Cancer Management during the COVID-19 Pandemic in the United States: Results from a National Physician Cross-sectional Survey

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Abstract

Objectives:The coronavirus disease 2019 (COVID-19) has significantly impacted health care delivery across the United States, including treatment of cancer. We aim to describe the determinants of treatment plan changes from the perspective of oncology physicians across the United States during the COVID-19 pandemic.Methods:Participants were recruited to an anonymous cross-sectional online survey of oncology physicians (surgeons, medical oncologists, and radiation oncologists) using social media from March 27 to April 10, 2020. Physician demographics, practice characteristics, and cancer treatment decisions were collected.Results:The analytic cohort included 411 physicians: 241 (58.6%) surgeons, 106 (25.8%) medical oncologists, and 64 (15.6%) radiation oncologists. In all, 38.0% were practicing in states with 1001 to 5000 confirmed COVID-19 cases as of April 3, 2020, and 37.2% were in states with >5000 cases. Most physicians (N=285; 70.0% of surgeons, 64.4% of medical oncologists, and 73.4% of radiation oncologists) had altered cancer treatment plans. Most respondents were concerned about their patients' COVID-19 exposure risks, but this was the primary driver for treatment alterations only for medical oncologists. For surgeons, the primary driver for treatment alterations was conservation of personal protective equipment, institutional mandates, and external society recommendations. Radiation oncologists were primarily driven by operational changes such as visitor restrictions.Conclusions:The COVID-19 pandemic has caused a majority of oncologists to alter their treatment plans, but the primary motivators for changes differed by oncologic specialty. This has implications for reinstitution of standard cancer treatment, which may occur at differing time points by treatment modality.

Original languageEnglish (US)
Pages (from-to)679-684
Number of pages6
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume43
Issue number10
DOIs
StatePublished - Oct 1 2020

Bibliographical note

Funding Information:
From the Departments of *Surgery; †Radiation Oncology; ‡Obstetrics, Gynecology and Women’s Health; §Division of Hematology, Oncology, and Transplantation; and ∥School of Public Health, University of Minnesota, Minneapolis, MN. This research was supported in part by the National Institutes of Health’s National Center for Advancing Translational Sciences, grant UL1TR002494. This research was also supported in part by the National Cancer Institute P30 Cancer Center Support Grant, grant CA77598, of Masonic Cancer Center, University of Minnesota. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health’s National Center for Advancing Translational Sciences or of the National Cancer Institute. The authors declare no conflicts of interest. Reprints: Jane Yuet Ching Hui, MD, MS, 420 Delaware St SE, MMC 195, Minneapolis, MN 55455. E-mail: jhui@umn.edu. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved. ISSN: 0277-3732/20/4310-0679 DOI: 10.1097/COC.0000000000000757

Publisher Copyright:
© 2020 Lippincott Williams and Wilkins. All rights reserved.

Keywords

  • cancer
  • oncologists
  • pandemics
  • surveys
  • treatment

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural

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