PD03-11: Patient-reported delays in treatment for urologic cancers during the Covid-19 pandemic: A national cross-sectional analysis

Jacob Lang*, Sree Jambunathan, Toledo, OH, Eashwar Somasundaram, Cleveland, OH, Nagalakshmi Nadiminty, Firas Petros, Ahmed El-Zawahry, Obi Ekwenna, Puneet Sindhwani, Toledo, OH

Introduction: The Covid-19 pandemic has disrupted every facet of medical care, without exception in urologic cancer care. Access to care and surgery rates significantly decreased during the initial period of the pandemic, but the overall impact on care and survival has not yet been fully appreciated. This study aims to characterize and analyze patient reported delays in treatment or ancillary care due to the pandemic for the two most common urologic cancers, prostate cancer (PC) and bladder cancer (BC) at the national level.

Methods: This retrospective, cross-sectional study used the National Health Interview Survey 2020, which consists of a nationally representative sample of 31,568 adults 18 or older. Data were then weighted to account for complex survey design and provide national estimates. Patients with a known history of PC or BC were included. Proportion of patients reporting changes, delays, or cancellations to cancer treatment or other ancillary care during the pandemic were analyzed and compared across cancer groups.

Results: A sample-weighted estimate of 1,720,245 patients with history of PC (n=1,439,867, 83.7%) or BC (n=280,379, 16.3%) of known treatment or other care status during Covid-19 were included. 282,929 (16.5%) reported receiving or supposed to be receiving treatment since the start of the pandemic, while 298,116 (17.3%) reported needing other care including lab visits, imaging, monitoring visits, rehabilitation, physical therapy, care for side-effects, or visits with medical specialists. Of those receiving or supposed to be receiving treatment, 76,984 (27.2%; 95% CI 15.7-43.0%) reported their cancer treatment was changed, delayed, or cancelled due to the pandemic, with no significant difference between those with history of PC vs. BC (27.2% vs. 27.5%; P=.99). Of those needing other care, 73,189 (24.5%; 95% CI 13.8-39.7%) reported change, delay, or cancellation due to the pandemic, again with no significant difference between patients with history of PC vs. BC (24.4% vs. 26.0%; P=0.93).

Conclusions: Approximately ¼ of PC and BC patients requiring treatment or other ancillary care during the pandemic reported change, delay, or cancellation. Delays in BC treatment have previously been shown to increase mortality, thus necessitating further study of the long-term implications of delays due to the Covid-19 pandemic on outcomes.

Source of Funding: None