Exploring the Impact of the COVID-19 Pandemic on Cancer-Related Distress Among Thoracic Oncology Patients at a Rural Cancer Center

Abstract

Abstract Purpose: Cancer-related distress (CRD) is frequently observed in rural settings and may have been exacerbated during the COVID-19 pandemic. We examined pre and post COVID-19 changes in CRD among individuals treated for thoracic cancers at a rural cancer center. Methods: Patient demographics, clinical information, and CRD measures derived from the National Comprehensive Cancer Network psychosocial distress problem list were abstracted from electronic medical records for thoracic oncology patients treated at a rural Michigan cancer center before (January 1, 2019-January 1, 2020; n=139) and during (January 20, 2020-January 31, 2021; n=84) the COVID-19 pandemic. CRD scores overall and by type (practical, emotional, social, and physical concerns) were calculated by summing the relevant problem list items. We assessed changes in CRD overall and by type using chi-square tests, Fisher’s exact tests, and multivariable logistic regression models. Results: CRD prevalence increased by 9.1% during vs. before the pandemic (97.6% vs. 88.5%; p=0.02), with largest increases evident for emotional (82.1% vs. 64.0%; p=0.004) and physical (82.1% vs. 67.6%; p=0.02) concerns. CRD scores were slightly higher during vs. before the pandemic but the differences were not significant (all p-values>0.05). Compared to those treated in the year prior, patients treated during the pandemic had higher odds of elevated CRD (OR (95% CI) =1.86 (1.1, 3.2)), and practical concerns (OR (95% CI) =2.19 (1.3, 3.8)). Conclusions: Findings from this preliminary study suggest an increased prevalence of CRD among rural thoracic oncology patients treated during compared to before the COVID-19 pandemic.