(006) A Pandemic's Effect on Cancer Worry in H&N Cancer

Introduction: A head and neck cancer diagnosis, its treatments and surveillance are stressful experiences for most patients. Recently the global pandemic of SARS-CoV-2 was superimposed on cancer care. How COVID-19 influenced “cancer worry” in head and neck cancer is unclear.

Methods: As part of routine clinical care at MSK, patients report cancer worry as a component of the FACE-Q Head and Neck Cancer Module, our patient-reported outcomes (PROs) program. Cancer worry scores were analyzed from Feb 1, 2019 through Jan 31, 2022. Mean scores were scaled by the sample size of each month, creating standardized values to account for different response numbers between months. Monthly scores were plotted over time and compared using Pearson’s correlation to the publicly available NYC death and hospitalization rates.

Results: There were 5369 surveys in the pre-COVID era (Feb ‘19-Feb ‘20), 4541 surveys during the first year of COVID in the U.S. (Mar ‘20-Feb ‘21), and 3963 surveys in the following year (Mar ‘21-Jan ‘22). There was no difference in mean scores between the pre-COVID period and the first or second year of COVID (pre-COVID 30.4 vs. 29.4 in year-1 [p=0.0569] and vs. 29.5 in year-2 [p=0.05234]). The 476 survey scores during March and April 2020 were significantly higher during the first COVID peak when compared to the 4065 surveys taken over the rest of the year [p=0.0063]. NYC hospitalization and death rates peaked in April 2020 and again to a lesser extent in January 2021. Cancer worry score was mildly and significantly correlated with the NYC death rate (R=0.40, p=0.04658). Cancer worry score was also mildly correlated with the NYC hospitalization rate but this did not reach statistical significance (R=0.35, p=0.08677).

Conclusions: These data show that there was a correlation on cancer worry in head and neck cancer during the COVID pandemic that significantly decreased over time. How this influenced access to care and outcomes could be hypothesized on. Cancer worry is influenced by external events and integration of PROs in clinical care allows for early identification of patients at risk so that additional support can be provided.