Examining the association among fear of COVID‐19, psychological distress, and delays in cancer care
Open accessAbstract
Background: Given the high risk of COVID‐19 mortality, patients with cancer may be vulnerable to fear of COVID‐19, adverse psychological outcomes, and health care delays. Methods: This longitudinal study surveyed the pandemic's impact on patients with cancer (N= 1529) receiving Patient Advocate Foundation services during early and later pandemic. Generalized estimating equation with repeated measures was conducted to assess the effect of COVID‐19 on psychological distress. Logistic regression with repeated measures was used to assess the effect of COVID‐19 on any delays in accessing health care (e.g., specialty care doctors, laboratory, or diagnostic testing, etc.). Results: Among 1199 respondents, 94% considered themselves high risk for COVID‐19. Respondents with more fear of COVID‐19 had a higher mean psychological distress score (10.21; 95% confidence intervals [CI] 9.38–11.03) compared to respondents with less fear (7.55; 95% CI 6.75–8.36). Additionally, 47% reported delaying care. Respondents with more fear of COVID‐19 had higher percentages of delayed care than those with less (56; 95% CI 39%–72% vs. 44%; 95% CI 28%–61%). These relationships persisted throughout the pandemic. For respondents with a COVID‐19 diagnosis in their household (n = 116), distress scores were similar despite higher delays in care (58% vs. 27%) than those without COVID‐19. Conclusions: Fear of COVID‐19 is linked to psychological distress and delays in care among patients with cancer. Furthermore, those who are personally impacted see exacerbated cancer care delays. Timely psychosocial support and health care coordination are critical to meet increased care needs of patients with cancer during the COVID‐19 pandemic.
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Fear of COVID-19 transmission was associated with higher intentions to use telehealth services among cancer patients in the United States.
“Specific to the pandemic situation, recent studies found that fear of COVID-19 transmission was associated with higher intentions to use contact tracing apps among the general population in Germany [18] and telehealth services among cancer patients in the United States [19].”
From Applying the Unified Theory of Acceptance and Use of Technology to Identify Factors Associated With Intention to Use Teledelivered Supportive Care Among Recently Diagnosed Breast Cancer Survivors During COVID-19 in Hong Kong: Cross-Sectional Survey (2024) · cites this paper as [19]
Section 3.2 (page unavailable) reports that patients with more fear of COVID-19 used telehealth more often than those with less fear, both early and later in the pandemic. The study reports actual use, not intentions to use telehealth, and does not identify fear of transmission specifically as the measured association. (LLM, conf=0.88)
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“Specific to the pandemic situation, recent studies found that fear of COVID-19 transmission was associated with higher intentions to use contact tracing apps among the general population in Germany [18] and telehealth services among cancer patients in the United States [19].”
BackgroundResult
- Authors
- Caston, N. E., Lawhon, V. M., Smith, K. L., Gallagher, K., Angove, R., Anderson, E., Balch, A., Azuero, A., Huang, C. S., & Rocque, G. B.
- Affiliations
- University of Alabama at Birmingham (US)
- Johns Hopkins University (US)
- Patient Advocate Foundation (US)
- Division of Hematology and Oncology University of Alabama at Birmingham (UAB) Birmingham Alabama USA
- Corresponding author
- Rocque, Gabrielle B.
- ORCID
- Venue
- Cancer Medicine
- Publisher
- Wiley
- Published
- 2021-11-29
- Volume
- 10
- Issue
- 24
- Pages
- 8854-8865
- ISSN
- 2045-7634 (ISSN-L)
- PMC
- PMC8683527
- OpenAlex
- W3216584564
- Cited by
- 56
- References
- 30
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 12 · 2023: 18 · 2022: 15 · 2021: 1
- FWCI
- 4.19
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Cancer Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Breast Cancer Research Foundation of Alabama
- Topics
- Health Sciences › Medicine › Oncology › COVID-19 and healthcare impacts
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Keywords
- COVID-19 pandemic, cancer patients, fear of COVID-19, psychological distress, delayed cancer care, health care access, psychosocial support, care coordination
- MeSH terms
- Psychological Distress, COVID-19, Adult, Aged, Fear, Female, Humans, Longitudinal Studies, Male, Middle Aged, Neoplasms, Stress, Psychological, Young Adult, Pandemics
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