Lung cancer patients report high anxiety levels and experience treatment delays due to the pandemic

Reviewed by Emily Henderson, B.Sc.Sep 12 2021

Patients coping with lung cancer and treated in one hospital in Mexico reported high levels of anxiety and saw their treatment delayed or due to the COVID-19 pandemic, according to a study presented today at the IASLC World Conference on Lung Cancer.

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. Oscar Arrieta, from Instituto Nacional de Cancerología, Mexíco City, Mexico. Dr. Arrieta and his colleagues sought to determine the prevalence and impact of psychological disorders due to the COVID-19 pandemic.

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, to February 28, 2021. Dr. Arrieta and his colleague enrolled 548 patients, average age 61.5. 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.

The mean DASS-21 score was 10.45 with women reporting higher levels (11.41 vs 9.08) than men. 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%, followed by treatment suspension at 37.4%.

After we adjusted for age and gender, we found that patients with lung cancer and depression were 4.5 times (95% CI 1.53 to 13.23, p=0.006) more likely to experience delays in their lung cancer treatment."

Dr. Oscar Arrieta, Instituto Nacional de Cancerología, Mexíco City, Mexico

Similarly, patients with stress had 3.18 higher odds of experiencing delays (95% CI 1.2 to 10.06, p= 0.006). Anxiety was not associated with delays in care.

Dr. Arrieta also found that patients who reported no changes or delays in treatment had a more prolonged progression-free survival and overall survival [HR 0.21, p<0.001] and [HR 0.28, p<0.001].

"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.