Pandemic-fueled psych problems, fear of recurrence common among cancer patients

Psychological problems, such as post-traumatic stress disorder (PTSD), depression, and anxiety, are common among cancer patients during the COVID-19 pandemic, as were fears of disease progression or recurrence, a recent study has found.

Researchers conducted a meta-analysis of 40 studies (n=27,590 participants) retrieved from the online databases of PubMed, Embase, Web of Science, and PsycINFO. Pooled analyses revealed cumulative prevalence rates of 32.5 percent, 31.3 percent, and 28.2 percent for clinically significant depression, anxiety, and PTSD, respectively.

Meanwhile, distress was present in 53.9 percent of the pooled sample, insomnia in 23.2 percent, and fear of cancer recurrence or disease progression in 67.4 percent.

Sensitivity analyses revealed important differences in these prevalence rates according to patient subgroup. For instance, depression (74.6 percent) and anxiety (92.3 percent) were most common among those with head and neck cancer.

Heterogeneity was also significant for the analysis on fear of progression/recurrence, driven by the use of different quantitative scales, cancer types, geographical location, and study risk of bias.

In terms of study quality, the researchers reported asymmetrical funnel plots for the analyses on depression, anxiety, PTSD, and fear of recurrence/progression. Egger’s test also identified significant potential publication bias for depression (p=0.019), anxiety (p=0.009), PTSD (p=0.038), and fear of progression/recurrence (p=0.001). No such effects were found for distress (p=0.139) and insomnia (p=0.079).

“Oncologists may ignore the psychological problems of patients when formulating cancer treatment plans,” the researchers said. “Thus, our meta‐analysis suggests that a comprehensive assessment of the prevalence of psychological disorder is necessary before providing optimal care to cancer patients in clinical practice.”