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1.
BMC Cancer ; 21(1): 1356, 2021 Dec 31.
Article in English | MEDLINE | ID: covidwho-1591573

ABSTRACT

BACKGROUND: The majority of breast cancer patients are severely psychologically affected by breast cancer diagnosis and subsequent therapeutic procedures. The COVID-19 pandemic and associated restrictions on public life have additionally caused significant psychological distress for much of the population. It is therefore plausible that breast cancer patients might be particularly susceptible to the additional psychological stress caused by the pandemic, increasing suffering. In this study we therefore aimed to assess the level of psychological distress currently experienced by a defined group of breast cancer patients in our breast cancer centre, compared to distress levels pre-COVID-19 pandemic. METHODS: Female breast cancer patients of all ages receiving either adjuvant, neoadjuvant, or palliative therapies were recruited for the study. All patients were screened for current or previous COVID-19 infection. The participants completed a self-designed COVID-19 pandemic questionnaire, the Stress and Coping Inventory (SCI), the National Comprehensive Cancer Network® (NCCN®) Distress Thermometer (DT), the European Organization for Research and Treatment of Cancer (EORTC) QLQ C30, and the BR23. RESULTS: Eighty-two breast cancer patients were included. Therapy status and social demographic factors did not have a significant effect on the distress caused by the COVID-19 pandemic. The results of the DT pre and during COVID-19 pandemic did not differ significantly. Using the self-designed COVID-19 pandemic questionnaire, we detected three distinct subgroups demonstrating different levels of concerns in relation to SARS-CoV-2. The subgroup with the highest levels of concern reported significantly decreased life quality, related parameters and symptoms. CONCLUSIONS: This monocentric study demonstrated that the COVID-19 pandemic significantly affected psychological health in a subpopulation of breast cancer patients. The application of a self-created "COVID-19 pandemic questionnaire" could potentially be used to help identify breast cancer patients who are susceptible to increased psychological distress due to the COVID-19 pandemic, and therefore may need additional intensive psychological support. TRIAL REGISTRATION: DRKS-ID: DRKS00022507 .


Subject(s)
Breast Neoplasms/psychology , Psychological Distress , Stress, Psychological/epidemiology , Adult , Aged , Breast Neoplasms/epidemiology , COVID-19 , Female , Germany , Humans , Mental Health , Middle Aged , Pandemics , Surveys and Questionnaires
2.
J Med Internet Res ; 23(2): e25404, 2021 02 25.
Article in English | MEDLINE | ID: covidwho-1575459

ABSTRACT

BACKGROUND: Despite Saudi Arabia's free and well-established cancer care program, breast cancer incidence and mortality are rising. Husbands' knowledge, and wives' attitudes and practices related to breast cancer screening are not well understood in Saudi Arabia. OBJECTIVE: The aim of this study was to investigate husbands' knowledge, and wives' attitudes and practices related to breast cancer screening in Saudi Arabia. METHODS: This cross-sectional study collected data from 403 husbands in the holy city of Makkah through an online self-reported questionnaire over a period of 2 months, from May 6 to July 7, 2020. Tabulation, bivariate, and multiple regression analyses were the major tools used for data analysis. Multivariate logistic regressions were used to examine the association between husbands' knowledge and wives' behavior regarding breast cancer screening methods. RESULTS: Husbands' knowledge score (a 1-point increase) was significantly associated with the wives' utilization of mammograms (adjusted odds ratio [AOR] 1.089, 95% CI 1.024-1.159) and breast self-examination (AOR 1.177, 95% CI 1.105-1.255). Husbands' knowledge also influenced the wives' attitudes toward learning about breast self-examination (AOR 1.138, 95% CI 1.084-1.195). There was no significant association between husbands' knowledge and wives' utilization of clinical breast examination. However, richer husbands showed a socioeconomic gradient concerning their wives' utilization of clinical breast examinations (AOR 2.603, 95% CI 1.269-5.341). CONCLUSIONS: Overall, husbands' knowledge of breast cancer influences wives' attitudes and practices related to breast cancer screening methods in Saudi Arabia. Thus, interventions delivered to husbands might increase breast cancer awareness and survival.


Subject(s)
Breast Neoplasms/psychology , Health Knowledge, Attitudes, Practice , Internet Use/trends , Adult , Breast Neoplasms/epidemiology , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Saudi Arabia , Self Report , Spouses , Surveys and Questionnaires , Young Adult
3.
Support Care Cancer ; 28(8): 3517-3531, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-1453749

ABSTRACT

PURPOSE: Rural breast cancer survivors (BCS) in the United States face unique challenges during survivorship, related to knowledge and accessibility of resources. Survivorship care plans should address five key areas that include surveillance and screening for new/reoccurring cancer; management of long-term effects of cancer treatment; health promotion; and care coordination/practice implications. To maximize the benefit of survivorship care for rural BCS, it is necessary to better understand their experiences and preferences. METHODS: A systematic review of the extant literature addressing the survivorship needs and interventions for rural BCS was conducted. The following databases were searched for reports published between January, 2007, and December, 2018: PubMed, CINAHL, SCOPUS, PsycINFO (EBSCO), CAB Direct, and Sociological Abstracts. Reports published after 2007 with samples including and comprised of rural BCS in the United States were included. Screening of the search results followed PRISMA guidelines using Covidence systematic review software. RESULTS: Findings were extracted from 30 reports disseminating findings of 14 research studies. The five areas of a survivorship care were counted/accounted for during data extraction. The included reports concentrated on health promotion (e.g., weight loss and exercise) and the management of long-term effects of cancer treatment as key outcomes. There is a gap in the literature addressing care coordination, surveillance, and screening. CONCLUSION: Additional research including interventions for rural BCS that address more survivorship care areas would benefit this population and improve survivorship quality of life for rural BCS.


Subject(s)
Breast Neoplasms/mortality , Cancer Survivors/statistics & numerical data , Breast Neoplasms/psychology , Cancer Survivors/psychology , Databases, Factual , Female , Humans , Needs Assessment , Quality of Life , Rural Population , Survival Rate , Survivorship , United States/epidemiology
4.
J Natl Cancer Inst ; 113(9): 1161-1167, 2021 09 04.
Article in English | MEDLINE | ID: covidwho-1402395

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic led to a near-total cessation of mammography services in the United States in mid-March 2020. It is unclear if screening and diagnostic mammography volumes have recovered to prepandemic levels and whether use has varied by women's characteristics. METHODS: We collected data on 461 083 screening mammograms and 112 207 diagnostic mammograms conducted during January 2019 through July 2020 at 62 radiology facilities in the Breast Cancer Surveillance Consortium. We compared monthly screening and diagnostic mammography volumes before and during the pandemic stratified by age, race and ethnicity, breast density, and family history of breast cancer. RESULTS: Screening and diagnostic mammography volumes in April 2020 were 1.1% (95% confidence interval [CI] = 0.5% to 2.4%) and 21.4% (95% CI = 18.7% to 24.4%) of the April 2019 prepandemic volumes, respectively, but by July 2020 had rebounded to 89.7% (95% CI = 79.6% to 101.1%) and 101.6% (95% CI = 93.8% to 110.1%) of the July 2019 prepandemic volumes, respectively. The year-to-date cumulative volume of screening and diagnostic mammograms performed through July 2020 was 66.2% (95% CI = 60.3% to 72.6%) and 79.9% (95% CI = 75.4% to 84.6%), respectively, of year-to-date volume through July 2019. Screening mammography rebound was similar across age groups and by family history of breast cancer. Monthly screening mammography volume in July 2020 for Black, White, Hispanic, and Asian women reached 96.7% (95% CI = 88.1% to 106.1%), 92.9% (95% CI = 82.9% to 104.0%), 72.7% (95% CI = 56.5% to 93.6%), and 51.3% (95% CI = 39.7% to 66.2%) of the July 2019 prepandemic volume, respectively. CONCLUSIONS: Despite a strong overall rebound in mammography volume by July 2020, the rebound lagged among Asian and Hispanic women, and a substantial cumulative deficit in missed mammograms accumulated, which may have important health consequences.


Subject(s)
Breast Neoplasms/diagnosis , COVID-19/epidemiology , Early Detection of Cancer/statistics & numerical data , Mammography/statistics & numerical data , Registries/statistics & numerical data , SARS-CoV-2/isolation & purification , Adult , Aged , Breast Neoplasms/psychology , COVID-19/virology , Female , Humans , Middle Aged , United States/epidemiology
5.
Zhonghua Zhong Liu Za Zhi ; 42(4): 288-291, 2020 Apr 23.
Article in Chinese | MEDLINE | ID: covidwho-1379995

ABSTRACT

The outbreak of 2019 novel coronavirus disease (COVID-19) is spreading rapidly. In order to prevent cluster outbreaks, the government strengthened the management and control of personnel mobility, which had a great impact on the examination and treatment of breast cancer patients. This paper discusses how to realize scientific health management of breast cancer patients outside the hospital based on the existing epidemic situation, characteristics of breast cancer patients and public health safety factors. The breast cancer patients should synthetically consider the epidemic prevention situation of inhabitance, the disease stage and previous therapeutic schedule to decide the next therapeutic schedule. If necessary, after professional discussion and communication between doctors and patients online or offline, the hospital visiting time should be delayed through seeking alternative treatment schemes, and psychological counseling for patients should be paid attention to at the same time.


Subject(s)
Breast Neoplasms , Coronavirus Infections , Coronavirus , Disease Outbreaks/prevention & control , Pandemics/prevention & control , Pneumonia, Viral , Telemedicine , Ambulatory Care , Betacoronavirus , Breast Neoplasms/diagnosis , Breast Neoplasms/psychology , Breast Neoplasms/therapy , COVID-19 , China , Coronavirus Infections/epidemiology , Humans , Pneumonia, Viral/epidemiology , SARS-CoV-2
6.
JAMA ; 325(6): 536, 2021 Feb 09.
Article in English | MEDLINE | ID: covidwho-1323835
7.
Future Oncol ; 17(25): 3373-3381, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1320568

ABSTRACT

Aim: To assess the anxiety levels of breast cancer patients during the COVID-19 pandemic. Materials & methods: A total of 298 patients completed the State-Trait Anxiety Inventory (STAI-S and STAI-T) and the Visual Analogue Scale for Anxiety (VAS) and VAS for Anxiety in COVID-19 (VAS-CoV). Results: 144 patients were in the high anxiety category for STAI-S, and 202 patients were in the high anxiety category for STAI-T. STAI-T score was significantly high in the metastatic group (p = 0.017). VAS-CoV score in the hormonotherapy group was significantly higher than in the no-treatment group (p = 0.023). There was a positive correlation between VAS-CoV and VAS levels (r = 0.708, p < 0.001), VAS-CoV and STAI-S and STAI-T scores (r = 0.402, p < 0.001; r = 0.185, p = 0.001, respectively), and a negative correlation between education years and STAI-T scores (r = -0.172, p = 0.003). Conclusion: The COVID-19 pandemic is related to high anxiety levels in breast cancer patients.


Lay abstract COVID-19 pandemic is related to rapidly rising anxiety levels worldwide. Because of the high mortality of COVID-19 in cancer patients, changing treatment routines and disruptions of the healthcare system, cancer patients are the most affected population in this situation. Anxiety among females and breast cancer patients tend to be high, although anxiety levels in cancer patients during the pandemic period varies according to the cancer type, treatment status and sociodemographic factors. This study assessed the effect of the COVID-19 pandemic on breast cancer patients' anxiety levels according to treatment status and stage of the disease. A total of 298 breast cancer patients completed the universally validated anxiety questionnaires. Results demonstrated high trait anxiety in breast cancer patients, particularly in the metastatic group. The current findings highlighted the importance of intensive assessment and close monitoring of breast cancer patients' psychological situations. It is crucial to provide psychological support to breast cancer patients to contribute to both treatment and follow-up processes during the pandemic.


Subject(s)
Anxiety/epidemiology , Breast Neoplasms/epidemiology , Breast Neoplasms/psychology , COVID-19/epidemiology , Aged , Aged, 80 and over , Anxiety/diagnosis , Anxiety/therapy , Breast Neoplasms/diagnosis , Breast Neoplasms/therapy , COVID-19/virology , Comorbidity , Cross-Sectional Studies , Disease Management , Female , Humans , Middle Aged , Public Health Surveillance , SARS-CoV-2 , Socioeconomic Factors , Turkey/epidemiology
8.
BMJ ; 374: n1647, 2021 07 21.
Article in English | MEDLINE | ID: covidwho-1320441

ABSTRACT

OBJECTIVE: To evaluate effects of remote monitoring of adjuvant chemotherapy related side effects via the Advanced Symptom Management System (ASyMS) on symptom burden, quality of life, supportive care needs, anxiety, self-efficacy, and work limitations. DESIGN: Multicentre, repeated measures, parallel group, evaluator masked, stratified randomised controlled trial. SETTING: Twelve cancer centres in Austria, Greece, Norway, Republic of Ireland, and UK. PARTICIPANTS: 829 patients with non-metastatic breast cancer, colorectal cancer, Hodgkin's disease, or non-Hodgkin's lymphoma receiving first line adjuvant chemotherapy or chemotherapy for the first time in five years. INTERVENTION: Patients were randomised to ASyMS (intervention; n=415) or standard care (control; n=414) over six cycles of chemotherapy. MAIN OUTCOME MEASURES: The primary outcome was symptom burden (Memorial Symptom Assessment Scale; MSAS). Secondary outcomes were health related quality of life (Functional Assessment of Cancer Therapy-General; FACT-G), Supportive Care Needs Survey Short-Form (SCNS-SF34), State-Trait Anxiety Inventory-Revised (STAI-R), Communication and Attitudinal Self-Efficacy scale for cancer (CASE-Cancer), and work limitations questionnaire (WLQ). RESULTS: For the intervention group, symptom burden remained at pre-chemotherapy treatment levels, whereas controls reported an increase from cycle 1 onwards (least squares absolute mean difference -0.15, 95% confidence interval -0.19 to -0.12; P<0.001; Cohen's D effect size=0.5). Analysis of MSAS sub-domains indicated significant reductions in favour of ASyMS for global distress index (-0.21, -0.27 to -0.16; P<0.001), psychological symptoms (-0.16, -0.23 to -0.10; P<0.001), and physical symptoms (-0.21, -0.26 to -0.17; P<0.001). FACT-G scores were higher in the intervention group across all cycles (mean difference 4.06, 95% confidence interval 2.65 to 5.46; P<0.001), whereas mean scores for STAI-R trait (-1.15, -1.90 to -0.41; P=0.003) and STAI-R state anxiety (-1.13, -2.06 to -0.20; P=0.02) were lower. CASE-Cancer scores were higher in the intervention group (mean difference 0.81, 0.19 to 1.43; P=0.01), and most SCNS-SF34 domains were lower, including sexuality needs (-1.56, -3.11 to -0.01; P<0.05), patient care and support needs (-1.74, -3.31 to -0.16; P=0.03), and physical and daily living needs (-2.8, -5.0 to -0.6; P=0.01). Other SCNS-SF34 domains and WLQ were not significantly different. Safety of ASyMS was satisfactory. Neutropenic events were higher in the intervention group. CONCLUSIONS: Significant reduction in symptom burden supports the use of ASyMS for remote symptom monitoring in cancer care. A "medium" Cohen's effect size of 0.5 showed a sizable, positive clinical effect of ASyMS on patients' symptom experiences. Remote monitoring systems will be vital for future services, particularly with blended models of care delivery arising from the covid-19 pandemic. TRIAL REGISTRATION: Clinicaltrials.gov NCT02356081.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Cell Phone , Drug-Related Side Effects and Adverse Reactions/diagnosis , Quality of Life , Telemedicine/methods , Adult , Aged , Austria , Breast Neoplasms/psychology , Breast Neoplasms/therapy , Chemotherapy, Adjuvant/adverse effects , Colorectal Neoplasms/psychology , Colorectal Neoplasms/therapy , Drug-Related Side Effects and Adverse Reactions/etiology , Drug-Related Side Effects and Adverse Reactions/psychology , Female , Greece , Hodgkin Disease/psychology , Hodgkin Disease/therapy , Humans , Ireland , Lymphoma, Non-Hodgkin/psychology , Lymphoma, Non-Hodgkin/therapy , Male , Middle Aged , Norway , Telemedicine/instrumentation , Treatment Outcome , United Kingdom
9.
Cancer ; 127(19): 3671-3679, 2021 10 01.
Article in English | MEDLINE | ID: covidwho-1279355

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has had wide-ranging health effects and increased isolation. Older with cancer patients might be especially vulnerable to loneliness and poor mental health during the pandemic. METHODS: The authors included active participants enrolled in the longitudinal Thinking and Living With Cancer study of nonmetastatic breast cancer survivors aged 60 to 89 years (n = 262) and matched controls (n = 165) from 5 US regions. Participants completed questionnaires at parent study enrollment and then annually, including a web-based or telephone COVID-19 survey, between May 27 and September 11, 2020. Mixed-effects models were used to examine changes in loneliness (a single item on the Center for Epidemiologic Studies-Depression [CES-D] scale) from before to during the pandemic in survivors versus controls and to test survivor-control differences in the associations between changes in loneliness and changes in mental health, including depression (CES-D, excluding the loneliness item), anxiety (the State-Trait Anxiety Inventory), and perceived stress (the Perceived Stress Scale). Models were adjusted for age, race, county COVID-19 death rates, and time between assessments. RESULTS: Loneliness increased from before to during the pandemic (0.211; P = .001), with no survivor-control differences. Increased loneliness was associated with worsening depression (3.958; P < .001) and anxiety (3.242; P < .001) symptoms and higher stress (1.172; P < .001) during the pandemic, also with no survivor-control differences. CONCLUSIONS: Cancer survivors reported changes in loneliness and mental health similar to those reported by women without cancer. However, both groups reported increased loneliness from before to during the pandemic that was related to worsening mental health, suggesting that screening for loneliness during medical care interactions will be important for identifying all older women at risk for adverse mental health effects of the pandemic.


Subject(s)
Anxiety/psychology , Breast Neoplasms/psychology , COVID-19/psychology , Loneliness/psychology , Aged , Aged, 80 and over , Anxiety/complications , Anxiety/epidemiology , Anxiety/virology , Breast Neoplasms/complications , Breast Neoplasms/epidemiology , Breast Neoplasms/virology , COVID-19/complications , COVID-19/epidemiology , COVID-19/virology , Cancer Survivors/psychology , Female , Humans , Mental Health , Middle Aged , Pandemics , SARS-CoV-2/pathogenicity , Surveys and Questionnaires
11.
Medicine (Baltimore) ; 100(24): e26332, 2021 Jun 18.
Article in English | MEDLINE | ID: covidwho-1269621

ABSTRACT

BACKGROUND: Patients after breast cancer surgery have a high sense of stigma due to the formation of surgical scars, loss of breast shape or other reasons, leading to anxiety, depression, and other adverse mental health problems, thus reducing their quality of life. Remote peer support intervention based on telephone, internet or email is low-cost and easy to spread, and protects patients' privacy, solves the barriers to access that many patients face when attending face-to-face programs. Therefore, remote peer support may be an effective way to reduce stigma and improve mental health in patients after breast cancer surgery during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: Eight databases (PubMed, Embase, Cochrane Library, CNKI, PsycNET, MEDLINE, Psychology & Behavioral Sciences Collection and Web of Science) will be used to select eligible studies that were published from inception to May, 2021. The eligible studies will be screened, extracted and then the methodological quality will be evaluated independently by 2 reviewers. Review manager software version 5.3 software and Stata version 14.0 software will be used for meta-analysis. RESULTS: The results of this study will show the effect of remote peer support on stigma, depression and anxiety in patients after breast cancer surgery during the COVID-19 pandemic and will be submitted to a peer-reviewed journal for publication. CONCLUSION: The results of this study will provide evidence for the effectiveness of remote peer support in patients after breast cancer surgery during the COVID-19 pandemic. PROSPERO REGISTRATION NUMBER: CRD42021255971.


Subject(s)
Breast Neoplasms/psychology , Mastectomy/psychology , Postoperative Complications/therapy , Social Stigma , Social Support , Anxiety/etiology , Anxiety/therapy , Breast Neoplasms/surgery , COVID-19 , Depression/etiology , Depression/therapy , Female , Humans , Meta-Analysis as Topic , Peer Group , Postoperative Complications/etiology , Postoperative Complications/psychology , Research Design , SARS-CoV-2 , Systematic Reviews as Topic , Treatment Outcome
13.
J Natl Cancer Inst ; 113(11): 1495-1505, 2021 11 02.
Article in English | MEDLINE | ID: covidwho-1246732

ABSTRACT

BACKGROUND: Fear of recurrence (FoR) is a prevalent concern among breast cancer survivors (BCS), yet few accessible interventions exist. This study evaluated a targeted eHealth intervention, "FoRtitude," to reduce FoR using cognitive behavioral skills training and telecoaching. METHODS: BCS (N = 196) were recruited from an academic medical center and 3 National Cancer Institute Community Oncology Research Program community sites, had stage 0-III breast cancer, were 1-10 years postprimary treatment, with moderate to high FoR and familiarity with the internet. Using the Multiphase Optimization Strategy, participants were independently randomly assigned to 3 cognitive behavioral skills (relaxation, cognitive restructuring, worry practice) vs an attention control condition (health management content [HMC]) and to telecoaching (motivational interviewing) vs no telecoaching. Website content was released across 4 weeks and included didactic lessons, interactive tools, and a text-messaging feature. BCS completed the Fear of Cancer Recurrence Inventory at baseline and at 4 and 8 weeks. Fear of Cancer Recurrence Inventory scores over time were compared using mixed-effects models. All statistical tests were 2-sided. RESULTS: FCRI scores [SD] decreased statistically significantly from baseline to postintervention (T0 = 53.1 [17.4], T2 = 41.9 [16.2], P < .001). The magnitude of reduction in FCRI scores was comparable across cognitive behavior therapy (CBT) and attention control HMC conditions and was predicted by increased self-efficacy. Telecoaching was associated with lower attrition and greater website use (mean adherence score [SD] = 26.6 [7.2] vs 21.0 [10.5], P < .001). CONCLUSIONS: BCS experienced statistically significant reductions in FoR postintervention, but improvements were comparable between CBT and attention controls. Telecoaching improved adherence and retention. Future research is needed on optimal integration of CBT and HMC, dose, and features of eHealth delivery that contributed to reducing FoR. In the COVID-19 era, remote delivery has become even more essential for reaching survivors struggling with FoR.


Subject(s)
Breast Neoplasms/therapy , Cancer Survivors/psychology , Cognitive Behavioral Therapy/methods , Fear/psychology , Neoplasm Recurrence, Local/prevention & control , Telemedicine/methods , Adult , Aged , Breast Neoplasms/psychology , Female , Humans , Middle Aged , Quality of Life
14.
Cancer Med ; 10(10): 3288-3298, 2021 05.
Article in English | MEDLINE | ID: covidwho-1209703

ABSTRACT

BACKGROUND: Given excellent survival outcomes in breast cancer, there is interest in de-escalating the amount of chemotherapy delivered to patients. This approach may be of even greater importance in the setting of the COVID-19 pandemic. METHODS: This concurrent mixed methods study included (1) interviews with patients and patient advocates and (2) a cross-sectional survey of women with breast cancer served by a charitable nonprofit organization. Questions evaluated interest in de-escalation trial participation, perceived barriers/facilitators to participation, and language describing de-escalation. RESULTS: Sixteen patient advocates and 24 patients were interviewed. Key barriers to de-escalation included fear of recurrence, worry about decision regret, lack of clinical trial interest, and dislike for focus on less treatment. Facilitators included trust in physician recommendation, toxicity avoidance, monitoring for progression, perception of good prognosis, and impact on daily life. Participants reported that the COVID-19 pandemic made them more likely to avoid chemotherapy if possible. Of 91 survey respondents, many (43%) patients would have been unwilling to participation in a de-escalation clinical trial. The most commonly reported barrier to participation was fear of recurrence (85%). Few patients (19%) considered clinical trials themselves as a barrier to de-escalation trial participation. The most popular terminology describing chemotherapy de-escalation was "lowest effective chemotherapy dose" (53%); no patients preferred the term "de-escalation." CONCLUSIONS: Fear of recurrence is a common concern among breast cancer survivors and patient advocates, contributing to resistance to de-escalation clinical trial participation. Additional research is needed to understand how to engage patients in de-escalation trials.


Subject(s)
Breast Neoplasms/drug therapy , COVID-19/prevention & control , SARS-CoV-2/isolation & purification , Surveys and Questionnaires , Adult , Aged , Anxiety/psychology , Breast Neoplasms/psychology , COVID-19/epidemiology , COVID-19/virology , Cross-Sectional Studies , Fear/psychology , Female , Humans , Middle Aged , Pandemics , Qualitative Research , SARS-CoV-2/physiology
15.
J Natl Cancer Inst ; 113(9): 1161-1167, 2021 09 04.
Article in English | MEDLINE | ID: covidwho-1155794

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic led to a near-total cessation of mammography services in the United States in mid-March 2020. It is unclear if screening and diagnostic mammography volumes have recovered to prepandemic levels and whether use has varied by women's characteristics. METHODS: We collected data on 461 083 screening mammograms and 112 207 diagnostic mammograms conducted during January 2019 through July 2020 at 62 radiology facilities in the Breast Cancer Surveillance Consortium. We compared monthly screening and diagnostic mammography volumes before and during the pandemic stratified by age, race and ethnicity, breast density, and family history of breast cancer. RESULTS: Screening and diagnostic mammography volumes in April 2020 were 1.1% (95% confidence interval [CI] = 0.5% to 2.4%) and 21.4% (95% CI = 18.7% to 24.4%) of the April 2019 prepandemic volumes, respectively, but by July 2020 had rebounded to 89.7% (95% CI = 79.6% to 101.1%) and 101.6% (95% CI = 93.8% to 110.1%) of the July 2019 prepandemic volumes, respectively. The year-to-date cumulative volume of screening and diagnostic mammograms performed through July 2020 was 66.2% (95% CI = 60.3% to 72.6%) and 79.9% (95% CI = 75.4% to 84.6%), respectively, of year-to-date volume through July 2019. Screening mammography rebound was similar across age groups and by family history of breast cancer. Monthly screening mammography volume in July 2020 for Black, White, Hispanic, and Asian women reached 96.7% (95% CI = 88.1% to 106.1%), 92.9% (95% CI = 82.9% to 104.0%), 72.7% (95% CI = 56.5% to 93.6%), and 51.3% (95% CI = 39.7% to 66.2%) of the July 2019 prepandemic volume, respectively. CONCLUSIONS: Despite a strong overall rebound in mammography volume by July 2020, the rebound lagged among Asian and Hispanic women, and a substantial cumulative deficit in missed mammograms accumulated, which may have important health consequences.


Subject(s)
Breast Neoplasms/diagnosis , COVID-19/epidemiology , Early Detection of Cancer/statistics & numerical data , Mammography/statistics & numerical data , Registries/statistics & numerical data , SARS-CoV-2/isolation & purification , Adult , Aged , Breast Neoplasms/psychology , COVID-19/virology , Female , Humans , Middle Aged , United States/epidemiology
16.
Breast Cancer Res Treat ; 186(2): 577-583, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1086614

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.


Subject(s)
Anxiety/psychology , Breast Neoplasms/psychology , COVID-19/psychology , Cancer Survivors/psychology , Depression/psychology , Aged , Anxiety/epidemiology , Breast Neoplasms/epidemiology , COVID-19/epidemiology , Cancer Survivors/statistics & numerical data , Cross-Sectional Studies , Depression/epidemiology , Female , Humans , Male , Middle Aged , Patient Acceptance of Health Care/psychology , Patient Acceptance of Health Care/statistics & numerical data , Prevalence , Prospective Studies , Risk Factors , SARS-CoV-2 , Surveys and Questionnaires
17.
Support Care Cancer ; 29(8): 4773-4782, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1060225

ABSTRACT

PURPOSE: This study aimed to examine the prevalence of psychological distress and the corresponding risk factors among patients with breast cancer affected by the outbreak of coronavirus disease 2019 (COVID-19). METHODS: This cross-sectional, survey-based, region-stratified study was conducted from March 14 to March 21, 2020. An online survey was used to collect the basic characteristics of patients with breast cancer. The degree of depression, anxiety, and insomnia symptoms were assessed using the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder (GAD-7), and the Insomnia Severity Index (ISI) questionnaires, respectively. Multivariate logistic analysis was performed to identify factors associated with psychological distress outcomes. RESULTS: Among the 834 patients with breast cancer included in the study, the prevalence of depression, anxiety, and insomnia was 21.6%, 15.5%, and 14.7%, respectively. No statistically significant difference in the prevalence of these symptoms was observed between patients in Wuhan and those outside Wuhan. Multivariate logistic regression analyses revealed that comorbidity, living alone, deterioration of breast cancer, and affected treatment plan were risk factors for psychological distress including depression, anxiety, and insomnia. When stratified by location, living alone was associated with depression and insomnia only among patients in Wuhan, but not those outside Wuhan. CONCLUSIONS: This study shows an elevated prevalence of depression, anxiety, and insomnia among patients with breast cancer during part of the COVID-19 pandemic. Patients with comorbidity, living alone, deterioration of breast cancer, and whose treatment plan was affected should be paid more attention to prevent mental disorders.


Subject(s)
Anxiety , Breast Neoplasms , COVID-19 , Depression , Psycho-Oncology , Sleep Initiation and Maintenance Disorders , Anxiety/diagnosis , Anxiety/epidemiology , Breast Neoplasms/epidemiology , Breast Neoplasms/psychology , COVID-19/epidemiology , COVID-19/psychology , China/epidemiology , Cross-Sectional Studies , Depression/diagnosis , Female , Humans , Middle Aged , Prevalence , Psycho-Oncology/methods , Psycho-Oncology/statistics & numerical data , Psychological Distress , Risk Factors , SARS-CoV-2 , Sleep Initiation and Maintenance Disorders/diagnosis , Sleep Initiation and Maintenance Disorders/epidemiology
18.
Rev. enferm. UERJ ; 28: e51821, jan.-dez. 2020.
Article in English, Portuguese | LILACS (Americas) | ID: covidwho-1016415

ABSTRACT

Objetivo: compreender a vivência do enfrentamento e repercussões da COVID-19, na percepção de mulheres em tratamento oncológico. Método: estudo qualitativo, do tipo ação-participante, fundamentado no Itinerário de Pesquisa de Paulo Freire, que possui três fases: Investigação Temática; Codificação e Descodificação; Desvelamento Crítico. Foi realizado Círculo de Cultura virtual, com a participação de 12 mulheres em tratamento do câncer de mama, de diferentes localidades do Brasil. Resultados: no Círculo de Cultura virtual discutiram dois temas: desafios no enfrentamento do câncer e da COVID-19; aprendizados gerados nessa vivência, considerando um renascimento das próprias cinzas. Considerações finais: o momento pandêmico tem instigado reflexões sobre o viver. Assim, as mulheres em tratamento oncológico e também em restrição social puderam expressar seus sentimentos, descobrindo e redescobrindo fragilidades e fortalezas para ressignificar e crescer como seres, em uma sociedade, que pode e deve articular estratégias para promoção da saúde.


Objective: to understand the experience of coping with COVID-19, as perceived by women undergoing cancer treatment. Method: qualitative, participatory action research based on the three phases of Paulo Freire's Research Itinerary: Thematic Investigation; Coding and Decoding; and Critical Unveiling. A Culture Circle was held online with 12 women from different places in Brazil undergoing breast cancer treatment. Results: in the virtual Culture Circle, they discussed two themes: challenges in coping with cancer and COVID-10; and learning generated in that experience, with a view to rebirth from their own ashes. Final considerations: the pandemic has prompted thinking about living. Accordingly, women undergoing cancer treatment and also under social restrictions were able to express their feelings, and in discovering and rediscovering weaknesses and strengths, to resignify themselves and to grow in a society that can and should deploy strategies for health promotion.


Objetivo: comprender la experiencia de afrontamiento del COVID-19, según la perciben las mujeres en tratamiento oncológico. Método: investigación-acción cualitativa y participativa basada en las tres fases del Itinerario de Investigación de Paulo Freire: Investigación Temática; Codificación y decodificación; y revelación crítica. Se realizó un Círculo Cultural en línea con 12 mujeres de diferentes lugares de Brazil sometidas a tratamiento contra el cáncer de mama. Resultados: en el Círculo de Cultura virtual se discutieron dos temas: desafíos en el afrontamiento del cáncer y COVID-10; y el aprendizaje generado en esa experiencia, con miras a renacer de sus propias cenizas. Consideraciones finales: la pandemia ha llevado a pensar en vivir. En consecuencia, las mujeres en tratamiento oncológico y también bajo restricciones sociales pudieron expresar sus sentimientos, y al descubrir y redescubrir debilidades y fortalezas, resignificarse y crecer en una sociedad que puede y debe desplegar estrategias de promoción de la salud.


Subject(s)
Humans , Female , Adult , Middle Aged , Breast Neoplasms/psychology , Adaptation, Psychological , Quarantine/psychology , Coronavirus Infections/epidemiology , Health Promotion , Learning , Brazil , Health-Disease Process , Telemedicine , Qualitative Research , Emotions , Life Change Events
19.
Curr Oncol ; 28(1): 294-300, 2021 01 08.
Article in English | MEDLINE | ID: covidwho-1016109

ABSTRACT

BACKGROUND: The current Coronavirus disease 2019 (COVID-19) pandemic is a highly stressful event that may lead to significant psychological symptoms, particularly in cancer patients who are at a greater risk of contracting viruses. This study examined the frequency of stressors experienced in relation to the ongoing coronavirus pandemic and its relationship with psychological symptoms (i.e., anxiety, depression, insomnia, fear of cancer recurrence) in breast cancer patients. METHODS: Thirty-six women diagnosed with a non-metastatic breast cancer completed the Insomnia Severity Index, the Hospital Anxiety and Depression Scale, the severity subscale of the Fear of Cancer Recurrence Inventory, and the COVID-19 Stressors Questionnaire developed by our research team. Participants either completed the questionnaires during (30.6%) or after (69.4%) their chemotherapy treatment. RESULTS: Results revealed that most of the participants (63.9%) have experienced at least one stressor related to the COVID-19 pandemic (one: 27.8%, two: 22.2%, three: 11.1%). The most frequently reported stressor was increased responsibilities at home (33.3%). Higher levels of concerns related to the experienced stressors were significantly correlated with higher levels of anxiety, depressive symptoms, insomnia, and fear of cancer recurrence, rs(32) = 0.36 to 0.59, all ps < 0.05. CONCLUSIONS: Cancer patients experience a significant number of stressors related to the COVID-19 pandemic, which are associated with increased psychological symptoms. These results contribute to a better understanding of the psychological consequences of a global pandemic in the context of cancer and they highlight the need to better support patients during such a challenging time.


Subject(s)
Breast Neoplasms/complications , COVID-19/epidemiology , Cancer Survivors/psychology , Pandemics , Stress, Psychological/epidemiology , Adult , Anxiety/diagnosis , Anxiety/epidemiology , Anxiety/psychology , Breast Neoplasms/immunology , Breast Neoplasms/psychology , Breast Neoplasms/therapy , COVID-19/immunology , COVID-19/psychology , Cancer Survivors/statistics & numerical data , Cross-Sectional Studies , Depression/diagnosis , Depression/epidemiology , Depression/psychology , Fear , Female , Humans , Middle Aged , Neoplasm Recurrence, Local/psychology , Patient Health Questionnaire/statistics & numerical data , Severity of Illness Index , Sleep Initiation and Maintenance Disorders/diagnosis , Sleep Initiation and Maintenance Disorders/epidemiology , Sleep Initiation and Maintenance Disorders/psychology , Stress, Psychological/diagnosis , Stress, Psychological/etiology , Stress, Psychological/psychology
20.
Support Care Cancer ; 29(7): 4075-4080, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1009141

ABSTRACT

OBJECTIVE: Cumulative knowledge indicates that cancer patients, among them breast cancer patients, are more susceptible to COVID-19 than individuals without cancer. Therefore, these patients need to take additional precautions against the COVID-19 outbreak. This study aimed to examine factors associated with precautionary behavior among Israeli breast cancer patients during the COVID-19 pandemic. METHODS: A cross-sectional study was conducted among 151 women with breast cancer. Participants completed measures of knowledge about COVID-19, perceived threat, sense of mastery, social support, precautionary behavior, and socio-demographic questionnaires. A multivariate regression model was calculated with precautionary behavior as the dependent variable. RESULTS: The mean of precautionary behavior score was relatively high. Participants perceived their health as relatively good, had relatively high knowledge about COVID-19, and moderate perceived threat. Sense of mastery was relatively moderate and perceived social support was relatively high. In the multivariate regression analysis, after controlling for the background variables, knowledge about COVID-19 (F(2,149) = 8.68, p < 0.001; beta = 0.36) was significantly associated with precautionary behavior. This variable explained 15.4% of the precautionary behavior variance. CONCLUSION: Findings suggest that in order to enhance precautionary behavior among women with breast cancer during a pandemic outbreak, it is recommended to pay attention their knowledge about the virus.


Subject(s)
Breast Neoplasms/epidemiology , COVID-19/prevention & control , Health Behavior , Health Knowledge, Attitudes, Practice , Adult , Aged , Aged, 80 and over , Avoidance Learning , Breast Neoplasms/psychology , COVID-19/epidemiology , COVID-19/psychology , Cross-Sectional Studies , Disease Outbreaks , Female , Health Behavior/physiology , Humans , Israel/epidemiology , Middle Aged , Pandemics , Quarantine/psychology , Quarantine/statistics & numerical data , SARS-CoV-2 , Self Care/psychology , Self Care/statistics & numerical data , Surveys and Questionnaires , Young Adult
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