Examining COVID-19 Preventive Behaviors among Cancer Survivors in the United States: An Analysis of the COVID-19 Impact Survey

Background: The COVID-19 pandemic has impacted adults with chronic diseases, and their health care delivery. Patterns of COVID-19-related preventive behaviors practiced by cancer survivors are unknown, including practices related to canceling doctor's appointments. We evaluated COVID-19-related preventive behaviors among cancer survivors in the United States. Methods: We used nationally representative data of 10,760 U.S. adults from the COVID-19 Impact Survey. We defined cancer survivors as those with a self-reported diagnosis of cancer (n = 854, 7.6%). We present frequencies and chi(2) tests to evaluate COVID-19-related preventive behaviors among cancer survivors. We estimated determinants of canceling doctor's appointments among cancer survivors using Poisson regression models. Results: Cancer survivors were more likely to practice preventive behaviors, including social distancing (93%, chi(2) P < 0.001), wearing a face mask (93%, chi(2) P < 0.001), and avoiding crowded areas (84%, chi(2) P < 0.001) compared with adults without cancer. Cancer survivors were more likely to cancel doctor's appointments (41%, chi(2) P < 0.001), whereas they were less likely to cancel other social activities such as work (19%, chi(2) P < 0.001) and school-related (13%, chi(2) P < 0.001) activities. After adjustment for covariates, while non-Hispanic (NH)-Black cancer survivors were less likely to cancel a doctor's appointment compared with NH-White cancer survivors, cancer survivors aged 18 to 29, who were female, and who had least one comorbid condition were more likely. Conclusions: Cancer survivors are adhering to recommended preventive behaviors. Cancer survivor's continuity of care may be impacted by COVID-19, specifically young adults, females, and those with existing comorbid conditions. Impact: Insights into cancer survivors whose care may be most impacted by COVID-19 will be valuable toward surveillance and survivorship of U.S. cancer survivors.