Cancer Care Access in Chile's Vulnerable Populations During the COVID-19 Pandemic.

Abstract

<b>Objectives.</b> To examine the COVID-19 pandemic's impact on cancer care access in Chile, analyzing differential effects by insurance type, gender, and age. <b>Methods.</b> We conducted a quasi-experimental study using interrupted time series analysis. We used multiple data sources for a broad evaluation of cancer-related health care utilization from January 2017 to December 2020. We fit negative binomial models by population groups for a range of services and diagnoses. <b>Results.</b> A sharp drop in oncology health care utilization in March was followed by a slow, incomplete recovery over 2020. Cumulative cancer-related services, diagnostic confirmations, and sick leaves were reduced by one third in 2020; the decrease was more pronounced among women and the publicly insured. Early diagnosis was missed in 5132 persons with 4 common cancers. <b>Conclusions.</b> The pandemic stressed the Chilean health system, decreasing access to essential services, with a profound impact on cancer care. Oncology service reductions preceded large-scale lockdowns and supply-side disruptions. Importantly, not all population groups were equally affected, with patterns suggesting that gender and socioeconomic inequalities were exacerbated. (<i>Am J Public Health</i>. 2022;112(S6):S591-S601. https://doi.org/10.2105/AJPH.2021.306587).