Abstract 438: Psychosocial outcomes, sleep, and substance use among male cancer survivors during the COVID-19 pandemic
Authors: McGrath Colleen B. , Shreves Alaina H. , Stopsack Konrad , Cheung Lilian , Fisher Ann , Markt Sarah , Valdimarsdottir Unnur , Mucci Lorelei A. 
Published: June 2022

Introduction: Cancer survivors may experience impacts on their psychosocial health and sleep quality due to the cancer diagnosis and severity as well as treatments. The COVID-19 pandemic has greatly disrupted the lives of cancer survivors, including those who are in treatment and those who are living cancer-free. A better understanding of psychosocial behaviors, sleep, and substance use is of timely importance. Aim: To better understand the individual-level psychosocial outcomes, sleep patterns, and substance use of cancer survivors during the COVID-19 pandemic, and compared to individuals without a history of cancer.

Methods: Participants of the Health Professionals Follow-up Study, enrolled since 1986, were asked to self-report health behaviors during the pandemic on three web-based questionnaires administered during the COVID-19 pandemic (baseline COVID: October 2020, first follow-up: January 2021, second follow-up: April 2021). Psychosocial presentations, sleep patterns, and substance use were analyzed descriptively between cancer survivors and individuals without a history of cancer. Substance use and non-continuous sleep outcomes (e.g., trouble falling asleep) were recoded dichotomously and assessed via logistic regression to calculate odds ratios (OR) and 95% confidence Intervals (CI). Continuous psychosocial outcomes and sleep outcomes (e.g., hours slept last night) were analyzed via linear regression. Models were adjusted for covariates such as age, race, marital status, living arrangement, employment status, and other health information, as appropriate.

Results: Of 4,416 men who completed the baseline COVID-19 questionnaire, 962 were cancer survivors (after excluding those with non-melanoma skin cancer). Poor sleep quality was prevalent for all eligible men (median age: 78 years); 34% reported trouble falling asleep, 74% woke during the night, 50% woke too early without getting back to sleep, 59% needed a nap most or some of the time. Cancer survivors were significantly more likely to wake early and not get back to sleep (OR = 1.19, (1.00, 1.41)) and sleep a greater amount in the past week (+0.14 (0.03, 0.25) hours per day) compared to those without a history of cancer. Compared to those without a history of cancer, survivors were more likely to present with lower psychological wellbeing, higher post-traumatic stress, and higher stress and lower gratitude. Across all men, healthful changes in alcohol (decreased) use were observed at baseline (10% of men) and second follow-up (15% of men). At the first follow-up, cancer survivors were at significantly higher odds to regularly use CBD products compared to individuals without a history of cancer (OR: 1.63 (1.03, 2.55)).

Conclusion: Among male cancer survivors, there were significant impacts in sleep patterns and substance use, and further understanding of the effects of such differences is needed.

Citation Format: Colleen B. McGrath, Alaina H. Shreves, Konrad Stopsack, Lilian Cheung, Ann Fisher, Sarah Markt, Unnur Valdimarsdottir, Lorelei A. Mucci. Psychosocial outcomes, sleep, and substance use among male cancer survivors during the COVID-19 pandemic [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 438.