{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,3,23]],"date-time":"2024-03-23T07:52:10Z","timestamp":1711180330004},"reference-count":17,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"5","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Clinical Cancer Informatics"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec><jats:title>PURPOSE<\/jats:title><jats:p> As health inequities during the pandemic have been magnified, we evaluated how use of SARS-CoV-2 testing differed by race or ethnicity in a large cohort of breast cancer survivors and examined the correlates of testing positive. <\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p> We conducted a retrospective cohort study of 22,481 adult breast cancer survivors who were active members of a large California integrated healthcare plan in 2020. We collected data on their breast cancer diagnosis, comorbidity, and demographic characteristics. We examined SARS-CoV-2 testing utilization between March 2020 and September 2020 by race or ethnicity, comorbidity, and other patient characteristics. We also examined the correlates of a having a positive SARS-CoV-2 test result. We conducted bivariable and multivariable logistic regression to identify correlates of testing utilization and test positivity. <\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p> Of these 22,481 women, 3,288 (14.6%) underwent SARS-CoV-2 testing. The cohort included 51.8% women of color. Of the 3,288 tested, 264 (8.0%) women had a positive test result. In multivariable analyses, Latinx survivors were more likely (adjusted odds ratio [OR], 1.23; 95% CI, 1.12 to 1.34) to undergo testing than White survivors; however, Asian or Pacific Islander survivors were 16% less likely to get tested (adjusted OR, 0.84; 95% CI, 0.75 to 0.94). Compared to White survivors, Latinx survivors were 3.5 times (adjusted OR, 3.47; 95% CI, 2.52 to 4.77) and Asian or Pacific Islander or Other survivors were 2.2-fold (adjusted OR, 2.23; 95% CI, 1.49 to 3.34) more likely to test positive. Being overweight (adjusted OR, 1.83; 95% CI, 1.24 to 2.72) or obese (adjusted OR, 2.04; 95% CI, 1.39 to 2.98) were also strongly associated with SARS-CoV-2 positivity. <\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p> Even in an integrated healthcare system, Asian or Pacific Islander patients were less likely to undergo SARS-CoV-2 testing than White survivors, but more likely to test positive. Additionally, Latinx ethnicity and high body mass index were strongly correlated with a greater odds of SARS-CoV-2 test positivity. <\/jats:p><\/jats:sec>","DOI":"10.1200\/cci.20.00158","type":"journal-article","created":{"date-parts":[[2021,2,4]],"date-time":"2021-02-04T21:37:34Z","timestamp":1612474654000},"page":"168-175","update-policy":"http:\/\/dx.doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":1,"title":["SARS-CoV-2 Testing, Positivity Rates, and Healthcare Outcomes in a Cohort of 22,481 Breast Cancer Survivors"],"prefix":"10.1200","author":[{"given":"Reina","family":"Haque","sequence":"first","affiliation":[{"name":"Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA"},{"name":"Kaiser Permanente Bernard J. Tyson School of Medicine, Department of Health Systems Science, Pasadena, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"LieHong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"233","reference":[{"key":"b1","author":"Zhang H","journal-title":"J Natl Cancer Inst"},{"key":"b2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(20)30096-6"},{"key":"b3","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2020.0980"},{"key":"b4","volume-title":"Health Equity Considerations and Racial and Ethnic Minority Groups","author":"Centers for Disease Control"},{"key":"b5","volume-title":"Current Population Reports, P60-267(RV), Health Insurance Coverage in the United States: 2018","author":"Berchick ER","year":"2019"},{"key":"b6","volume-title":"Care Without Coverage: Too Little, Too Late","author":"Institute of Medicine (US): Committee on the Consequences of Uninsurance","year":"2002"},{"key":"b7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa2011686"},{"key":"b8","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2020.05.003"},{"key":"b9","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyl056"},{"key":"b10","doi-asserted-by":"publisher","DOI":"10.1037\/dev0000511"},{"key":"b11","doi-asserted-by":"publisher","DOI":"10.1016\/j.sste.2020.100355"},{"key":"b12","volume-title":"Unequal Opportunities in Education [online]","author":"The Annie E. Casey Foundation","year":"2006"},{"key":"b13","volume-title":"Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care","author":"Institute of Medicine, Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care","year":"2003"},{"key":"b14","doi-asserted-by":"publisher","DOI":"10.3322\/canjclin.54.2.78"},{"key":"b15","doi-asserted-by":"publisher","DOI":"10.3322\/CA.2007.0011"},{"key":"b16","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlr.0000182534.19832.83"},{"key":"b17","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-021816"}],"container-title":["JCO Clinical Cancer Informatics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/CCI.20.00158","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,29]],"date-time":"2022-05-29T07:31:18Z","timestamp":1653809478000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/CCI.20.00158"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12]]},"references-count":17,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["10.1200\/CCI.20.00158"],"URL":"https:\/\/doi.org\/10.1200\/cci.20.00158","relation":{},"ISSN":["2473-4276"],"issn-type":[{"value":"2473-4276","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12]]},"assertion":[{"value":"2020-11-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-08","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-02-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}