Patients' expectations of preventive measures of medical institutions during the SARS-CoV-2 pandemic in Germany in women with an increased risk of breast and ovarian cancer: a cross-sectional, web-based survey

Retrospective Impact of COVID-19 Pandemic on Primary Breast Cancer Care

Background

The COVID-19 pandemic has transformed breast cancer care for patients and healthcare providers. Circumstances varied greatly by region and hospital, depending on COVID-19 prevalence, case mix, hospital type, and available resources. These challenges have disrupted screening programs and have been particularly distressing for both women with a breast cancer diagnosis and their providers.

Summary

This review explores the retrospective impact of the COVID-19 pandemic on primary breast cancer care. It analyzes changes in screening participation, diagnosis rates, treatment modalities, and the delivery of psycho-oncological support during the pandemic. The study found a significant reduction in breast cancer screenings and a subsequent stage shift in diagnoses, with fewer early-stage and more advanced-stage cancers being detected. Additionally, the review discusses the psychosocial challenges faced by patients and the adaptations made in care delivery, such as the increased use of telemedicine. Despite these challenges, the healthcare systems showed resilience, with core treatment services largely maintained and rapid adaptations to new care models.

Key Messages

There was a marked decrease in breast cancer screenings and early diagnoses during the pandemic, with a shift toward more advanced-stage detections. While there was an increased use of neoadjuvant therapies and telemedicine, essential breast cancer treatments were mostly sustained, reflecting the resilience of healthcare systems. The pandemic significantly impacted the mental health of breast cancer patients, exacerbating anxiety and depression and highlighting the need for improved psycho-oncological support. The full impact of these disruptions on long-term breast cancer outcomes remains uncertain, necessitating ongoing monitoring and adaptation of care strategies to mitigate adverse effects.

Factors Associated with Increased Analgesic Use in German Women with Endometriosis during the COVID-19 Pandemic

(1) Background: Endometriosis is a frequent chronic pain condition in women of fertile age. Pain management with analgesics is frequently used by women with endometriosis. During the COVID-19 pandemic, access to health services was temporarily restricted in various countries for persons without serious conditions, resulting in increased physical and mental health issues. The present study was conducted in order to assess the risk factors predicting increased analgesic intake by women with endometriosis during the COVID-19 pandemic. (2) Methods: The increased intake of over-the-counter (OTC) and prescription-only (PO) analgesics was assessed with an anonymous online questionnaire, along with demographic, pandemic-specific, disease-specific, and mental health characteristics. Anxiety and depression were assessed with the Generalized Anxiety Disorder Scale (GAD-2) and the Patient Health Questionnaire for Depression (PHQ-2), respectively. Pain-induced disability was assessed with the pain-induced disability index (PDI). (3) Results: A high educational level (OR 2.719; 95% CI 1.137–6.501; p = 0.025) and being at higher risk for depressive disorders, as measured by PHQ-2 ≥ 3 (OR 2.398; 95% CI 1.055–5.450; p = 0.037), were independent risk factors for an increased intake of OTC analgesics. Current global pain-induced disability (OR 1.030; 95% CI 1.007–1.054; p = 0.010) was identified as a risk factor for an increased intake of PO pain medication. The degree of reduction in social support and in social networks were independent predictors of an increased intake of PO analgesics in a univariate logistic regression analysis, but lost significance when adjusted for additional possible influencing factors. (4) Conclusions: In this population, an increased intake of OTC analgesics was related to a higher educational level and having a depressive disorder, while a higher pain-induced disability was an independent risk factor for an increased intake of PO analgesics. Pandemic-specific factors did not significantly and independently influence an increased intake of analgesics in women with endometriosis during the first wave of the COVID-19 pandemic in Germany. Healthcare providers should be aware of the possible factors related to increased analgesic use in women with endometriosis in order to identify persons at risk for the misuse of pain medication and to prevent potential adverse effects.