Mental Health Challenges in Cancer Survivors From Diverse Backgrounds During COVID-19 Pandemic: Insights From the All...

The COVID-19 pandemic exacerbated mental health challenges. This study aimed to investigate the mental health impact of the pandemic on cancer survivors from diverse backgrounds using the All of Us Research Program's COVID-19 Participant Experience (COPE) survey.

This analysis included respondents of the COPE survey with average depression, anxiety, and self-harm metrics computed for individuals completing multiple survey iterations. Multivariable logistic regression assessed the relationship between cancer survivorship, demographic factors, and mental health outcomes. Sensitivity analyses were conducted to investigate peak mental health challenges and time trend.

Among 100,203 respondents, 20,561 (20.5%) were cancer survivors. Cancer survivors differed demographically from the general population, tending to be older and more likely to report higher socioeconomic status. Cancer survivors exhibited significantly higher odds of self-harm (aOR = 1.09, 95% CI 1.01-1.18). Sensitivity analyses focusing on peak mental health scores revealed that cancer survivors had significantly increased odds of experiencing anxiety (aOR = 1.11, 95% CI 1.06-1.17), depression (aOR = 1.11, 95% CI 1.06-1.17), and self-harm tendencies (aOR = 1.09, 95% CI 1.01-1.18) compared to non-cancer survivors. Within the cancer survivor subgroup, younger age, gender and sexual minority status, lower income, and widowed/separated/divorced status were associated with worse mental health outcomes.

During the COVID-19 pandemic, cancer survivors exhibited significantly higher odds of depression, anxiety, and self-harm compared to non-survivors, with certain subgroups demonstrating heightened vulnerability. Our study highlights the critical need for integrated mental health services in cancer survivorship care programs, especially among those from underserved groups who are at high risk, as we continue to evolve with the pandemic.