Roles of unmet supportive care needs, supportive cancer care service disruptions, and COVID-19–related perceptions in psychological distress among recently diagnosed breast cancer survivors in Hong Kong

Introduction: Receiving a cancer diagnosis and living with breast cancer can be particularly stressful during pandemic situations. This study examined how cancer care service disruptions, unmet supportive care needs (SCNs), and coronavirus disease 2019 (COVID-19)–related perceptions were associated with psychological distress among Hong Kong breast cancer survivors (BCS) during the COVID-19 pandemic. Methods: A total of 209 female BCS diagnosed since January 2020 (ie, the start of the COVID-19 pandemic in Hong Kong) were recruited from the Hong Kong Breast Cancer Registry to complete a cross-sectional survey measuring the aforementioned variables. Results: Multivariable logistic regression analysis indicated that unmet physical/daily living needs (odds ratio [OR]=1.03; P=0.002), unmet psychological needs (OR=1.06; P<0.001), and perceived severity of COVID-19–related health consequences in BCS (OR=1.67; P=0.02) were significantly associated with moderate-to-severe psychological distress. However, cancer treatment/supportive care service disruptions, fear of COVID-19, and unmet SCNs in patient care/health system information/sexual domains were not significant contributors (P=0.77-0.89). Conclusion: Half of the BCS in Hong Kong experienced substantial psychological distress during the pandemic. Survivors with higher levels of unmet SCNs in physical/daily living and psychological domains, as well as those with greater perceived severity of COVID-19–related health consequences, were more likely to experience moderate-to-severe psychological distress. These findings suggest that efforts to address specific unmet SCNs and risk perceptions are important for reducing psychological distress among BCS during pandemic situations.