R01CA265020

Assessing the Long-Term Impacts of the COVID-19 Pandemic on Disparities in Cancer Screening and Follow-Up - Project Summary/Abstract:

The COVID-19 pandemic has led to dramatic reductions in cancer screening and follow-up services. During the early months of the pandemic, national organizations recommended postponing all routine cancer screening, resulting in dramatic reductions in adult primary care and specialty care visits. Current rates remain far below pre-pandemic levels. Modeling suggests that these reductions will result in over 57,000 missed cancer diagnoses and 10,000 excess deaths over the next decade. However, these models are largely informed by data sources made up predominantly of insured patients and lacking race/ethnicity information. Thus, more information is needed to understand the strategies and resources needed to support the recovery of health systems and communities that have been most impacted by COVID-19.

The effects of the pandemic on cancer screening uptake may be particularly profound for patients served by resource-limited Federally Qualified Health Centers (FQHCs), which deliver services to a large share of patients with incomes below the federal poverty level and who are Latinx. Latinx populations already have some of the lowest rates of cancer screening and follow-up care in the United States and are likely to experience the largest reductions in care and slower return to normal following COVID-19. This is, in part, because their communities have been hit particularly hard by COVID-19 (e.g. high rates of COVID-19 infections and hospitalizations and job loss) and they may fear returning for preventive care even when medical authorities have deemed it safe.

Our proposed mixed-methods study will estimate the impact of the COVID-19 pandemic on rates of cancer screening and follow-up in patients served by a large, diverse FQHC (Aim 1), and estimate impacts on cancer outcomes (e.g. changes in life years gained, cancers prevented, and late-stage cancer incidence) in the FQHC population building on models developed by the CRC-SPN Cancer Intervention and Surveillance Modeling Network (Aim 2). Finally, we will gather qualitative data from clinic staff and patients to identify opportunities to improve post-pandemic cancer preventive care delivery for adults served by FQHCs (Aim 3).

There is a critical need to understand the long-term impacts of COVID-19 care reductions on vulnerable populations and identify opportunities to meet the ongoing cancer prevention needs of patients served by FQHCs. We will collaborate with national stakeholders to develop FQHC-specific guidance to inform future interventions to support recovery from COVID-like care disruptions. Thus, our findings will support access to care and reduction of health disparities for communities most impacted by COVID-19.

University Of Arizona

TO IDENTIFY CANCER RISKS AND RISK REDUCTION STRATEGIES, TO IDENTIFY FACTORS THAT CAUSE CANCER IN HUMANS, AND TO DISCOVER AND DEVELOP MECHANISMS FOR CANCER PREVENTION AND PREVENTIVE INTERVENTIONS IN HUMANS. RESEARCH PROGRAMS INCLUDE: (1) CHEMICAL, PHYSICAL AND MOLECULAR CARCINOGENESIS, (2) SCREENING, EARLY DETECTION AND RISK ASSESSMENT, INCLUDING BIOMARKER DISCOVERY, DEVELOPMENT AND VALIDATION, (3) EPIDEMIOLOGY, (4) NUTRITION AND BIOACTIVE FOOD COMPONENTS, (5) IMMUNOLOGY AND VACCINES, (6) FIELD STUDIES AND STATISTICS, (7) CANCER CHEMOPREVENTION AND INTERCEPTION, (8) PRE-CLINICAL AND CLINICAL AGENT DEVELOPMENT, (9) ORGAN SITE STUDIES AND CLINICAL TRIALS, (10) HEALTH-RELATED QUALITY OF LIFE AND PATIENT-CENTERED OUTCOMES, AND (11) SUPPORTIVE CARE AND MANAGEMENT OF SYMPTOMS AND TOXICITIES. SMALL BUSINESS INNOVATION RESEARCH (SBIR) PROGRAM: TO EXPAND AND IMPROVE THE SBIR PROGRAM, TO STIMULATE TECHNICAL INNOVATION, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT FUNDING, TO INCREASE SMALL BUSINESS PARTICIPATION IN FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION IN INNOVATION AND ENTREPRENEURSHIP BY WOMEN AND SOCIALLY/ECONOMICALLY DISADVANTAGED PERSONS. SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM: TO STIMULATE AND FOSTER SCIENTIFIC AND TECHNOLOGICAL INNOVATION THROUGH COOPERATIVE RESEARCH AND DEVELOPMENT CARRIED OUT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO FOSTER TECHNOLOGY TRANSFER THROUGH COOPERATIVE RESEARCH AND DEVELOPMENT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT FUNDING, AND FOSTER PARTICIPATION IN INNOVATION AND ENTREPRENEURSHIP BY WOMEN AND SOCIALLY/ECONOMICALLY DISADVANTAGED PERSONS.

93.393 - Cancer Cause and Prevention Research

National Cancer Institute (NCI) [HHS - NIH]

Tucson, Arizona 857210001 United States

Single Zip Code

Long-Term Effects of Disasters on Health Care Systems Serving Health Disparity Populations (R01- Clinical Trial Optional) (PA-20-172)

Amendment Since initial award the total obligations have increased 354% from $673,573 to $3,060,936.