Patients coping with lung cancer treated at one hospital in Mexico reported high levels of anxiety and saw their treatment delayed due to the COVID-19 pandemic, according to a study presented by Oscar Arrieta, MD, at the 2021 International Association for the Study of Lung Cancer (IASLC) World Conference on Lung Cancer (Abstract OA17.03).
There is limited evidence in Latin America about the overall detrimental effects of depression, anxiety, and distress due to the COVID-19 pandemic, according to Dr. Arrieta, of the Instituto Nacional de Cancerología, Mexico City, Mexico. Dr. Arrieta and his colleagues sought to determine the prevalence and impact of psychological disorders due to the COVID-19 pandemic.
Mental Health Evaluation
To determine the impact of COVID-19 on the mental health of patients with lung cancer, psychiatrists performed a cross-sectional mental health evaluation in a single center between March 1, 2020, and February 28, 2021. Dr. Arrieta and his colleagues enrolled 548 patients with an average age of 61.5 years. Most patients had been diagnosed with non–small cell lung cancer (86.9%) and 80% had metastatic disease.
Patients were assessed using the DASS-21 screening tool, a 21-question survey divided into three sections: depression, anxiety, and distress.
There is enough evidence to suggest that depression among patients with thoracic neoplasms is associated with treatment delays and changes in primary treatment, especially delays due to pandemic, were associated with lower survival rates than those without changes.— Oscar Arrieta, MD
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The mean DASS-21 score was 10.45, with women reporting higher levels than men (11.41 vs 9.08). Almost a third of the patients reported they experienced anxiety during the pandemic, followed by depression and distress in equal proportions (18%). Nearly a quarter of patients (23.9%) reported a change in treatment, and 78.6% said those changes were due to reasons pertaining to the pandemic. Delays (≥ 7 days) were the most frequent treatment change in 41.9% of patients, followed by treatment suspension at 37.4%.
“After we adjusted for age and [sex], we found that patients with lung cancer and depression were 4.5 times (95% confidence interval [CI] = 1.53–13.23, P = .006) more likely to experience delays in their lung cancer treatment,” Dr. Arrieta reported. Similarly, patients with stress had 3.18 times higher odds of experiencing delays (95% CI = 1.2–10.06, P = .006). Anxiety was not associated with delays in care.
Dr. Arrieta also found that patients who reported no changes or delays in treatment had prolonged progression-free and overall survival (hazard ratio [HR] = 0.21, P < .001; HR = 0.28, P < .001, respectively).
“There is enough evidence to suggest that depression among patients with thoracic neoplasms is associated with treatment delays and changes in primary treatment, especially delays due to pandemic, were associated with lower survival rates than those without changes,” Dr. Arrieta reported.
