Cancer survivors' cancellations of healthcare appointments during the COVID‐19 pandemic: Associations with anxiety and depression

Objective Though it is well‐documented that cancer survivors experienced healthcare delays during the COVID‐19 pandemic, who initiated those delays has not been examined. This longitudinal study distinguishes rates of patient‐from provider‐cancelled healthcare appointments at three timepoints during the pandemic, and examines psychosocial factors associated with patient‐cancelled appointments. Methods Cancer survivors (N = 147) in the United States completed psychosocial and health behavior measures three times between May and December 2020. We examined rates of patient‐ and provider‐cancelled healthcare appointments, including cancer screening appointments, at each timepoint and change between timepoints. Logistic regression was used to determine if anxiety symptoms, depression symptoms, and COVID‐19 fears were associated with self‐cancelled healthcare appointments. Results In May 2020, one third (33.79%) of participants reported one or more self‐cancelled appointments within the prior 2 months and nearly half (45.89%) reported one or more provider‐cancelled appointments. Rates of provider‐cancelled appointments decreased to 35.71% in June/July 2020 and to 9.24% in November/December 2020 (both reflected p 0.144). In June/July and November/December 2020, higher depression and anxiety symptoms, but not COVID‐19 fears, were associated with greater likelihood of self‐cancelled appointments. Conclusions Cancer survivors cancelled their healthcare appointments at a stable rate even as provider‐cancelled appointments declined. Depression and anxiety symptoms, but not COVID‐19 concerns, were associated with patient cancellations. Interventions that address anxiety and depression symptoms may help to promote adherence to cancer survivorship care during the pandemic.