The first year of the COVID-19 pandemic and health among cancer survivors in the United States

• Authors: Xuesong Han, Emory University; Sylvia Kewei Shi, American Cancer Society; Jingxuan Zhao, American Cancer Society; Leticia Nogueira, Emory University; Priti Bandi, American Cancer Society; Stacey Fedewa, Emory University; Ahmedin Jemal, Emory University; Karen Yabroff, Emory University
• Journal Title: CANCER
• Volume: Volume 128, Number 20
• Publisher: WILEY | 2022-08-22, Pages 3727-3733
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1002/cncr.34386
• Subjects: Health Sciences, Oncology
• Keywords: Science & Technology; Life Sciences & Biomedicine; Oncology; cancer survivorship; coronavirus disease 2019 (COVID-19) pandemic; employment; health behaviors; insurance coverage; self-reported health

Abstract

Background: Cancer survivors represent a population with high health care needs. If and how cancer survivors were affected by the first year of the coronavirus disease 2019 (COVID-19) pandemic are largely unknown. Methods: Using data from the nationwide, population-based Behavioral Risk Factor Surveillance System (2017–2020), the authors investigated changes in health-related measures during the COVID-19 pandemic among cancer survivors and compared them with changes among adults without a cancer history in the United States. Sociodemographic and health-related measures such as insurance coverage, employment status, health behaviors, and health status were self-reported. Adjusted prevalence ratios of health-related measures in 2020 versus 2017–2019 were calculated with multivariable logistic regressions and stratified by age group (18–64 vs. ≥65 years). Results: Among adults aged 18–64 years, the uninsured rate did not change significantly in 2020 despite increases in unemployment. The prevalence of unhealthy behaviors, such as insufficient sleep and smoking, decreased in 2020, and self-rated health improved, regardless of cancer history. Notably, declines in smoking were larger among cancer survivors than nonelderly adults without a cancer history. Few changes were observed for adults aged ≥65 years. Conclusions: Further research is needed to confirm the observed positive health behavior and health changes and to investigate the role of potential mechanisms, such as the national and regional policy responses to the pandemic regarding insurance coverage, unemployment benefits, and financial assistance. As polices related to the public health emergency expire, ongoing monitoring of longer term effects of the pandemic on cancer survivorship is warranted.