Abstract 442: Exploring the impact that COVID-19 had on patient distress in a rural cancer center
Authors: Silverwood Sierra , Hirko Kelly 
Published: June 2022

Abstract
Cancer-related psychosocial distress is defined by the National Comprehensive Cancer Network (NCCN) as a multifactorial unpleasant experience of a psychological, social, spiritual, and/or physical nature that may interfere with the ability to cope effectively with cancer, its physical symptoms, and its treatment. Cancer-related psychological distress is common in patients, and it has been implicated in increasing mortality risk. Findings from prior studies suggest that individuals undergoing cancer treatment in rural areas experience greater psychosocial distress than their urban counterparts. Given healthcare access barriers in rural areas, the COVID-19 pandemic may present an even greater strain on these patients. However, the impact of COVID-19 on psychosocial distress among rural cancer patients is unclear. Thus, the objective of this study was to examine changes in psychosocial distress among rural thoracic oncology patients before and after the onset of COVID-19. We also examined whether demographic, geographic, or clinical factors were associated with overall distress within this population. All thoracic oncology patients treated at Cowell Family Cancer Center (CFCC) in rural Michigan from January 1, 2019 through January 1, 2020 (pre-COVID-19, n=139) and from January 1, 2020 through January 31, 2021 (during COVID-19, n=84) were included in this study. Data on patient demographics, degree of rurality, cancer site, and NCCN psychosocial distress measures were abstracted from the electronic medical records. We assessed differences in participant characteristics and psychosocial distress measures between the pre-COVID and during COVID groups using Chi-square, Fisher’s exact, and t-tests. Using multivariable logistic regression models, we estimated odds ratios and 95% CI for associations between participant characteristics and psychosocial distress. Overall psychosocial distress scores were higher during COVID-19 versus before the pandemic (6.5 vs. 5.8, p=0.045). Differences in specific problems contributing to psychosocial distress were also observed. For example, participants were more likely to report being worried about needing help with daily tasks (25.0% vs. 8.6%, p=.001), fear and worry about the future (60.7% vs. 40.3%, p=.003), feeling more dependent on others (45.2% vs. 33.1%, p=.07), and changes in urination (14.3% vs. 5.0%, p=0.02) during vs. before the pandemic. Being single was associated with higher psychosocial distress compared to married individuals (OR=5.29, 95% CI=1.12, 24.7), while age, distance to hospital, rurality, sex, and occupational status were not significant predictors. Findings from this study suggest increases in psychosocial distress among rural thoracic oncology patients during the COVID-19 pandemic. Further research is needed to characterize the impact of COVID-19 on overall distress and quality of life among cancer patients.
Citation Format: Sierra Silverwood, Kelly Hirko. Exploring the impact that COVID-19 had on patient distress in a rural cancer center [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 442.