新冠病毒（COVID-19）大流行导致癌症连续中的护理中断。目前不清楚，被免疫抑制的癌症患者是否更容易受到SARS-CoV-2感染的并发症影响。因此，我们旨在比较HIV阳性的癌症患者（PLWH）、普通癌症人群（GCP）和有固体器官移植历史的癌症患者之间的癌症治疗延误情况。比较的时间跨度为疫情前2年与疫情爆发的第一年。我们使用美国一份真实电子健康记录的匿名数据库（2018-2021年），该数据库由美国全国范围内800个护理地点的癌症患者的数据组成。我们包括了19种不同癌症类型的患者。我们计算了癌症治疗开始时间（TTI），即癌症诊断日期与最早记录到的癌症治疗日期之间的时间差。样本包括181名PLWH、65,073名GCP患者和195名有器官移植历史的患者。经年龄、性别和癌症诊断时是否存在转移性疾病进行调整的差异-差异回归模型显示，在COVID-19期间与COVID-19之前相比，PLWH的TTI延迟显著增加，疫情期间延迟约1个月（差异-差异：32.6天[8.9-56.3]；p = 0.007）。PLWH的TTI增加在手术（差异-差异：55.1 [28.8-81.3]，p <0.001）和全身治疗（差异-差异：30.4 [4.6-56.3]，p = 0.021）等治疗方式中均有观察到。PLWH在COVID-19的第一年癌症诊断后在癌症治疗开始方面遇到了显著延迟，这种延迟可能对癌症预后产生负面影响。这些数据要求疫情持续影响美国医疗系统时，患者和医务人员予以关注。 © 2023 The Authors. Cancer Medicine由John Wiley & Sons Ltd出版。

The COVID-19 pandemic led to care disruptions across the cancer continuum. It is unknown if immunosuppressed patients with cancer, who may be at higher risk for complications of SARS-CoV-2 infection, are disproportionately impacted. Thus, we aimed to compare delays in cancer treatment initiation between people living with HIV (PLWH) and cancer, the general cancer population (GCP), and patients with cancer and a history of solid organ transplant (SOT). Comparisons were made across the period 2 years preceding the pandemic versus the first year of the pandemic.We used data from a real-world electronic health record-derived de-identified database (2018-2021) comprised of US patients with cancer from 800 sites of care across the country. We included patients with 19 different cancer types. We calculated time to cancer treatment initiation (TTI) as the difference between the date of cancer diagnosis and the earliest date that cancer treatment was recorded.The sample included 181 PLWH, 65,073 GCP patients, and 195 patients with a SOT. Difference-in-difference regression models adjusted for age, sex, and presence of metastatic disease at cancer diagnosis revealed a significant increase in delayed TTI among PLWH compared to the GCP during COVID-19 versus prior to COVID-19, with delays increasing by approximately 1 month during the pandemic (DID: 32.6 days [8.9-56.3]; p = 0.007). The increase in TTI for PLWH was observed across treatment modalities, including surgery (DID: 55.1 [28.8-81.3], p < 0.001) and systemic therapy (DID: 30.4 [4.6-56.3], p = 0.021).PLWH experienced significant delays in cancer treatment initiation after diagnosis during the first year of COVID-19, delays that may negatively impact cancer outcomes. These data warrant patient and provider attention as the pandemic continues to impact the US healthcare system.© 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.