Search

The coronavirus disease 2019 (COVID‐19) pandemic led to health care disruptions and declines in cancer diagnoses in the United States. However, the impact of the pandemic on cancer incidence rates by stage at diagnosis and race and ethnicity is unknown. This cross‐sectional study calculated delay‐ and age‐adjusted incidence rates, stratified by stage at diagnosis and race and ethnicity, and rate ratios (RRs) comparing changes in year‐over‐year incidence rates (eg, 2020 vs 2019) from 2016 to 2020 for 22 cancer types based on data obtained from the Surveillance, Epidemiology, and End Results 22‐registry database. From 2019 to 2020, the incidence of local‐stage disease statistically significantly declined for 19 of the 22 cancer types, ranging from 4% (RR = 0.96; 95%CI, 0.93‐0.98) for urinary bladder cancer to 18% for colorectal (RR = 0.82; 95%CI, 0.81‐0.84) and laryngeal (RR = 0.82; 95%CI, 0.78‐0.88) cancers, deviating from pre‐COVID stable year‐over‐year changes. Incidence during the corresponding period also declined for 16 cancer types for regional‐stage and six cancer types for distant‐stage disease. By race and ethnicity, the decline in local‐stage incidence for screening‐detectable cancers was generally greater in historically marginalized populations. The decline in cancer incidence rates during the first year of the COVID‐19 pandemic occurred mainly for local‐ and regional‐stage diseases across racial and ethnic groups. Whether these declines will lead to increases in advanced‐stage disease and mortality rates remain to be investigated with additional data years. Nevertheless, the findings reinforce the importance of strengthening the return to preventive care campaigns and outreach for detecting cancers at early and more treatable stages. [ABSTRACT FROM AUTHOR]

Despite advances in cancer control—prevention, screening, diagnosis, treatment, and survivorship—racial disparities in cancer incidence and survival persist and, in some cases, are widening in the United States. Since 2020, there's been growing recognition of the role of structural racism, including structurally racist policies and practices, as the main factor contributing to historical and contemporary disparities. Structurally racist policies and practices have been present since the genesis of the United States and are also at the root of environmental injustices, which result in disproportionately high exposure to environmental hazards among communities targeted for marginalization, increased cancer risk, disruptions in access to care, and worsening health outcomes. In addition to widening cancer disparities, environmental injustices enable the development of polluting infrastructure, which contribute to detrimental health outcomes in the entire population, and to climate change, the most pressing public health challenge of our time. In this commentary, we describe the connections between climate change and cancer through an Environmental Justice perspective (defined as the fair treatment and meaningful involvement of people of all racialized groups, nationalities, or income, in all aspects, including development, implementation, and enforcement, of policies and practices that affect the environment and public health), highlighting how the expertise developed in communities targeted for marginalization is crucial for addressing health disparities, tackling climate change, and advancing cancer control efforts for the entire population. [ABSTRACT FROM AUTHOR]

The impact of disasters on the delivery of health services suggests that patients with cancer should be identified as a vulnerable population that requires additional attention and assistance during a disaster. Incorporating the special case of these patients into an event management framework can elevate resilience, decrease suffering, and save lives. [ABSTRACT FROM AUTHOR]

The dependent coverage expansion (DCE) and Medicaid expansions (ME) under the Affordable Care Act (ACA) may differentially affect eligibility for health insurance coverage in young adult cancer patients. Studies examining temporal patterns of coverage changes in young adults following these policies are lacking. We used data from the National Cancer Database 2003–2015 to conduct a quasi-experimental study of cancer patients ages 19–34 years, grouped as DCE-eligible (19- to 25-year-olds) and DCE-ineligible (27- to 34-year-olds). Although private insurance coverage in DCE-eligible cancer patients increased incrementally following DCE implementation (0.5 per quarter; P <.001), an immediate effect on Medicaid coverage gains was observed after ME in all young adult cancer patients (3.01 for DCE-eligible and 1.62 for DCE-ineligible, both P <.001). Therefore, DCE and ME each had statistically significant and distinct effects on insurance coverage gains. Distinct temporal patterns of ACA policies' impact on insurance coverage gains likely affect patterns of receipt of cancer care. Temporal patterns should be considered when evaluating the impact of health policies. [ABSTRACT FROM AUTHOR]