early BC at diagnosis after March 2020 was found (7.2% vs. 1.9%, p = 0.043). These findings support international recommendations for an accelerated restoration of BC screening, to reduce incidence of advanced breast cancer at diagnosis and mitigate the expected impact of the COVID-19 pandemic on patients with cancer. Further work is needed to examine in detail the impact of measures to manage the COVID-19 pandemic on breast cancer outcomes.

The COVID-19 Era Is Associated With Delays in Esophageal Cancer Diagnosis and Treatment

IntroductionThe coronavirus disease-2019 (COVID-19) pandemic has substantially affected the delivery of healthcare globally. The purpose of this study was to evaluate the association of this era with the timeline of care in esophageal cancer patients. MethodsWe performed a retrospective chart-review of patients presenting to a single high-volume tertiary care center with the diagnosis of esophageal cancer. COVID era was defined as March 2020-December 2020 and compared with the year before (3/2019-12/2019). ResultsIn total, 117 patients presented in the COVID-era versus 190 in pre-COVID. Stage 3 + 4 disease was found in 77.8% of the patients in the COVID-era compared to 68.9% in the pre-COVID era (P = 0.34). Diagnoses through emergency department admission were 35.5% in the COVID versus 26.7% in the pre-COVID group (P = 0.15). In the COVID era it took a median of 78 d to visit primary care provider (versus 52 d, P = 0.12 in pre-COVID), 45 d to endoscopy (versus 18 d, P = 0.004) and 38 d to treatment initiation (versus 36 d, P = 0.48). Thirty-five percent of the patients underwent esophagectomy compared to 26% in the pre-COVID-era. Median days of intensive-care-unit (ICU) (2 versus 3, P = 0.16) and hospital stay (14 versus 15, P = 0.28) were similar in both groups as well as postoperative 30-day morbidities (63 versus 63%, P = 0.48). One-year follow-up showed 83.7% (95% confidence interval [CI]: 73.8%-90.1%) survival in the COVID-group compared to 76.4% (95% CI: 66.9%-83.5%) in the pre-COVID-group (P = 0.58). Only three patients had a positive COVID result. ConclusionsOur institution treated fewer esophageal cancer patients during COVID-19 accompanied by a delay in endoscopic diagnosis. Postoperative outcomes and 1-year survival remained similar.

Improving equity in access to early diagnosis of cancer in different healthcare systems of Latin America: protocol for the EquityCancer-LA implementation-effectiveness hybrid study

IntroductionHealthcare fragmentation, a main cause for delay in cancer diagnosis and treatment, contributes to high mortality in Latin America (LA), particularly among disadvantaged populations. This research focuses on integrated care...

Oral Antiviral Therapy and Monoclonal Antibody for the Treatment of COVID-19 Infection in Outpatients Receiving Anti-Cancer Treatment for Hematological Malignancies: A Multicenter Prospective Study Exploring Efficacy, Safety and Predictors of COVID-19 Lung Failure

Background: Serious complications during SARS-CoV2 infection were reported in onco-haematological patients; in addition, COVID-19 can also indirectly force the interruption or delay of cancer treatment. Early administration of oral antivirals [molnupiravir (MOL) and nirmatrelvir/ritonavir (NIR/r)] or monoclonal antibody (Sotrovimab) may reduce hospitalization and death risk. However, data in hematological patients are lacking. Methods: Outpatients diagnosed with onco-hematologic malignancy presenting COVID-19 were treated with oral antivirals. Hospitalization and lung failure rate, overall mortality, and safety were analyzed. Results: Overall, 83 outpatients were prospectively enrolled in the study [median (q1-q3) age of 61 (48 - 72) years; males in 52% of cases]. All subjects were affected by B.1.1.529 (omicron) SARS-CoV2 variant. Notably, 75 (90%) were fully vaccinated against SARS-CoV2. A total of 33 (40%) was affected by HL/NHL, 21 (25%) by AML/MDS, 14 (17%) by CLL, 15 (18%) by other malignancies, including 4 ALL, 9 MM, and 2 CML. At the time of COVID-19, 11 (13%) were hematopoietic-stem-cell transplant recipients, 19 (23%) were treated with anti-CD20, 7 (8%) were under chronic steroid therapy. After multidisciplinary evaluation, 44 (53%) and 39 (47%) were treated with NIR/r and MOL, respectively; in addition, 14 (17%) patients underwent a combination therapy with Sotrovimab. Median (q1-q3) time from diagnosis of COVID-19 to therapy was of 1 (1-2) days. No grade 3-4 adverse events related to antiviral or Sotrovimab were reported. Overall, 7 (8%) patients were hospitalized for COVID-19 despite therapy. By performing a univariate and multivariate logistic regression, predictors of hospitalization were: recent administration of anti-CD20 (aOR=13.03, 95%CI=1.86-91.3), chronic steroid therapy (aOR=21.37, 95%CI=1.86-244), incomplete/lack of vaccination (aOR=16.07, 95%CI=1.45-177). Interestingly, the subgroup of patients affected by HL/NHL and CLL presented a longer viral shedding, if compared with AML/MDS and other malignancies groups (14 vs 14 vs 8 vs 8 days respectively, p=.031); similarly, persisting COVID-19 symptoms (>21 days) was significantly more frequent in HL/NHL group vs others (18% vs 0% in other groups, p=.020). Conclusions: The early administration of oral antivirals may be safe in onco-hematologic outpatients and could reduce the risk of hospitalization and death due to SARS-COV2 infection. Nevertheless, some groups of patients are still at higher risk and need further attention. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

15P Delays in breast cancer treatment in a tertiary hospital

The burden of treatment delay in breast cancer is high, especially among developing countries. Despite adversely affecting morbidity and mortality, this burden still remains largely unexplored. This study aimed to determine treatment delays among breast cancer patients in a tertiary hospital during surgery, neoadjuvant chemotherapy, and adjuvant chemotherapy and to identify predictors of delay.