Abstract B129: The association of Covid-19 pandemic restrictions with patient-reported outcomes and lifestyle behaviors among breast cancer survivors: Evidence from a cohort of Black and Hispanic breast cancer survivors in New Jersey
Authors: Sanchez-Diaz Carola T. , Zeinomar Nur , Iyer Hari S. , Perlstein Marley , Hong Chi-Chen , Qin Bo , Bandera Elisa V. 
Published: December 2023

Abstract
Purpose: The onset of COVID-19 pandemic restrictions in the US since March 2020 has worsened the disproportionate burden of physical and mental health challenges faced by vulnerable Black and Hispanic breast cancer (BrCa) patients. BrCa survivors experienced delays in their cancer treatments and limited access to supportive care, which may lead to further physical, and psychosocial challenges during an already difficult time. This study aimed to evaluate the association of the COVID-19 pandemic restrictions with patient-reported outcomes (PROs) (i.e. health-related quality of life (HRQoL), sleep, perceived stress, coping and financial toxicity), and lifestyle behaviors (i.e. obesity, smoking, and alcohol) among Black and Hispanic BrCa survivors participating in the Women’s Circle of Health Follow-Up 1 (WCHSFU1) and the New Jersey Breast Cancer Survivors Study (NJBCS), two ongoing population-based studies in New Jersey. Methods: The NJBCS followed similar methods to those in the WCHSFU1. We included a total of 447 Black (npre=364 and npost=83) and 182 Hispanic (npre=102 and npost=80) BrCa survivors who completed a home interview ~24 months post-diagnosis, from 2017 to 2023. The COVID-19 pandemic era was defined as pre- (recruited prior to March 2020) and post-(recruited after March 2020) pandemic. To assess the association of the pandemic with PROs and lifestyle behaviors we employed multivariable adjusted Poisson regression models with robust standard errors to estimate prevalence ratios with 95%CI. Results: Compared to the pre-pandemic group, Black survivors in the post-pandemic group were more likely to be educated, to have higher income, and to be foreign-born, while Hispanic women were significantly more likely to have private insurance and higher HRQoL, physical and emotional well-being mean scores (p&lt;0.05 for all). Adjusted Poisson models indicated that Hispanic women in the post-pandemic group had 1.53 times higher prevalence of low resilience (vs high resilience) (PR:1.53 95% CI: 1.15-2.04), compared to the pre-pandemic group. Whereas Black women in the post-pandemic group reported a higher prevalence of clinically significant sleep disturbance and efficiency (PR: 1.43 95% CI: 1.23-1.68 and PR:1.50 95% CI: 1.30 – 1.73, respectively), compared to the pre-pandemic group. Both Hispanic and Black women in the post-pandemic group showed significantly less perceived stress and a lower prevalence of alcohol consumption. Conclusion: We found heterogeneity in the prevalence of PROs and lifestyle behaviors by pandemic era among Black and Hispanic survivors. Notably, we also noticed differences in demographic characteristics of women participating after the onset of the pandemic, which highlights the importance of considering the impact of the pandemic in all aspects of research, including the interpretation of findings. Continuing research to untangle important factors contributing to racial and ethnic differences in patient characteristics, PROs and lifestyle behaviors post-pandemic in cancer survivorship is warranted.
Citation Format: Carola T. Sanchez-Diaz, Nur Zeinomar, Hari S. Iyer, Marley Perlstein, Chi-Chen Hong, Bo Qin, Elisa V. Bandera. The association of Covid-19 pandemic restrictions with patient-reported outcomes and lifestyle behaviors among breast cancer survivors: Evidence from a cohort of Black and Hispanic breast cancer survivors in New Jersey [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B129.