Association of Cancer History with COVID-19 Risk and Outcomes among Older Postmenopausal Women: Results from the Women's Health Initiative.

BACKGROUND

Several studies early in the COVID-19 pandemic suggested that those with a cancer history had a higher risk of COVID-19 infections and complications. However, few prospective studies evaluated the association of cancer with COVID-19 in older women. We aimed to examine the association of cancer history with the risk of COVID-19 and various COVID-19 outcomes among older women.

METHODS

The Women's Health Initiative is an ongoing cohort study that recruited 161,808 postmenopausal women of 50 to 79 years of age from 1993 to 1998. Those who completed the COVID-19 survey (2021-2022) were included (n = 35,623). Multivariable linear and logistic regressions were used to examine COVID-19 positivity, symptom severity, long COVID, and COVID concerns/anxiety outcomes.

RESULTS

Twenty-eight percent (n = 9,901) of participants had a history of cancer. Cancer history was not significantly associated with COVID-19 positivity [OR = 0.94; 95% confidence interval (CI), 0.81-1.08], COVID-19 hospitalization (OR = 1.21; 95% CI, 0.85-1.72), number of symptoms (least squares mean = 0.33; 95% CI, -0.20 to 0.85), and long COVID (OR = 1.18; 95% CI, 0.88-1.58).

CONCLUSIONS

A history of cancer was not associated with most COVID-19 outcomes. Future studies should continue to examine physiologic mechanisms contributing to differences among cancer survivors and prioritize the inclusion of underserved populations to identify strategies to address the impact of COVID-19.

IMPACT: These findings may assure cancer survivors that their diagnosis alone does not increase their risk of COVID-19 and suggest that older women with a history of cancer may have similar risks of COVID-19 outcomes compared with their noncancer counterparts.