HSR23-096: COVID-19 Impact and Psychosocial Well-Being Among Adults Living With Cancer: A Longitudinal Analysis

Background: COVID-19 continues to have long-lasting effects on healthcare experiences and health-related quality of life, especially for individuals who are more reliant on frequent medical services, such as those living with a cancer diagnosis. We examined the effects of healthcare disruption and psychosocial well-being among people with cancer more than 2 years into the evolving COVID-19 pandemic. Method: A longitudinal sample (N=173) of adults aged 18+ in the US who have ever been diagnosed with cancer participated in online surveys about their COVID-19 experiences at three timepoints (T1=Sep–Dec 2020; T2=Jun–Jul 2021; T3=Jun–Jul 2022). Participants answered questions about COVID-19 negative impact (1=Not at all negatively impacted; 5=Extremely negatively impacted) and diagnosis, as well as disruptions in cancer care (if experienced and why) and psychosocial well-being (PROMIS-29 depression, anxiety). Frequencies were calculated and within-groups (repeated measures) and between-groups analyses (t-tests) were conducted. Results: Participants’ (80% women; Mean age=60; 79% White, 7% Black, 6% Hispanic) most common cancer diagnoses included breast (31%), blood (28%), lung (7%), gastrointestinal (6%), and gynecologic (6%), with 19% ever being metastatic (yrs since diagnosis Mdn=7). Frequency of ever testing positive for COVID-19 increased over time (T1: 2%; T2: 6%; T3: 25%). Disruption in cancer care (eg, routine cancer screenings, imaging and lab services, etc) decreased from T1 (45%) to T2 (16%) but remained stable at T3 (16%). Commonly cited reasons for care disruptions were similar across timepoints (recommended by provider; fear of contracting COVID-19), with more disruption occurring at T3 due to COVID-19 diagnosis. Anxiety, depression, and COVID-19 negative impact were highest at T1 and then significantly decreased at T2, remaining stable at T3. Disruption in cancer care was significantly associated with more anxiety, depression, and COVID-19 negative impact at each timepoint, including the most recent (T3). Conclusion: While disruptions in cancer care, anxiety, depression, and COVID-19 negative impact decreased over time, those experiencing disruption in their cancer care reported worse psychosocial well-being and more COVID-19 negative impact at each of three timepoints. Our results underscore the continued need for accessible psychosocial support and resources among those experiencing delays in cancer care due to COVID-19.