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BACKGROUND: The COVID-19 pandemic has imposed significant changes in cancer service delivery resulting in increased anxiety and distress in both patients and clinicians. We aimed to investigate how these changes have been perceived by patients diagnosed with colorectal cancer and identify determinants of increased anxiety. PATIENTS AND METHODS: An anonymised 32-item survey in a specialised lower gastrointestinal cancer outpatient clinics at a tertiary cancer centre in North West England between 18 May and 1 July 2020. Self-reported anxiety based on General Anxiety Disorder-7 (GAD-7) screening tool. RESULTS: Of 143 participants who completed the survey (response rate 67%), 115 (82%) were male and median age group was 61-70 years. 112 (78%) participants had telephone consultation (83% met needs), and 57 (40%) had radiological scan results discussed over the phone (96% met needs). In total, 23 (18%) participants were considered to have anxiety (GAD-7 score ≥ 5), with 7 (5.5%) scoring for moderate or severe anxiety. Those concerned about getting COVID-19 infection, and worried COVID-19 would have effect on their mental health, and affect their experience of cancer care, were most likely to have anxiety (p<0.05, multivariate analysis). Majority did not feel they needed support during this phase of the pandemic. Participants felt that friends and family had been very supportive, but less so the primary care services (p<0.05). CONCLUSIONS: The findings of this survey suggest that some of the service changes implemented may have already improved the overall experience of cancer care amongst patients with colorectal cancer at our institute. Reassuringly, the incidence of participants with moderate to severe anxiety levels during the peak of COVID-19 in the UK was much lower than anticipated. Importantly, patients were much more concerned about their cancer treatment than COVID-19, emphasising the need to continue to provide comprehensive cancer care even with a “2(nd) wave” of COVID-19.
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10.1016/j.clcc.2020.11.006
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document_parses/pdf_json/0150befd6d9d56a7fd7d500dce4877cd16826db8.json
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document_parses/pmc_json/PMC7718777.xml.json
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The impact of changes in service delivery in patients with colorectal cancer during the initial phase of the COVID-19 pandemic
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