Table 3.
Multivariable associations of demographic and clinical characteristics of survivors of adolescent and young adult cancers and changes in healthcare utilization during the COVID-19 pandemic
| Models | Delayed/skipped care from March 2020 to January 2021 | Changes to medication obtainment or use because of the COVID-19 pandemic | ||||
|---|---|---|---|---|---|---|
| Cancer care | Other care | Obtainmenta | Use | |||
| OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | |||
| 1 | Gender | Female | 0.83 (0.39–1.76) | 2.41 (1.26–4.62)* | 1.17 (0.62–2.20) | 1.49 (0.71–3.15) |
| Male | 1 | 1 | 1 | 1 | ||
| 2 | Marital status | Divorced/widowed/separated | 1.65 (0.37–7.36) | 1.56 (0.42–5.82) | 3.32 (1.08–10.2)* | 0.55 (0.14–2.10) |
| Married/cohabitating | 1.28 (0.54–3.05) | 2.34 (1.15–4.76)* | 0.64 (0.31–1.33) | 0.31 (0.13–0.73)* | ||
| Single | 1 | 1 | 1 | 1 | ||
| 3 | Sexuality | LGBTQ + | 2.25 (0.65–7.80) | 0.64 (0.20–2.10) | 1.72 (0.62–4.73) | 3.51 (1.35–9.11)* |
| Cis-heterosexual | 1 | 1 | 1 | 1 | ||
| 4 | Education | ≤ High school | 0.77 (0.14–4.34) | 0.77 (0.22–2.68) | 2.63 (0.68–10.1) | 0.60 (0.11–3.11) |
| Some college | 1.32 (0.37–4.69) | 0.95 (0.38–2.38) | 1.53 (0.50–4.68) | 1.01 (0.29–3.52) | ||
| College | 0.93 (0.26–3.38) | 1.15 (0.46–2.88) | 1.39 (0.45–4.36) | 0.80 (0.22–2.93) | ||
| Grad school | 1 | 1 | 1 | 1 | ||
| 5 | Health insurance | Employer/military/individual | 0.60 (0.26–1.42) | 0.76 (0.37–1.56) | 0.42 (0.21–0.82)* | 0.50 (0.23–1.08) |
| Public, uninsured, unknown | 1 | 1 | 1 | 1 | ||
| 6 | Diagnosis age (years) | 15–19 | 0.32 (0.02–4.61) | 0.21 (0.03–1.35) | 0.69 (0.11–4.28) | 1.32 (0.15–11.5) |
| 20–24 | 1.38 (0.14–13.5) | 0.24 (0.04–1.32) | 0.85 (0.16–4.66) | 1.19 (0.15–9.65) | ||
| 25–29 | 1.30 (0.16–10.6) | 0.22 (0.05–1.07) | 1.11 (0.23–5.28) | 1.26 (0.18–8.87) | ||
| 30–34 | 2.43 (0.53–11.1) | 0.46 (0.12–1.73) | 1.45 (0.41–5.07) | 1.53 (0.30–7.86) | ||
| 35–40 | 1 | 1 | 1 | 1 | ||
| 7 | Diagnosis | CNS and nervous system | 0.66 (0.16–2.81) | 0.50 (0.12–2.11) | 1.42 (0.24–8.37) | 1.02 (0.08–12.7) |
| Carcinoma | 0.58 (0.15–2.21) | 0.76 (0.23–2.53) | 1.61 (0.30–8.57) | 2.46 (0.28–21.9) | ||
| Gonadal or related tumors | 0.39 (0.06–2.56) | 0.20 (0.03–1.27) | 1.66 (0.24–11.7) | 5.74 (0.51–64.2) | ||
| Leukemia or lymphoma | 0.35 (0.09–1.37) | 1.32 (0.41–4.29) | 1.67 (0.33–8.47) | 2.66 (0.31–22.7) | ||
| Sarcoma | 0.47 (0.09–2.56) | 1.66 (0.42–6.56) | 0.96 (0.14–6.35) | 3.61 (0.36–36.7) | ||
| Melanoma | 1 | 1 | 1 | 1 | ||
| 8 | Therapy since March 2020 | No | 0.88 (0.41–1.89) | 1.42 (0.78–2.60) | 1.37 (0.74–2.52) | 1.74 (0.84–3.62) |
| Yes | 1 | 1 | 1 | 1 | ||
aAdaptive behaviors to find more affordable medications
Models for cancer care exclude n = 33 and other care exclude n = 57 with delayed/skipped care due to provider/facility preference. Persons with no information on medication obtainment (n = 68) or use (n = 61) were excluded
Model 1 controls for survey age and race/ethnicity. Models 2–7 control for gender, survey age, and race/ethnicity
OR, odds ratio; CI, confidence interval. *p < 0.05