Depression and anxiety in cancer patients before and during the SARS-CoV-2 pandemic: association with treatment delays

Qual Life Res. 2021 Jul;30(7):1903-1912. doi: 10.1007/s11136-021-02795-4. Epub 2021 Feb 26.


Purpose: Pandemics can be associated with anxiety and depression in cancer patients who are undergoing treatment. In the present study, we aimed to perform a comparative evaluation of the conditions of cancer patients before and during the severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2) pandemic using the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) to detect the impact of the pandemic on treatment delays that are associated with anxiety and depression in cancer patients. In addition, the effect of public transport use on treatment delays was examined.

Methods: BDI and BAI were administered to 595 breast, ovarian, colon and gastric cancer patients before and during the pandemic. The questionnaires were administered by the physician blindly, who was unaware of the delay of the patients. The number of days by which the patients delayed their treatment due to the fear of contamination were recorded retrospectively. Correlation analyses were performed between the obtained scores and treatment delays.

Results: The depression and anxiety levels in cancer patients were found to increase during the pandemic (p = 0.000), and this increase was positively correlated with the disruption of their treatment (p = 0.000, r = 0.81). Depression and anxiety levels and treatment delays were higher in elderly patients (p = 0.021). Depression and anxiety were more pronounced in female patients (p = 0.000). Moreover, treatment delays were more common in patients who had to use public transportation (p = 0.038).

Conclusion: SARS-CoV-2 pandemic may increase anxiety and depression in cancer patients. This can cause patients to experience treatment delays due to concerns about becoming infected. At this point, if necessary, assistance should be obtained from psychiatric and public health experts.

Keywords: Anxiety; Cancer patients; Depression; SARS-CoV-2.

MeSH terms

  • Aged
  • Anxiety / psychology*
  • COVID-19 / epidemiology*
  • COVID-19 / psychology
  • Depression / psychology*
  • Female
  • Humans
  • Male
  • Neoplasms / psychology*
  • Neoplasms / therapy*
  • Pandemics
  • Quality of Life / psychology
  • Retrospective Studies
  • SARS-CoV-2 / isolation & purification
  • Time-to-Treatment*
  • Turkey / epidemiology