Impact of the Pandemic on Cancer Survivors’ Mental Health
Economic hardship and its ramifications may also significantly effect patients’ mental health.58 Unemployment has been reported to be strongly associated with suicide [odds ratio (OR) 2.6, 95% confidence interval (CI) 2.0-3.4].59 In a study investigating “economic suicides”, it was found that the 2008 recession was associated with at least 10,000 additional suicides in Europe and North America between 2008 and 2010.60 The effect of the COVID-19 pandemic on mental health and suicide rates is difficult to predict. Several large-scale studies have linked a current cancer diagnosis with increased incidence of suicide (from a 1.9-fold risk61 to a 4.4-fold risk62 in a more recent study) when compared to the general population. HNC survivors, in particular, have been found to be at higher risk of suicide and suicide-related death compared to patients with other types of cancer.62,63 Cancer-related financial toxicity has been associated with depressed mood (OR 1.95, 95% CI 1.29-2.95),5 all of which may be exacerbated by unemployment and economic burden during this pandemic. This highlights an imperative need for the incorporation of mental health services and supportive interventions, even if these services may only be delivered through telehealth platforms within the current framework of public health measures.