Impact of COVID-19 pandemic on surgical cancer care disparities according to socioeconomic status

Objectives This study aimed to examine whether healthcare scarcity during the COVID-19 pandemic amplified prior socioeconomic disparities in access to Dutch surgical cancer care. Study design Retrospective population-based cohort study Methods Patients who underwent surgery for lung, oesophageal, gastric, pancreatic, or malignant liver tumours were identified in national quality of care registries. A pandemic cohort (15-03-2020 to 24-04-2022) was compared with a pre-pandemic cohort (2018–2019). Socioeconomic status (SES) was based on postal-code–level scores. Primary outcome was the difference in SES distribution between cohorts. Secondary outcomes were time to treatment and likelihood of stage III disease. Multivariate logistic regression incorporated all variables associated with tumour stage. Results A total of 29,792 procedures were analysed (14,208 pandemic; 15,584 pre-pandemic). SES distribution was similar between periods (median 0.057 vs 0.059, p=0.7). Median time to treatment was 27 days in both cohorts (p=0.10) with no SES-related differences. Rates of surgery for stage III were comparable across SES groups. Adjusted analyses showed no association between SES and tumour stage in either cohort (pandemic aOR 0.88, 95% CI 0.74–1.03). Conclusions Despite pressure on healthcare during the pandemic, access to surgical cancer care remained equitable across SES groups in the Netherlands.