The Impact of COVID-19 on cancer screening and treatment in older adults: the multiethnic cohort study

Abstract
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Abstract

Background: The Coronavirus Disease of 2019 (COVID-19) has impacted the health and day-to-day life of individuals, especially the elderly and people with certain pre-existing medical conditions, including cancer. The purpose of this study was to investigate how COVID-19 impacted access to cancer screenings and treatment, by studying the participants in the Multiethnic Cohort (MEC) study.

Methods: The MEC has been following over 215,000 residents of Hawai'i and Los Angeles for the development of cancer and other chronic diseases since 1993-1996. It includes men and women of five racial and ethnic groups: African American, Japanese American, Latino, Native Hawaiian, and White. In 2020, surviving participants were sent an invitation to complete an online survey on the impact of COVID-19 on their daily life activities, including adherence to cancer screening and treatment. Approximately 7,000 MEC participants responded. A cross-sectional analysis was performed to investigate the relationships between the postponement of regular health care visits and cancer screening procedures or treatment with race and ethnicity, age, education, and comorbidity.

Results: Women with more education, women with lung disease, COPD, or asthma, and women and men diagnosed with cancer in the past 5 years were more likely to postpone any cancer screening test/procedure due to the COVID-19 pandemic. Groups less likely to postpone cancer screening included older women compared to younger women and Japanese American men and women compared to White men and women.

Conclusions: This study revealed specific associations of race/ethnicity, age, education level, and comorbidities with the cancer-related screening and healthcare of MEC participants during the COVID-19 pandemic. Increased monitoring of patients in high-risk groups for cancer and other diseases is of the utmost importance as the chance of undiagnosed cases or poor prognosis is increased as a result of delayed screening and treatment.

Funding: This research was partially supported by the Omidyar 'Ohana Foundation and grant U01 CA164973 from the National Cancer Institute.

Data availability

The Multiethnic Cohort welcomes applications from researchers to maximize the utility of the MEC data and/or specimens for prevention and etiological research on cancer and other chronic diseases. For access, a research application is required. To request access to the MEC resource for data analyses or ancillary studies, and to submit an application, please visit https://www.uhcancercenter.org/for-researchers/mec-data-sharing for further instructions. You will need to request an account in the system if you do not already have one. Proposals for access to MEC data or biospecimen are reviewed quarterly by the MEC Research Committee (MECRC) and must be submitted by the following deadlines: December 1, March 1, June 1, and September 1. All applications are reviewed by the MECRC following a standard procedure. The Statistical Analysis System (SAS), version 9.4 codes used for this study are available upon request. If you have questions please contact Gail Ichida at gichida@cc.hawaii.edu.

Article and author information

Author details

Victoria P Mak

Population Sciences in the Pacific Program, University of Hawaii at Manoa, Honolulu, United States

For correspondence
vmak@hawaii.edu

Competing interests
The authors declare that no competing interests exist.

"This ORCID iD identifies the author of this article:" 0000-0002-0908-5018
Kami White

Population Sciences in the Pacific Program, University of Hawaii at Manoa, Honolulu, United States

Competing interests
The authors declare that no competing interests exist.
Lynne R Wilkens

Population Sciences in the Pacific Program, University of Hawaii at Manoa, Honolulu, United States

Competing interests
The authors declare that no competing interests exist.
Iona Cheng

Department of Epidemiology and Biostatistics, University of California, San Francisco, Fremont, United States

Competing interests
The authors declare that no competing interests exist.
Christopher A Haiman

Center for Genetic Epidemiology, University of Southern California, Los Angeles, United States

Competing interests
The authors declare that no competing interests exist.

"This ORCID iD identifies the author of this article:" 0000-0002-0097-9971
Loic Le Marchand

Population Sciences in the Pacific Program, University of Hawaii at Manoa, Honolulu, United States

Competing interests
The authors declare that no competing interests exist.

Funding

Hawaii Community Foundation (Omidyar 'Ohana Fund,20DA-101546)

Loic Le Marchand

National Cancer Institute (U01 CA164973)

Lynne R Wilkens
Christopher A Haiman
Loic Le Marchand

The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.

Ethics

Human subjects: All participants provided informed consent before filling out the survey. The study was approved by the IRBs of the University of Hawaii (CHS 9575) and the University of Southern California (HS-17-00714).

Copyright

This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.