Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynaecological Oncology, Hacettepe University, Ankara, Turkey.
European Society of Gynaecological Oncoloy (ESGO, European Network of Gynaecological Cancers Advocacy Groups (ENGAGe) Executive Group, Prague, Czech Republic.
Cancer Med. 2021 Jan;10(1):208-219. doi: 10.1002/cam4.3605. Epub 2020 Nov 18.
The impact of the COVID-19 pandemic on European gynaecological cancer patients under active treatment or follow-up has not been documented. We sought to capture the patient perceptions of the COVID-19 implications and the worldwide imposed treatment modifications.
A patient survey was conducted in 16 European countries, using a new COVID-19-related questionnaire, developed by ENGAGe and the Hospital Anxiety & Depression Scale questionnaire (HADS). The survey was promoted by national patient advocacy groups and charitable organisations.
We collected 1388 forms; 592 online and 796 hard-copy (May, 2020). We excluded 137 due to missing data. Median patients' age was 55 years (range: 18-89), 54.7% had ovarian cancer and 15.5% were preoperative. Even though 73.2% of patients named cancer as a risk factor for COVID-19, only 17.5% were more afraid of COVID-19 than their cancer condition, with advanced age (>70 years) as the only significant risk factor for that. Overall, 71% were concerned about cancer progression if their treatment/follow-up was cancelled/postponed. Most patients (64%) had their care continued as planned, but 72.3% (n = 892) said that they received no information around overall COVID-19 infection rates of patients and staff, testing or measures taken in their treating hospital. Mean HADS Anxiety and Depression Scores were 8.8 (range: 5.3-12) and 8.1 (range: 3.8-13.4), respectively. Multivariate analysis identified high HADS-depression scores, having experienced modifications of care due to the pandemic and concern about not being able to visit their doctor as independent predictors of patients' anxiety.
Gynaecological cancer patients expressed significant anxiety about progression of their disease due to modifications of care related to the COVID-19 pandemic and wished to pursue their treatment as planned despite the associated risks. Healthcare professionals should take this into consideration when making decisions that impact patients care in times of crisis and to develop initiatives to improve patients' communication and education.
COVID-19 大流行对正在接受治疗或随访的欧洲妇科癌症患者的影响尚未记录。我们试图了解患者对 COVID-19 影响的看法以及全球范围内实施的治疗调整。
我们在 16 个欧洲国家进行了一项患者调查，使用了由 ENGAGe 和医院焦虑与抑郁量表（HADS）开发的新的 COVID-19 相关问卷。该调查由国家患者倡导团体和慈善组织推广。
我们共收集了 1388 份表格；592 份在线表格和 796 份纸质表格（2020 年 5 月）。由于数据缺失，我们排除了 137 份表格。患者的中位年龄为 55 岁（范围：18-89 岁），54.7%患有卵巢癌，15.5%为术前。尽管 73.2%的患者认为癌症是 COVID-19 的危险因素，但只有 17.5%的患者更担心 COVID-19 而不是他们的癌症病情，年龄较大（>70 岁）是唯一的显著危险因素。总体而言，如果他们的治疗/随访被取消/推迟，71%的患者担心癌症进展。大多数患者（64%）的治疗按计划进行，但 72.3%（n=892）的患者表示，他们没有收到有关患者和工作人员的 COVID-19 总体感染率、检测或他们所在治疗医院采取的措施的信息。平均 HADS 焦虑和抑郁评分分别为 8.8（范围：5.3-12）和 8.1（范围：3.8-13.4）。多变量分析确定，HADS 抑郁评分高、因大流行而经历治疗调整以及担心无法看医生是患者焦虑的独立预测因素。
妇科癌症患者对因 COVID-19 大流行而导致的治疗调整导致疾病进展表示出明显的焦虑，并希望在相关风险下按计划进行治疗。医疗保健专业人员在做出影响患者护理的决策时应考虑到这一点，并制定举措以改善患者的沟通和教育。
