Researchers from the Weill Cornell Medical College in New York City evaluated how the pandemic impacted cancer treatment, anxiety, and financial distress among Medicaid-insured patients treated for gynecologic cancer at their center. Their findings were published in Cancer.
The team conducted telephone interviews with 100 patients between March and April 2020. The median patient age was 60 years and 71% made <$40,000 annually. The 50-question survey covered topics like patient demographics, current cancer treatment, care delays, telemedicine use, financial anxiety, and COVID-19 symptoms, hospitalization, and testing access.
Participants making <$40,000 annually had increased anxiety and cancer-related worry than those making >$40,000 per year (P = 0.036 and P = 0.017, respectively). Twenty-one percent of patients reported a change in employment due to the pandemic, and these individuals experienced increased financial distress compared to those whose job status remained unchanged (P < 0.001). Half of patients reported feeling more financial stress since the pandemic began, and 54% reported worry about future finances. Patients diagnosed with early stage cancer (stage I and II) and those who participated in telemedicine were more likely to worry about future finances (P = 0.017 and P = 0.04, respectively).
“Patients with cancer are already financially vulnerable as many face changes in employment status when they undergo treatment, and also because cancer treatments can become costly as they accrue over time,” said co-author Y. Stefanie Chen, MD, via press release. “Patients with low income may struggle to prioritize cancer care and treatments over other costs of daily living, especially when they face changes in employment not only due to their cancer diagnosis but also due to the changes in the job market caused by the pandemic.”
Delays in medical care were found to be significant source of distress and were associated with a four-fold increase in anxiety (P = 0.023; 95% confidence interval 1.278–14.50).
“The ongoing COVID‐19 pandemic has highlighted existing inequities in health care, and consideration of alternative methods to achieve health equity are pertinent,” wrote the authors in conclusion. “Increased screening for anxiety and financial toxicity in this population is essential, as is a restructuring of practices to minimize delays in care while maintaining appropriate social distancing and safe practices for both providers and patients.”