Abstract S07-01: Examining COVID-19 preventive behaviors among cancer survivors in the United States: An analysis of the COVID-19 Impact Survey
Authors: Islam Jessica Y. , Camacho-Rivera Marlene , Vidot Denise C. 
Published: December 2020

Abstract
Background: Cancer survivors are at high risk of contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the infection that leads to COVID-19, as they are generally older and cancer therapies frequently lead to immunosuppression. Recently, to mitigate exposure the CDC recommended avoiding nonessential doctor appointments, which may lead to barriers in effective continuity of care and surveillance of cancer survivors during the COVID-19 pandemic. The patterns of COVID-19 preventive behaviors practiced by cancer survivors are unknown, including practices related to canceling doctors’ appointments.
Objective: Our objective was to evaluate COVID-19-related preventive behaviors among cancer survivors in the United States (US). We further examined behaviors related to canceling or postponing activities, specifically doctors’ appointments.
Methods: We utilized nationally representative weighted data from a sample of 4,428 US adults from the COVID-19 Impact Survey collected during Week 1 (April 20-26, 2020) and Week (May 4-10, 2020). We defined cancer survivors as those with a self-reported prior diagnosis of cancer. We presented frequencies and used χ2 tests to compare COVID-19-related preventive behaviors among cancer survivors to other adults. We calculated prevalence ratios with 95% confidence intervals using Poisson regression and robust estimation of standard errors to estimate determinants of canceling doctors’ appointments among cancer survivors.
Results: Cancer survivors were mostly over the age of 60 years (62%), female (53%), non-Hispanic White (62%), and resided in urban areas (72%). Cancer survivors adhered to most recommended COVID-19-related preventive behaviors and were more likely to maintain social distancing (92%, χ2 p-value=0.005), wear a face mask (89%, χ2 p-value=0.001), and avoid crowded areas (84%, χ2 p-value=0.048) compared to other adults. Additionally, we found that cancer survivors are more likely to cancel their doctors’ appointments (44%, χ2 p-value=0.001) whereas they were less likely to cancel other social activities such as work (20%, χ2 p-value=0.001) and school-related (12%, χ2 p-value=0.002) activities, even among those below the age of 60. However, cancer survivors were more likely to report symptoms in the last 7 days, including muscle or body aches (χ2 p-value=0.003). The proportion of cancer patients who have canceled doctors’ appointments due to COVID-19 rose from the month of April (35%) to May (52%). Younger adults aged 18-29 years, females, and rural cancer survivors were more likely to cancel their doctors’ appointments, whereas NH-Blacks are less likely to cancel a doctor's appointment when compared to NH-Whites.
Conclusion: Cancer survivors are adhering to recommended preventive behaviors. Cancer survivors’ continuity of care may be impacted by COVID-19, specifically young adults, females, and rural residents.
Citation Format: Jessica Y. Islam, Marlene Camacho-Rivera, Denise C. Vidot. Examining COVID-19 preventive behaviors among cancer survivors in the United States: An analysis of the COVID-19 Impact Survey [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr S07-01.