Cancer care in the context of COVID-19.

359 Background: The COVID pandemic increased mental health challenges for cancer patients, overburdened oncology providers, and exacerbated health disparities. Using focus groups, this study aimed to understand the impact of COVID on people with cancer from underserved communities in WA state. Methods: In 4 focus groups (English and Spanish) people diagnosed with cancer from March 2020 or later in WA state were asked about their treatment, mental health, COVID testing and vaccine experiences, finances, and bias and racism during the pandemic. Focus groups included individuals with a cancer diagnosis in specific communities: Black and African American (n=8), English-Speaking Hispanic/Latinx (n=5), Spanish-Speaking Hispanic/Latinx (n=5), and Rural (n=4). Transcripts were analyzed using conventional content analysis in Dedoose 9.0. Initial coding used notes from preliminary data review. Codes were combined, deleted, and added during subsequent coding. Data was exported and themes were developed. Results: Several themes emerged from the discussions. See table. Conclusions: Cancer patients in WA State reported increased difficulties with navigating hospital policies, mental health, racism during treatment and at work, and economic stress during COVID. Some identified emotional support from family and community as mitigating factors. Feedback from the groups confirmed the need to prioritize mental health and social needs of people with cancer. Future research is needed on interventions to address such needs among individuals with cancer.[Table: see text]