The Psychological Distress of Cancer Patients following the COVID-19 Pandemic First Lockdown: Results from a Large French Survey

SIMPLE SUMMARY: Cancer patients commonly experience anxiety which could increase with the COVID-19 pandemic situation. The aim of this study was to measure post-traumatic stress disorder (PTSD) and anxiety in cancer patients in France following the first COVID-19-related lockdown and associated factors. We found that the factors associated with PTSD and anxiety were different in nature. Factors associated with PTSD were not related to cancer but to the COVID-19 crisis, while factors associated with anxiety were mainly cancer related. More specifically, the fear of coming to hospital because of the risk of contracting COVID-19 was the strongest predictor of PTSD, and a better lockdown experience was protective against PTSD. Fear of cancer recurrence appear to be the main predictor of anxiety. Our study highlights the need to better integrate psychosocial support in pandemic response measures. Healthcare providers should not prioritize COVID-19 over cancer as the latter remains a central concern for cancer patients. ABSTRACT: Cancer patients commonly experience psychological distress that may increase with the current COVID-19 pandemic. This prospective study aimed to measure post-traumatic stress disorder (PTSD) and anxiety in cancer patients following France’s first COVID-19-related lockdown, together with associated factors. Cancer patients receiving outpatient treatment or post-treatment follow-up completed a questionnaire which measured, among other things, PTSD (IES-R), anxiety (State-Trait Anxiety Inventory), and fear of cancer recurrence (FCR). Of the 1097 patients included in the study, 14.7% and 30.5% suffered from PTSD and anxiety, respectively. Patients afraid to come to hospital due to the risk of COVID-19 transmission (OR = 3.49, p < 0.001), those with a negative lockdown experience (OR = 0.98, p < 0.001), women (OR = 1.97; p = 0.009), and patients living alone (OR = 1.63, p = 0.045) were all more likely to have PTSD. Older patients (OR = 1.65, p = 0.020), women (OR = 1.62, p = 0.018), those with a higher FCR score (OR = 5.02, p < 0.001), patients unsatisfied with their cancer management (OR = 2.36, p < 0.001), and those afraid to come to hospital due to COVID-19 (OR = 2.43, p < 0.001) all had a higher risk of anxiety. These results provide a greater understanding of the psychological consequences of the COVID-19 pandemic in cancer patients and highlight the need to better integrate psychosocial support in pandemic response measures in order to guide health systems.