Suboptimal Quality of Health Care and Associated Socioeconomic Factors Among Cancer Survivors During the COVID-19 Pandemic: A Cross-Sectional Study

We described disruptions in cancer-related healthcare appointments and perceived quality of healthcare during the COVID-19 pandemic and identified predictors, including socioeconomic factors, of perceived quality of healthcare among cancer survivors. In this cross-sectional study, we used 2021 Health Information National Trends Survey-Surveillance, Epidemiology, and End Results data from Iowa, Greater Bay Area (California), and New Mexico cancer registries. Among cancer survivors who visited a healthcare provider in the past 12-months (N = 1130), we reported weighted prevalence of disruptions in (cancelled and/or changed to telehealth) routine cancer screening, disruptions in cancer treatment or follow-up, and perceived quality of healthcare, by registry. Using logistic regression, we identified predictors associated with perceived quality of healthcare, adjusting for sex and age. Among cancer survivors with scheduled appointments, 25.0% (Iowa) to 39.6% (California) reported disrupted cancer screening and 16.6% (Iowa) to 33.9% (California) reported disrupted treatment or follow-up related to their cancer diagnosis. 12.5% (Iowa) to 22.5% (New Mexico) of survivors perceived suboptimal quality of healthcare. Survivors with disrupted cancer screening, lower education and income, longer wait times for results, did not spend enough time with their doctor, and did not receive assistance with health uncertainty had increased odds of perceiving suboptimal quality of healthcare (odds ratio range = 2.64-19.31). Disruptions in cancer screening, lower socioeconomic status, and negative patient experiences were associated with poorer perceived quality of healthcare. Continued efforts are needed to address existing disparities to ensure equitable access to quality of healthcare post-pandemic.