Delays In Cancer Treatment Research Articles

Development of a Model to Estimate the Association Between Delay in Cancer Treatment and Local Tumor Control and Risk of Metastases

The coronavirus disease 2019 (COVID-19) pandemic has led to treatment delays for many patients with cancer. While published guidelines provide suggestions on which cases are appropriate for treatment delay, there are no good quantitative estimates on the association of delays with tumor control or risk of new metastases. To develop a simplified mathematical model of tumor growth, control, and new metastases for cancers with varying doubling times and metastatic potential and to estimate tumor control probability (TCP) and metastases risk as a function of treatment delay interval. This decision analytical model describes a quantitative model for 3 tumors (ie, head and neck, colorectal, and non-small cell lung cancers). Using accepted ranges of tumor doubling times and metastatic development from the clinical literature from 2001 to 2020, estimates of tumor growth, TCP, and new metastases were analyzed for various treatment delay intervals. Risk estimates for potential decreases in local TCP and increases in new metastases with each interval of treatment delay. For fast-growing head and neck tumors with a 2-month treatment delay, there was an estimated 4.8% (95% CI, 3.4%-6.4%) increase in local tumor control risk and a 0.49% (0.47%-0.51%) increase in new distal metastases risk. A 6-month delay was associated with an estimated 21.3% (13.4-30.4) increase in local tumor control risk and a 6.0% (5.2-6.8) increase in distal metastases risk. For intermediate-growing colorectal tumors, there was a 2.1% (0.7%-3.5%) increase in local tumor control risk and a 2.7% (2.6%-2.8%) increase in distal metastases risk at 2 months and a 7.6% (2.2%-14.2%) increase in local tumor control risk and a 24.7% (21.9%-27.8%) increase in distal metastases risk at 6 months. For slower-growing lung tumors, there was a 1.2% (0.0%-2.8%) increase in local tumor control risk and a 0.19% (0.18%-0.20%) increase in distal metastases risk at 2 months, and a 4.3% (0.0%-10.6%) increase in local tumor control risk and a 1.9% (1.6%-2.2%) increase in distal metastases risk at 6 months. This study proposed a model to quantify the association of treatment delays with local tumor control and risk of new metastases. The detrimental associations were greatest for tumors with faster rates of proliferation and metastasis. The associations were smaller, but still substantial, for slower-growing tumors.

Examining patterns of and reasons for delays to treatment in colon cancer.

52 Background: Delays in colon cancer (CC) treatment can impact patient outcomes. Detailed examination into the patterns and reasons for delay in the diagnostic and pre-treatment work up are understudied, hindering the development of strategies to improve timeliness of care. Methods: CC patients diagnosed at an urban academic institution in 2018 were investigated. Chart review yielded presentation location, diagnostic-work up, treatment and patient characteristics. Time between presentation to the healthcare provider to treatment initiation of ≥ 60 days was considered a delay (Total_Delay). Total time further examined as 3 phases: presentation to diagnosis (PtoD), diagnosis to staging completion (DtoS), and staging completion to treatment (StoT). Delays for each phase was defined as ≥ 30 days. Total_Lt60d vs non-Total_Ge60d were compared. A logistic regression model was used to calculate odds ratio (OR) and 95% confidence intervals (CI) to identify associations with Total_Ge60d. Results: Among 121 CC patients, the median time and interquartile range (IQR) between presentation and treatment initiation was 29 (IQR 8, 53) days. Total_Delay occurred in 21% of patients. The median time between presentation and treatment and interquartile range (IQR) for Total_Delay was 106 (IQR 82, 162) and 16 (IQR 6, 39) for non-Total_Delay. Age, sex, race, and comorbidities were similar between Total_Delay and non-Total_Delay. Total_Delay patients were generally more functionally independent (92% vs 74%, p < .06), presented to locations other than the emergency department (64% vs 42%, p < .075) and were less likely to have hospital admission work-up (20% vs 60%, p < .001) compared to non-Total_Delay. The logistic model showed that Total_Delay is associated with non-hospital work-up (OR 8.3, 95% CI 1.9-45.3), adjusting for comorbidities, symptoms, functional status, cancer severity, and insurance. Delays similarly occurred in all three phases for Total_Delay patients; 48% had delay during PtoD, 60% during DtoS, and 48% during StoT. The most common reason for delay by phase was the following; in the PtoD phase, 5 of 11 (46%) was due to obtaining endoscopy, in DtoS and StoT, 6 of 15 (40%) and 5 of 11 (46%), respectively, was in getting outpatient specialty appointments. Delays due to patient factors (PtoD 18%, DtoS 27%, StoT 28%) were less frequent. Conclusions: Delays to treatment for CC are largely driven by health systems delays. Bundling of diagnostic evaluation and pre-treatment that mimics work-up during a hospital admission may overcome delays in cancer care.

Pancreatic Cancer–Associated Diabetes is Clinically Distinguishable From Conventional Diabetes

BackgroundType 3c diabetes mellitus (T3cDM) is diabetes secondary to other pancreatic diseases such as chronic pancreatitis, pancreatic resection, cystic fibrosis, and pancreatic ductal adenocarcinoma (PDA). Clinically, it may easily be confused with conventional type 2 diabetes mellitus (T2DM). A delay in pancreatic cancer diagnosis and treatment leads to a worse outcome. Therefore, early recognition of PDA-associated T3cDM and distinction from conventional T2DM represents an opportunity improve survival in patients with PDA. MethodsSix hundred and sixty four patients with PDA underwent pancreatic resection. Patients were classified as per whether or not they had diabetes. The specific type of diabetes was determined. T3cDM surgical patients (n = 127) were compared with a control group of medical patients with T2DM who did not have PDA (n = 127). ResultsPatients with T3cDM were older (66 versus 61 y, P < 0.001), had lower body mass indices (25.9 versus 32.1, P < 0.001), more favorable hemoglobin A1c levels (7.0 versus 8.8, P < 0.001), higher alanine aminotransferase levels (39 versus 20, P < 0.001), and lower creatinine levels (0.8 versus 0.9 mg/dL, P < 0.001). In addition, they were more likely to be insulin dependent. In a subgroup analysis of surgical patients, T3cDM (versus surgical patients with T2DM and no diabetes) was not associated with surrogate markers of main pancreatic duct obstruction and glandular atrophy. ConclusionsPDA-associated T3cDM has a distinctive presenting phenotype compared with medical patients with conventional T2DM. Greater attention to associated signs, symptoms, and biochemical data could identify patients at risk for harboring an underlying pancreatic malignancy and trigger diagnostic pathways leading to earlier PDA diagnosis and treatment.

IMPACT OF THE COVID-19 PANDEMIC ON THE AVAILABILITY OF MEDICAL CARE AMONG ONCOLOGICAL PATIENTS

The aim: Cancer is the second most common cause of death in Polish society. The healthcare system, already overwhelmed in many countries, has been further burdened by the outbreak of the SARS-CoV-2 pandemic. The healthcare system has become inefficient, especially in the oncology care sector. Surgeries, scheduled treatments, and follow-up appointments in some hospitals have been canceled or rescheduled to the “next available date after the end of the pandemic”. This research aims to analyze the impact of the COVID-19 pandemic on the availability of medical care among oncological patients and compare them with the results of studies on the effects of postponement of oncology treatment. Materials and methods: The study included a group of 544 respondents from all over Poland. The research tool was a self-administered survey questionnaire. Results: 37%, of those undergoing systemic treatment, experienced postponement of their treatment, and in the case of radiotherapy, it was 35%. Visits to the clinical oncologist/radiotherapist specialist were postponed in 51% of respondents. Imaging studies were delayed in 41.7% of respondents. Conclusions: The course of the COVID-19 pandemic has significantly impacted the health care system and, therefore, also on the availability of medical care among oncologicalpatients. The results signal an emerging problem. These visit shifts may negatively affect the outcome of cancer treatment. The potential risk of COVID-19 infection should beindividually balanced against cancer treatment delay in each patient. The ongoing pandemic, therefore, prompts a careful analysis of the effects of deferring cancer therapy.

Breast Cancer Screening and the COVID-19 Pandemic.

The novel SARS-CoV2 (COVID-19) pandemic has had a major impact on breast radiology practices. Initially, nonessential imaging studies, including screening mammography, were curtailed and even temporarily halted when lockdowns were instituted in many parts of the United States. As a result, imaging volumes plummeted while health care institutions worked to ensure safety measures were in place to protect patients and personnel. As COVID-19 infection levels started to stabilize in some areas, breast radiology practices sought guidance from national organizations, such as the Centers for Disease Control and Prevention, the Centers for Medicare and Medicaid Services, and radiology specialty societies, to develop strategies for patients to safely return for screening mammograms and other outpatient imaging studies. Postponement of breast cancer screening has led to delays in cancer diagnosis and treatment that could negatively affect patient outcomes for years to come. In order to continue to provide necessary imaging services, breast radiologists will need to face and overcome ongoing practical challenges related to the pandemic, such as negative financial impacts on practices and patients, the need for modifications in delivery of imaging services and trainee education, and differences in the health care system as a whole, including the shift to telehealth for clinical care. Nonetheless, despite the disruption the COVID-19 pandemic has caused, the need for breast radiology procedures, including breast cancer screening, remains strong.

Delays in lung cancer diagnosis and treatment: real-life assessment in a tertiary care center

Introduction: Clinical guidelines recommend rapid evaluation of patients with suspected lung cancer. There are few data concerning delays in the diagnostic process of lung cancer in Portugal and adherence to recommendations. The aim of this work is to review and analyze the different phases in the process of diagnosis, staging, therapeutic decision and treatment within a pulmonology department. Methods: Retrospective, single -center cohort study, with identification and analysis of the different stages of the pathway taken by patients with suspected lung cancer. The study contemplates the flow design and characterization related to waiting times. Descriptive statistical analysis of waiting times in each step and total waiting times and comparison with available guidelines. Results: 77 patients included, predominantly male (72.7%), mean age of 66. Mean time from admission to start of treatment was 68 days (±55.2). Most patients underwent bronchoscopy (71.4%), which was conclusive in 54.6%; 39 patients (50.6%) needed a second exam and 14 (18.2%) a third one. Mean time from multidisciplinary decision to treatment was 14 days (±25.6). There were great differences between modalities: 6 days (±8) to chemotherapy, 5 days (±2) to radiation therapy and 63 days (±33) to surgery. Adherence to guidelines varied between 36.4% and 50.6% concerning total time and between 44.2% and 58.4% for time from diagnosis to treatment. Conclusion: Total time of the process exceeded main guidelines in 6 to 26 days; however, there was considerable heterogeneity and results do not differ greatly from other published data. Proposing an optimized workflow may shorten critical stages and improve global performance, allowing for improvements in doctor and patient’s expectations.

The Fear Returns: Messaging in the Age of Coronavirus Disease 2019 (COVID-19)

The Fear Returns: Messaging in the Age of Coronavirus Disease 2019 (COVID-19)

The “New Normal” of Cancer Treatment Delays Is Nothing New

The “New Normal” of Cancer Treatment Delays Is Nothing New

Hypofractionated chemoradiation for head and cancer: Data from the PET NECK trial.

There has been increased interest in hypofractionated accelerated chemoradiation for head and neck cancer during the recent first peak of the COVID-19 pandemic. Prospective data regarding this approach from randomised trials is lacking. In the PET NECK study, 564 patients with squamous cell carcinoma of the head and neck receiving definitive chemoradiation were randomised to either planned neck dissection or PET CT scan guided surveillance. In this surgical trial, three radiotherapy fractionation schedules delivered over 7, 6 or 4 weeks were permitted with synchronous chemotherapy. The purpose of this study was to determine efficacy and quality of life outcomes associated with the use of these schedules.Primary local control and overall survival in addition to quality of life measures at immediately post treatment and 6, 12 and 24 months post-treatment were compared between the three fractionation cohorts.In the 525 patients where fractionation data was available, 181 (34%), 288 (55%) and 56 (11%) patients received 68–70 Gy in 34–35 fractions (#), 60–66 Gy in 30# and 55 Gy in 20# respectively. At a minimum follow up of two years following treatment there was no significant difference between the three fractionation schemes in local control, overall survival or any quality of life measure.Despite the obvious limitations of this study, some data is provided to support the use of hypofractionated accelerated chemoradiation to avoid delays in cancer treatment and reduce hospital visits during the peak of a pandemic. Data from on-going randomised trials examining hypofractionated chemoradiation may be useful for selecting fractionation schedules during future pandemics.

Approach to Cancer-Associated Thrombosis: Challenging Situations and Knowledge Gaps.

Malignancy is a significant risk factor for venous thromboembolism (VTE). It is estimated that up to 20% of patients with cancer may develop VTE at some time in their cancer journey. Cancer-associated VTE can lead to hospitalizations, morbidity, delayed cancer treatment, and mortality. The optimal prevention and management of cancer-associated thrombosis (CAT) is of utmost importance. Direct oral anticoagulants have been recommended as first-line therapy for VTE treatment in the general population and their efficacy has recently been demonstrated in the cancer population, leading to increased use. However, patients with cancer have unique challenges and comorbidities that can lead to increased risks and concerns with anticoagulation. Herein we will discuss commonly encountered challenges in patients with CAT, review available literature, and provide practice suggestions. IMPLICATIONS FOR PRACTICE: This article aims to specifically address cancer-associated thrombosis issues for which there is limited or absent evidence to guide best practice, for circumstances that pose unique challenges for clinicians, and for directions when the literature is conflicting. It reviews pertinent data for each selected topic and provides guidance for patient management based on the best available evidence and experiences from the panel.

COVID-19: A time of heightened uncertainty for cancer patients and increased need for psychosocial support

COVID-19: A time of heightened uncertainty for cancer patients and increased need for psychosocial support

Delayed Urological Cancer Care during the COVID-19 Pandemic: Urologists' Experience.

The arrival of coronavirus disrupted health care systems and forced delays in cancer treatment. We explored the experience of urologists who had to delay their patients' cancer care. Urologists who treat prostate, bladder, and renal cancers, selected through purposive sampling, responded to a survey about cancer treatment delay. They were asked about their practice setting, decision making and interactions with patients, and they were asked to reflect on their personal experience. A 0 to 10 point scale, modeled on the National Comprehensive Cancer Network' Distress Thermometer (NCCN-DT), validated for cancer patients with cancer, was used to estimate physician distress. We used descriptive statistics to analyze survey results. Of the 64 participating urologists, 98% delayed surgical treatment; fewer delayed cases of advanced cancers (42% for ≥T3/T4 or Gleason ≥8 prostate cancers, 58% for muscle invasive bladder cancer, 61% for ≥T2 renal cancers). They reported feeling anxious (44%) and helpless (29%), and their median distress score was 5 (range 0-10). They relied on their own risk assessments (67%) and consulted colleagues (56%) and national guidelines (53%) when making treatment deferral decisions. They identified a number of concerns as they resumed surgeries. Based on a comparison to the NCCN-DT clinical cutoff distress level of 4, urologists experienced moderately high levels of distress as they delayed cancer care during the COVID-19 pandemic and expressed concerns going forward. While the focus on patient care is paramount in a pandemic, it is important to recognize physician distress and develop practical and psychological strategies for distress mitigation.

Abstract PO-177: Cancer burden and survival among transgender patients in the United States

Abstract Background: Cancer burden among transgender patients is currently unknown due to a paucity of available data. Transgender patients face many barriers to healthcare, including discrimination, stigma, and lack of health insurance. Consequently, there may be delays in cancer diagnoses and treatment, resulting in increased cancer mortality among transgender individuals compared to cisgender persons. We sought to examine cancer stage at diagnosis, cancer treatment, and survival among transgender patients compared to cisgender patients in a large national cancer database. Methods: Data from the National Cancer Database (NCDB) included patients diagnosed with cancer between 2003 – 2016. Gender was recorded by physicians in the medical record and we included individuals categorized as “Male”, “Female”, or “Transsexual” (transgender). We examined primary cancers with ≥10 cases occurring in transgender adults aged ≥18 years. Multivariable logistic regression was used to estimate odds ratios (ORs) for advanced stage at diagnosis (stages III and IV versus stages 0, I, and II) and receipt of cancer treatment (e.g. surgery, chemotherapy, radiotherapy, or a combination) comparing transgender and cisgender patients for each cancer site. Hazard ratios (HRs) were estimated with Cox proportional hazards regression to estimate the associations between physician- recorded gender and all-cause survival for each cancer site. Models were adjusted for age at diagnosis, race/ethnicity, insurance status, year of diagnosis, stage at diagnosis, and treatment receipt as applicable. Results: There were 589 transgender cancer patients among the ≥11 million patients in NCDB. Differences in stage at diagnosis, treatment, and survival between transgender and cisgender cancer patients were not broadly observed across cancer sites. However, transgender patients with lung and bronchus cancer may be more likely to be diagnosed at later stages (OR: 1.76, 95% CI: 0.95, 3.28) than cisgender patients. In addition, compared to cisgender patients, transgender patients were less likely to receive treatment for kidney cancer (OR: 0.22, 95% CI: 0.09, 0.55). Finally, survival was worse in transgender patients compared to cisgender patients with non-Hodgkin lymphoma (HR: 2.36; 95% CI: 1.51, 3.70) and urinary bladder cancer (HR: 2.03, 95% CI: 1.31, 3.14). Conclusion: For specific cancers types, transgender patients may be diagnosed at a later stage, be less likely to receive treatment, and have worse survival. However, this study was hampered by the small number of transgender patients and the lack of self-reported gender identity separate from natal sex. Routine collection of gender identity in cancer registries and patient records will allow for improved estimates of cancer incidence, risk, and more meaningful comparisons between transgender and cisgender cancer patients. There is an urgent need to expand our knowledge of cancer burden among transgender individuals as this population grows and ages. Citation Format: Sarah S. Jackson, Xuesong Han, Ziling Mao, Leticia Nogueria, Gita Suneja, Ahmedin Jemal, Meredith S. Shiels. Cancer burden and survival among transgender patients in the United States [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-177.

The COVID-19 pandemic and impact on breast cancer diagnoses: what happened in England in the first half of 2020

Delays in cancer diagnosis and treatment due to the COVID-19 pandemic is a widespread source of concern, but the scale of the challenge for different tumour sites is not known. Routinely collected NHS England Cancer Waiting Time data were analysed to compare activity for breast cancer in the first 6 months of 2020 compared to the same time period in 2019. The number of referrals for suspected breast cancer was 28% lower (N = 231,765 versus N = 322,994), and the number of patients who received their first treatment for a breast cancer diagnosis was 16% lower (N = 19,965 versus N = 23,881). These data suggest that the number of breast cancers diagnosed during the first half of 2020 is not as low as initially feared, and a substantial proportion of the shortfall can be explained by the suspension of routine screening in March 2020. Further work is needed to examine in detail the impact of measures to manage the COVID-19 pandemic on breast cancer outcomes.

Cancer treatment delays caused by the COVID-19 pandemic may not hinder outcomes.

Cancer treatment delays caused by the COVID-19 pandemic may not hinder outcomes.

A Multidisciplinary Lung Cancer Program: Does It Reduce Delay Between Diagnosis and Treatment?

Lung canceris the leading cause of cancer death in the USA, claiming more than 140,000 deaths annually. Delays in diagnosis and treatment can lead to missed opportunities for both curative and life prolonging therapies. This study aimed to evaluate duration of time to diagnosis and first treatment, as well as investigate reasons for delays in care. This retrospective study included all lung cancer cases diagnosed by Stony Brook's Lung Cancer Evaluation Center (LCEC) between 2013 and 2019. Demographic, radiologic, pathologic and clinical variables were investigated, including cancer staging, histology, and medical and family histories. Evaluations included the determination of median time from initial encounter to diagnosis, median time from diagnosis to start of treatment and an exploration of the factors that influence possible causes for delays in care. The LCEC's comprehensive multidisciplinary lung nodule program yielded a median length of time from CT to PET of 11days, PET to procedure of 13days, procedure to treatment consult of 9days, and from consult to treatment of 9days. LCEC patients experienced an overall median of 44days from initial presentation to first treatment compared to the national ideal of 62days, thereby representing a 29% reduction in time from first CT to onset of treatment. Delays in lung cancer diagnosis and treatment can negatively impact patient morbidity and mortality. This study suggests that a coordinated multidisciplinary lung cancer program may reduce delays in care, thereby improving patient outcomes.

Mortality due to cancer treatment delay: systematic review and meta-analysis

ObjectiveTo quantify the association of cancer treatment delay and mortality for each four week increase in delay to inform cancer treatment pathways.DesignSystematic review and meta-analysis.Data sourcesPublished studies in Medline from...

Differences in terms of presentation and outcomes between patients with lung cancer as opposed to other solid organ cancer after infection with SARS-CoV-2: protocol for a systematic review

IntroductionScholars believe that COVID-19 can be particularly lethal for patients with cancer. Some studies found that COVID-19 appears to be more lethal in patients with lung cancer than in other...

Identifying Risk Profiles of Malignant Prostate Cancer Surgical Delay Using a Person-Centered Approach to Understand Prostate Cancer Disparities: The Constellation of Health Determinants Using Latent Class Analysis on Cancer Registry Data.

Surgical prostate cancer (PCa) treatment delay (TD) may increase the likelihood of recurrence of disease, and influence quality of life as well as survival disparities between Black and White men. We used latent class analysis (LCA) to identify risk profiles in localized, malignant PCa surgical treatment delays while assessing co-occurring social determinants of health. Profiles were identified by age, marital status, race, county of residence (non-Appalachian or Appalachian), and health insurance type (none/self-pay, public, or private) reported in the Tennessee Department of Health cancer registry from 2005 to 2015 for adults ≥18 years (N = 18,088). We identified three risk profiles. The highest surgical delay profile (11% of the sample) with a 30% likelihood of delaying surgery >90 days were young Black men, <55 years old, living in a non-Appalachian county, and single/never married, with a high probability of having private health insurance. The medium surgical delay profile (46% of the sample) with a 21% likelihood of delay were 55–69 years old, White, married, and having private health insurance. The lowest surgical delay profile (42% of the sample) with a 14% likelihood of delay were ≥70 years with public health insurance as well as had a high probability of being White and married. We identified that even with health insurance coverage, Blacks living in non-Appalachian counties had the highest surgical delay, which was almost double that of Whites in the lowest delay profile. These disparities in PCa surgical delay may explain differences in health outcomes in Blacks who are most at-risk.

Integrated Survival Estimates for Cancer Treatment Delay Among Adults With Cancer During the COVID-19 Pandemic

Cancer treatment delay has been reported to variably impact cancer-specific survival and coronavirus disease 2019 (COVID-19)-specific mortality during the severe acute respiratory syndrome coronavirus 2 pandemic. During the pandemic, treatment delay is being recommended in a nonquantitative, nonobjective, and nonpersonalized manner, and this approach may be associated with suboptimal outcomes. Quantitative integration of cancer mortality estimates and data on the consequences of treatment delay is needed to aid treatment decisions and improve patient outcomes. To obtain quantitative integration of cancer-specific and COVID-19-specific mortality estimates that can be used to make optimal decisions for individual patients and optimize resource allocation. In this decision analytical model, age-specific and stage-specific estimates of overall survival pre-COVID-19 were adjusted by the probability of COVID-19 (individualized by county, treatment-specific variables, hospital exposure frequency, and COVID-19 infectivity estimates), COVID-19 mortality (individualized by age-specific, comorbidity-specific, and treatment-specific variables), and delay of cancer treatment (impact and duration). These model estimates were integrated into a web application (OncCOVID) to calculate estimates of the cumulative overall survival and restricted mean survival time of patients who received immediate vs delayed cancer treatment. Using currently available information about COVID-19, a susceptible-infected-recovered model that accounted for the increased risk among patients at health care treatment centers was developed. This model integrated the data on cancer mortality and the consequences of treatment delay to aid treatment decisions. Age-specific and cancer stage-specific estimates of overall survival pre-COVID-19 were extracted from the Surveillance, Epidemiology, and End Results database for 691 854 individuals with 25 cancer types who received cancer diagnoses in 2005 to 2006. Data from 5 436 896 individuals in the National Cancer Database were used to estimate the independent impact of treatment delay by cancer type and stage. In addition, data from 275 patients in a nested case-control study were used to estimate the COVID-19 mortality rate by age group and number of comorbidities. Data were analyzed from March 17 to May 21, 2020. COVID-19 and cancer. Estimates of restricted mean survival time after the receipt of immediate vs delayed cancer treatment. At the time of the study, the OncCOVID web application allowed for the selection of up to 47 individualized variables to assess net survival for an individual patient with cancer. Substantial heterogeneity was found regarding the association between delayed cancer treatment and net survival among patients with a given cancer type and stage, and these 2 variables were insufficient to discriminate the net impact of immediate vs delayed treatment. Individualized overall survival estimates were associated with patient age, number of comorbidities, treatment received, and specific local community estimates of COVID-19 risk. This decision analytical modeling study found that the OncCOVID web-based application can quantitatively aid in the resource allocation of individualized treatment for patients with cancer during the COVID-19 global pandemic.