LAUSR

The COVID-19 pandemic has caused severe interruptions in care for patients across the disease spectrum. Reductions in health care utilization during the initial stages of the pandemic have been identified both domestically and internationally. 1,2 In the study by Walker et al, 3 the authors examined the changes in cancer care services across the continuum of care in Ontario, Canada, associated with the COVID-19 pandemic. Their results demonstrated an overall deficit in the first year of the pandemic, punctuated by steep reductions during the initial wave of COVID-19 followed by rebounding trends later in the year. These findings cast into stark relief how the COVID-19 pandemic represented a shock to the health care system in general, and to cancer care in particular. Individualcomponentsofcancercaredeliveryhavebeenpreviouslystudied.IntheUS,Bakouny et al 4 examined screening patterns in the Massachusetts General Brigham health care system and found that for common cancer screening examinations, including low-dose computed tomography, Papanicolaou test, colonoscopy, prostate-specific antigen screening, or mammography, the proportion of patients receiving at least 1 examination during the first 3 months of the pandemic amounted to only 24.0% of the total receiving at least 1 examination in the 3 months prior to the pandemic. In a study in Scotland, Baxter et al 5 reported that the receipt of scheduled anticancer systemic therapy delivery deceased 28.7% in the first 2 months after the outbreak of the pandemic compared with the 2 months prior to the pandemic, with particularly large reductions for some cancers, including colorectal cancer (43.4%). 5 These studies highlight the profound hesitancy that patients with cancer likely had when faced with the necessity to interact with the cancer care system during the initial stages of the pandemic. Such hesitancy extended even to the prospect of participating in clinical trials. According to a study by Fleury et al, 6 1 in 5 patients with cancer indicated they would be less willing to participate in a clinical trial owing to fears about contracting COVID-19. Such fears are not unfounded,