Covid-19, breast cancer care, and social determinants of health: a cross-sectional study to investigate the impact of a pandemic on health and health care
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Royal College of Surgeons in Ireland 123 St. Stephens Green Ireland
Royal College of Surgeons in Ireland
Publication date: 2023-04-26
Popul. Med. 2023;5(Supplement):A811
Health services for non-communicable diseases, including cancer, were significantly disrupted during COVID-19. Breast cancer (BC) is the most common cancer for women and the on-going impact of the pandemic on BC care needs to be established. The aims of this study were to explore the impact of COVID-19 stressors on healthcare services and quality of life (QoL) in women living with and beyond BC in Ireland and whether the impact varied by social determinants of health (SDH).

This cross-sectional study was conducted from September 2020 to April 2021. Questionnaire data was collected on predictor variables (e.g. COVID-19 impact, SDH, and clinical characteristics) and outcome variables (e.g. disrupted health services and QoL). The association between COVID-19 impact, disruption to BC services, and QoL was assessed using multivariable regression models. The interaction between COVID-19 impact and health insurance status was assessed within each model.

Of the 387 women who completed the survey, 30.5% reported a high COVID-19 impact and most women reported disrupted BC care. Women who reported a high COVID-19 impact reported significantly more disrupted BC services (p<0.001) and a lower QoL (p<0.001) compared to women who reported a low COVID-19 impact. Private health insurance was found to significantly moderate the impact of COVID-19 on BC services and QoL. Women with a high COVID-19 impact and no insurance experienced significantly more disruption to BC services and lower QoL compared to women with low COVID-19 impact and private insurance (p<0.05).

There was a large disruption to BC services and low QoL for women with BC in Ireland, however, the impact of COVID-19 was not the same for all women. It is important to identify the women who experienced a larger impact during the pandemic so they can be reintegrated into proper BC care, along the entire cancer continuum.

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