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Gultekin M, Ak S, Ayhan A, Strojna A, Pletnev A, Fagotti A, Perrone AM, Erzeneoglu BE, Temiz BE, Lemley B, Soyak B, Hughes C, Cibula D, Haidopoulos D, Brennan D, Cola E, van der Steen-Banasik E, Urkmez E, Akilli H, Zapardiel I, Tóth I, Sehouli J, Zalewski K, Bahremand K, Chiva L, Mirza MR, Papageorgiou M, Zoltan N, Adámková P, Morice P, Garrido-Mallach S, Akgor U, Theodoulidis V, Arik Z, Steffensen KD, Fotopoulou C. Perspectives, fears and expectations of patients with gynaecological cancers during the COVID-19 pandemic: A Pan-European study of the European Network of Gynaecological Cancer Advocacy Groups (ENGAGe). Cancer Med 2020; 10:208-219. [PMID: 33205595 PMCID: PMC7753798 DOI: 10.1002/cam4.3605] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/14/2020] [Accepted: 10/23/2020] [Indexed: 11/10/2022] Open
Abstract
Background 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. Methods 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. Findings 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. Interpretation 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.
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Affiliation(s)
- Murat Gultekin
- 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
| | - Sertac Ak
- Stress Assesment and Research Center (STAR, Hacettepe University, Ankara, Turkey.,Faculty of Medicine, Department of Psychiatry, Hacettepe University, Ankara, Turkey
| | - Ali Ayhan
- Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynaecological Oncology, Baskent University, Ankara, Turkey
| | - Aleksandra Strojna
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Andrei Pletnev
- Department of Gynecologic Oncology, N.N. Alexandrov National Cancer Center of Belarus, Minsk, Belarus
| | - Anna Fagotti
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy
| | | | - B Emre Erzeneoglu
- Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynaecological Oncology, Hacettepe University, Ankara, Turkey
| | - B Esat Temiz
- Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynaecological Oncology, Hacettepe University, Ankara, Turkey
| | - Birthe Lemley
- European Society of Gynaecological Oncoloy (ESGO, European Network of Gynaecological Cancers Advocacy Groups (ENGAGe) Executive Group, Prague, Czech Republic.,KIU - Patient Organisation for Women with Gynaecological Cancer, Copenhagen, Denmark
| | - Burcu Soyak
- Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynaecological Oncology, Hacettepe University, Ankara, Turkey
| | - Cathy Hughes
- Ovacome - Ovarian Cancer Support Charity, London, UK.,Department of Gynecology, Imperial College London, NHS Trust London, London, UK
| | - David Cibula
- Department of Obstetrics and Gynecology, Gynecologic Oncology Center, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Dimitrios Haidopoulos
- Department of Obstetrics and Gynecology, Alexandra Hospital, University of Athens, Athens, Greece
| | - Donal Brennan
- Department of Gynaecological Oncology, University College Dublin (UCD) School of Medicine, Catherine McAuley Research Centre, Mater University Hospital, Dublin, Ireland
| | - Edoardo Cola
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy
| | | | - Esra Urkmez
- European Society of Gynaecological Oncoloy (ESGO, European Network of Gynaecological Cancers Advocacy Groups (ENGAGe) Executive Group, Prague, Czech Republic.,Dance With Cancer Society, Ankara, Turkey
| | - Huseyin Akilli
- Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynaecological Oncology, Baskent University, Ankara, Turkey
| | - Ignacio Zapardiel
- Gynecologic Oncology Unit, La Paz University Hospital-IdiPAZ, Madrid, Spain
| | - Icó Tóth
- European Society of Gynaecological Oncoloy (ESGO, European Network of Gynaecological Cancers Advocacy Groups (ENGAGe) Executive Group, Prague, Czech Republic.,Mallow Flower Foundation, Budapest, Hungary
| | - Jalid Sehouli
- Department of Gynecology with Center for Oncological Surgery, Charité-University Hospital, Berlin, Germany
| | - Kamil Zalewski
- European Society of Gynaecological Oncoloy (ESGO, European Network of Gynaecological Cancers Advocacy Groups (ENGAGe) Executive Group, Prague, Czech Republic.,Department of Gynecological Oncology, Hollycross Cancer Center, Kielce, Poland.,Department of Molecular and Translational Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland.,Department of Gynaecological Oncology, Barts Health NHS Trust, London, UK
| | - Kiarash Bahremand
- Department of Gynaecology, National Institute of Oncology, Budapest, Hungary
| | - Luis Chiva
- Clinica Universidad de Navarra, Madrid, Spain
| | - Mansoor Raza Mirza
- Department of Oncology, The Finsen Centre, Rigshospitalet - Copenhagen University Hospital, Copenhagen, Denmark
| | - Maria Papageorgiou
- European Society of Gynaecological Oncoloy (ESGO, European Network of Gynaecological Cancers Advocacy Groups (ENGAGe) Executive Group, Prague, Czech Republic.,K.E.F.I. Cancer Society, Athens, Greece
| | - Novak Zoltan
- Department of Gynaecology, National Institute of Oncology, Budapest, Hungary
| | - Petra Adámková
- European Society of Gynaecological Oncoloy (ESGO, European Network of Gynaecological Cancers Advocacy Groups (ENGAGe) Executive Group, Prague, Czech Republic.,Onko Unie Cancer Society, Prague, Czech Republic
| | - Philippe Morice
- Department of Surgery, Institute Gustave Roussy, Villejuif, France
| | | | - Utku Akgor
- Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynaecological Oncology, Hacettepe University, Ankara, Turkey
| | - Vasilis Theodoulidis
- Department of Obstetrics and Gynecology, Alexandra Hospital, University of Athens, Athens, Greece
| | - Zafer Arik
- Faculty of Medicine, Department of Medical Oncology, Hacettepe University, Ankara, Turkey
| | - Karina D Steffensen
- European Society of Gynaecological Oncoloy (ESGO, European Network of Gynaecological Cancers Advocacy Groups (ENGAGe) Executive Group, Prague, Czech Republic.,Department of Oncology, Lillebaelt Hospital-University Hospital of Southern Denmark, Vejle, Denmark.,Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.,Center for Shared Decision Making, Lillebaelt Hospital-University Hospital of Southern Denmark, Vejle, Denmark
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