SARS-COV-2 Environmental Constraint Effects on Cancer Prevention and Management Outcomes

The Univ. of Colorado Cancer Center (UCCC) will participate in a consortium with other NCI-designated cancer centers to conduct a cross-sectional study within their respective regional catchment area populations. The consortium is led by the Univ. of Alabama (UAB), Birmingham's O'Neal Comprehensive Cancer Center. The first aim of the consortium is to investigate whether the SARS-COV-2 pandemic has impacted individuals' behaviors known to be associated with the development or prevention of cancer malignancies such as tobacco use, alcohol consumption, and physical activity. We are interested in investigating whether constraints due to the pandemic such as social distancing, loss of employment, and mental health challenges have affected individuals' health behaviors differently due to their age, race/ethnicity, rural/urban residency, or socio-economic status. UCCC will survey 1,500 individuals who experience cancer disparities in our catchment (Colorado), including individuals of Hispanic descent, who live in poverty, and reside in rural or frontier counties. We will use the Univ. of Colo. Health Survey Registry (Registry) to draw a sub-sample of individuals from these populations in Colorado. The Registry is enrolled from respondents to the statewide Tobacco Attitudes and Behavior Survey (TABS) on Health, a crosssectional population survey conducted in Colorado. The second aim of the consortium is to investigate whether constraints associated with the pandemic impacted cancer patients and survivors' ability to receive cancer treatment, follow-up or surveillance procedures, treatment regimens as prescribed, participation clinical trials, and interventions to manage pain and treatment side-effects. We will investigate if the pandemic impacted these outcomes differently for patients based on differences in their demographic characteristics, type of cancer diagnosed and stage of diagnosis, as well as their treatment status (active treatment, posttreatment survivorship). Moreover, we are also interested in investigating whether the SARS-COV-2 pandemic negatively affected outcomes that are important to cancer patients (patient-centered outcomes) such as their social and emotional functioning, quality of life, coping, social support/connectedness, and financial hardship due to loss of employment or health insurance associated with the pandemic's constraints. In Colorado, we will leverage our collaboration with UCCC's Oncology Research Information Exchange Network (ORIEN)/Total Cancer Care study platform to field a survey to 1,000 cancer patients and survivors who have been previously consented at UCCC to be contacted for research purposes. Constructs measured will be examined using descriptive statistics, with focus on how specific groups differ. Geospatial information will be used to compare area-based measures (e.g., socioeconomic indicators) to individual-level measures. Multilevel modeling will be conducted to understand the relationship between demographic variables and cancer preventive and cancer management outcomes and how the relationship is moderated by the SARS-COV-2 pandemic.