(Ex-)breast cancer patients with (pre-existing) symptoms of anxiety and/or depression experience higher barriers to contact health care providers during the COVID-19 pandemic

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Abstract

Purpose: To identify factors associated with (perceived) access to health care among (ex-)breast cancer patients during the COVID-19 pandemic. Methods: Cross-sectional study within a large prospective, multicenter cohort of (ex-)breast cancer patients, i.e., UMBRELLA. All participants enrolled in the UMBRELLA cohort between October 2013 and April 2020 were sent a COVID-19-specific survey, including the Hospital Anxiety and Depression Scale (HADS) questionnaire. Results: In total, 1051 (66.0%) participants completed the survey. During COVID-19, 284 (27.0%) participants reported clinically relevant increased levels of anxiety and/or depression, i.e., total HADS score ≥ 12. Participants with anxiety and/or depression reported statistically significant higher barriers to contact their general practitioner (47.5% vs. 25.0%, resp.) and breast cancer physicians (26.8% vs. 11.2%, resp.) compared to participants without these symptoms. In addition, a higher proportion of participants with anxiety and/or depression reported that their current treatment or (after)care was affected by COVID-19 compared to those without these symptoms (32.7% vs. 20.5%, resp.). Factors independently associated with symptoms of anxiety and/or depression during COVID-19 were pre-existent anxiety (OR 6.1, 95% CI 4.1–9.2) or depression (OR 6.0, 95% CI 3.5–10.2). Conclusion: During the COVID-19 pandemic, (ex-)breast cancer patients with symptoms of anxiety and/or depression experience higher barriers to contact health care providers. Also, they more often report that their health care was affected by COVID-19. Risk factors for anxiety and/or depression during COVID-19 are pre-existent symptoms of anxiety or depression. Extra attention—including mental health support—is needed for this group.

Original languageEnglish
Pages (from-to)577-583
Number of pages7
JournalBreast Cancer Research and Treatment
Volume186
Issue number2
DOIs
Publication statusPublished - Apr 2021

Keywords

  • Anxiety
  • Breast cancer
  • COVID-19
  • Depression
  • Patient-reported outcomes
  • UMBRELLA
  • Anxiety/epidemiology
  • Prevalence
  • Prospective Studies
  • Cross-Sectional Studies
  • Patient Acceptance of Health Care/psychology
  • Humans
  • Middle Aged
  • Risk Factors
  • Male
  • Breast Neoplasms/epidemiology
  • SARS-CoV-2
  • COVID-19/epidemiology
  • Depression/epidemiology
  • Female
  • Surveys and Questionnaires
  • Aged
  • Cancer Survivors/psychology

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