Monitoring cancer survival in Belgium: early insights 3years after the COVID-19 pandemic.

BackgroundColorectal cancer (CRC) is globally one of the most common cancers. Although studies have found a significant prognostic impact of cancer location for right-sided colon cancers compared with those of the left-side, evidence is lacking in a Japanese population. Therefore, we investigated 5-year net survival in colon cancer by tumor site in a Japanese population.MethodsDiagnoses obtained between 2006 and 2008 in 21 population-based cancer registries from the Monitoring of Cancer Incidence in Japan (MCIJ) project were used. Colon cancer patients were categorized as having right-sided (C18.0–18.4) or left-sided colon cancer (C18.5-C18.7). We calculated the 5-year net survival for subjects diagnosed from 2006 until 2008 by anatomical subsite according to sex, age groups, tumor stage at diagnosis. We applied the excess mortality model to calculate excess hazard ratios (EHRs) and 95% confidential intervals (CIs) with and without adjustment for age, sex and cancer stages to evaluate the effect of location of colon cancer.ResultsThis study analyzed a total of 62,350 colon cancer subjects. Five-year net survivals for subjects with left- and right-sided colon cancer were 74.0% (95% CI, 73.4–74.7%) and 70.4% (95% CI, 69.7–71.0%), respectively. Compared with left-sided colon cancers, the EHR for right-sided colon cancers was 1.20 (95% CI, 1.16–1.25) after adjustment for age, sex and stage.ConclusionOur study found that the net survival for right-sided colon cancer was significantly lower than that for left-sided colon cancer. The anatomical site of cancer in the colon might be an important stratification factor in future studies of colon cancer.

Objective: Cancer patients are at a high risk of exhibiting depressive symptoms. However, what remains unknown is whether gynecological cancer (GC) worsens this risk. This study seeks to compare depressive symptoms amongst women diagnosed with GC and women diagnosed with other cancer types before COVID-19 pandemic and during the COVID-19 pandemic. It also seeks to compare both study periods to confirm if COVID-19 influenced depressive symptoms of women with GC.
 Methods: A retrospective cross-sectional study was conducted to find an association between depressive symptoms and gynecological cancers using other cancer type diagnosis in females as a reference. We utilized the sample adult file of NHIS (National Health Interview Survey) data from 2019 (Pre-Pandemic data) and data from 2020 (Pandemic data). We also utilized the PHQ-8 scale to quantify major depressive disorder. Each of the 8 items were scored from 0-3. All statistical analysis were performed using SAS v9.4 ((SAS Institute Inc, Cary, NC), and statistical significance was set at α = 0.05.
 Results: A weighted population of women with GC vs other cancer types was obtained. Women with GC tend to have lesser Age, Educational status, Health status, Income. They also tend to be more obese and smokers. Women with GC tend to have had hysterectomy (68.03% vs 35.43%) and access to care during COVID-19 (71.63% vs 68.01%). Severe depressive symptoms were higher before pandemic and among women with GC OR 2.89 (95%CI 1.64 - 5.12). Moderate depressive symptoms were higher during the pandemic and among women with GC OR 2.19 (95%CI 1.35 – 3.57). Among women with GC, depressive symptoms were less likely in 2020 than 2019 with an OR 0.57 (95%CI 0.36 – 0.91)
 Conclusion: Based on the data available, women with gynecologic cancer are more prone to having depressive symptoms than women with other cancer types. Therefore, policies should be implemented to improve wellness of women with gynecologic cancer. Although, depressive symptoms wasn’t worsened by the COVID-19 pandemic.

Adult primary brain and central nervous system (CNS) cancers, though comprising only about 4% of new cancer diagnoses, significantly impact morbidity and mortality due to their low survival rates. Globally, brain and CNS tumor incidence varies considerably, with the United States exhibiting one of the highest rates and Japan among the lowest worldwide. In the United States, incidence rates differ by race, with higher rates in non‐Hispanic whites (NHW) and lower rates in Asian Americans and Pacific Islanders (AAPI). This study examines the incidence of malignant CNS tumors in Japan and Japanese Americans, comparing these groups to NHW and AAPI populations in the United States. We estimated age‐standardized incidence rates (ASR) of brain and CNS tumors among adults using data from the Monitoring of Cancer Incidence in Japan (MCIJ) and the U.S. Surveillance, Epidemiology, and End Results (SEER)‐9 registries from 2007 to 2014. Incidence rates were stratified by age, sex, and specific CNS tumor subtypes. Incidence rates of CNS tumors among Japanese (ASR: 3.66, 95% CI: 3.56–3.76) and Japanese Americans (ASR: 2.5, 95% CI: 2.13–3.05) were lower than among NHW (9.43, 95% CI, 9.31–9.56) and AAPI populations (ASR: 4.13, 95% CI: 3.94–4.33) in the United States. The same pattern was observed for CNS tumor subtypes and across age groups and sex. This study supports a genetic component in the risk of brain and CNS tumors, a cancer type with largely unknown etiology. By comparing incidence rates across populations, it contributes to understanding the balance of genetic and environmental risk factors in the development of these cancers.

In order to compare survival rates in Japan with those in the USA and European countries, we abstracted the 5-year relative survival rate from several data sources. Survival rates of cancer diagnosed in 1995 – 99 in the USA were abstracted from 18 cancer registries in the Surveillance Epidemiology and End Results (SEER) data (1). Survival rates of cancer diagnosed in 1995 – 99 in the UK and Norway were from four cancer registries (Norway, the UK: Northern Ireland, the UK: Scotland and the UK: Wales) in the European Network of Cancer Registries (ENCR) data (2), and the rate of cancer diagnosed in 2000 – 2002 in Japan was reported from six cancer registries (Miyagi, Yamagata, Niigata, Fukui, Osaka, and Nagasaki) in the Monitoring of Cancer Incidence in Japan (MCIJ) project (3). Here, we compared the cancer survival rate for larynx coded as C32 (ICD10). Figure 1 shows the 5-year relative survival rate of larynx cancer by age category for males; Fig. 2 shows these data for females. In these figures, even if the 5-year relative survival rate was over 100%, the rate was shown as it was. The survival rates for males are in the range from 60 to 80% for all age categories. In Japan, the rates are the highest in almost all age groups. In the USA and the UK (Scotland and Wales), survival rates are the highest in the youngest age category and they decrease with age afterwards. The degree of the decrease in survival rate with age in the USA is a little smaller than those in the UK, and is almost constant especially after 55 – 64 years old. The rates in Japan, Norway, and Northern Ireland show a similar trend. Those in the former two countries are the highest in those aged 45 – 54 years, and that in Northern Ireland is the highest in those aged 55– 64 years. Survival rates in these three countries decrease gently after these peaks. The survival rates for females are in the range from 40 to 100%. Since the incident rates of larynx cancer among females are considerably low (4), the relative survival rates in Japan and UK exceed 100% and the age trends are not smooth. However, it seems to be clear that the survival rate in Japan is higher than those in other countries, and that the survival rate in the advanced age group tends to be lower.

Prior studies reveal gaps in cancer survivors' discussions with health care providers about follow-up care and receipt of care plans; however, whether survivorship care planning may vary by cancer type is not known. We surveyed 615 survivors of breast, colorectal, prostate, lung cancer, and melanoma enrolled in three health plans to examine cancer survivors' self-reported discussions of follow-up care, including the need for surveillance, late and long-term effects, emotional needs, and health behaviors. We assessed whether cancer survivors received a written treatment summary and post-treatment care instructions. Most (92%) survivors reported having a discussion about the need for surveillance; 75%, late and long-term effects; 69%, lifestyle and health behaviors; and 53%, emotional and social needs. Most (88%) reported receiving post-treatment care instructions and 47%, a treatment summary. While there was little difference among survivors' receipt of surveillance or health behavior recommendations by cancer type (p=0.85 and p=0.66, respectively), discussions of late and long-term effects occurred among 82% of prostate, 78% of breast, 73% of melanoma, 72% of colorectal, and 67% of lung survivors (p=0.06). Approximately half of survivors reported discussions of emotional needs, with modest differences by cancer type (p=0.08). Our findings indicate that most patient-provider discussions cover information on surveillance, with less emphasis on late and long-term effects, lifestyle and health behaviors, and substantially less focusing on emotional and social needs. No or modest differences in discussions occurred by cancer type. Whether tailoring information to individual cancer survivor needs is beneficial should be examined.

In order to compare survival rates in Japan with those in the USA and European countries, we abstracted the 5-year relative survival rate from several data sources. Survival rates of cancer diagnosed in 1995 – 99 in the USA were abstracted from 18 cancer registries in the Surveillance Epidemiology and End Results (SEER) data (1). Survival rates of cancer diagnosed in 1995 – 99 in the UK and Norway were from four cancer registries (Norway, the UK: Northern Ireland, the UK: Scotland and the UK: Wales) in the European Network of Cancer Registries (ENCR) data (2), and the rate of cancer diagnosed in 2000 – 2002 in Japan was reported from six cancer registries (Miyagi, Yamagata, Niigata, Fukui, Osaka, and Nagasaki) in the Monitoring of Cancer Incidence in Japan (MCIJ) project (3). Here, we compared the survival rate of gallbladder and other biliary cancer coded as C23 – C24 (ICD10). Figure 1 shows the 5-year relative survival rate of gallbladder and other biliary cancer by age category for males; Fig. 2 shows these data for females. The 5-year relative survival rate of gallbladder cancer was decreasing with age; however, the age differences were not so large compared with other cancer sites. This is because the rates in those below 55 years old were relatively lower than those of other cancer sites. The rates were between 10 and 30% for males, and between 10 and 20% for females. In Japan, the rates tend to be high in all age categories, and in the USA and European areas, the rates were similar.

Introduction: Cannabis has therapeutic potentials for alleviating various cancer and treatment-related symptoms, such as refractory cancer pain, chemotherapy-induced nausea, and insomnia. However, less is known about the prevalence of cannabis use among US cancer survivors and its patterns by reason to use (any vs. medical), sociodemographic and lifestyle factors, state, and cancer type and history. Method: This study is a cross-sectional analysis of a US nationally representative sample of cancer survivors aged ≥ 20 years from the Behavioral Risk Factor Surveillance Survey 2016-2021. Data on the frequency of current cannabis use (past month: any use vs. daily use), reasons to use (medical vs. non-medical), participant characteristics and state cannabis legality were self-reported by 96,594 cancer survivors diagnosed with non-skin cancers. Information on cancer survivorship, including cancer type, age at diagnosis, treatment, and cancer-related pain, was further collected among 12,052 survivors. Weighted prevalence (95% confidence interval [CI]) of cannabis use (any, daily, and medical) was estimated overall and by participant characteristics, states, and cancer history and types. Weighted multivariable (MV) logistic regressions were used to evaluate correlates of cannabis use. Results and Conclusions: In 2016-2021, the prevalence of cannabis was 8.4% (95% CI, 7.9-9.0) for any use (daily use: 3.2% [95% CI, 2.9-3.5]) and 5.5% (95% CI, 5.0-5.9) for medical use among US cancer survivors. Compared to Non-Hispanic (NH) whites (7.9% [95% CI, 7.3-8.5]), NH blacks (10.4% [95% CI, 8.5-12.4]), Native Americans (16.2% [95% CI, 10.6-21.8]), and Hispanics (10.1% [95% CI, 7.7-12.4]) had a significantly higher prevalence of cannabis use. The prevalence of cannabis use was substantially higher among survivors living in states that legalized recreational use (11.2% [95% CI, 10.1-12.3]) than in states that only legalized medical use (6.7% [95% CI, 6.2-7.2]) and states where cannabis was illegal (4.9% [95% CI, 4.3-5.4]). Any cannabis use was most prevalent among cancer survivors in Nevada (21.6%), Maine (14.1%), and Alaska (12.5%). Survivors who were younger, male, not married, current smokers, drinkers, on low incomes, and of poor health status were more likely to report using cannabis than their counterparts. Among cannabis users, females, non-smokers, non-drinkers, and those with higher educational levels, higher BMI, and health conditions were more likely to use cannabis for medical reasons. By cancer type, survivors of testis (19.0%), brain (16.4%), and cervix (13.2%) cancers tended to have a higher prevalence of any cannabis use. Cancer survivors diagnosed at a younger age and reported cancer-related pain were more likely to use cannabis. Few survivors (0.4%) used cannabis during cancer treatment. Distinct cannabis use patterns were observed in US cancer survivors by lifestyle factors and cancer type. Citation Format: Chao Cao, Ruixuan Wang, Lin Yang, Electra D. Paskett, Ce Shang. Prevalence and cancer-specific patterns of cannabis use among US cancer survivors, 2016-2021 [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 740.

Five-year Relative Survival Rate of Cancer in the USA, Europe and JapanIn order to compare survival rates in Japan with those in the USA and European countries, we abstracted the 5-year relative survival rate from several data sources.Survival rates of cancer diagnosed in 1995 -99 in the USA were abstracted from 18 cancer registries in the Surveillance Epidemiology and End Results (SEER) data (1).Survival rates of cancer diagnosed in 1995 -99 in the UK and Norway were obtained from three cancer registries (Norway, the UK: Northern Ireland, the UK: Scotland and the UK: Wales) in the European Network of Cancer Registries (ENCR) data ( 2), and the rate of cancer diagnosed in 2000 -02 in Japan was reported from six cancer registries (Miyagi, Yamagata, Niigata, Fukui, Osaka and Nagasaki) in the monitoring of cancer incidence in Japan (MCIJ) project (3).Here, we compared the survival rate of all cancer sites coded as C00 -97 (ICD10) in the SEER and ENCR data and as C00 -96 (ICD10) in the MCIJ data.Figure 1 shows the 5-year relative survival rate of all cancer sites by age category for males; Fig. 2 shows these data for females.The 5-year relative survival rates for females ,65 years old were higher than those for males and the rates for males and females aged 65 years were in the same range.The reason why survival rates for young females are higher could be that breast and uterus cancers, which have high survival rates, are the main cancer for young females.The survival rates in the USA were the highest in all age -sex categories, except in 15 -44 years for males.Otherwise, the rates in the UK were relatively lower than those in other countries.Norway and Japan showed similar survival rates in both sexes and all age categories.Basically, the older the age at diagnosis of cancer, the lower the 5-year survival rate; however, only in the USA for males, the rates in those ,75 years old were not changed.The reason why the survival rates for patients 45 years of age in the USA were at the same level is that patients diagnosed with prostate cancer from PSA screening test had very high survival rates.

In order to compare survival rates in Japan with those in the USA and European countries, we abstracted the 5-year relative survival rate from several data sources. Survival rates of cancer diagnosed in 1995 – 99 in the USA were abstracted from 18 cancer registries in the Surveillance Epidemiology and End Results (SEER) data (1). Survival rates of cancer diagnosed in 1995 – 99 in the UK and Norway were from four cancer registries (Norway, the UK: Northern Ireland, the UK: Scotland and the UK: Wales) in the European Network of Cancer Registries (ENCR) data (2), and the rate of cancer diagnosed in 2000 – 2002 in Japan was reported from six cancer registries (Miyagi, Yamagata, Niigata, Fukui, Osaka, and Nagasaki) in the Monitoring of Cancer Incidence in Japan (MCIJ) project (3). Here, we compared the survival rate of cervix uteri cancer coded as C53 and corpus uteri cancer coded as C54 (ICD10). Figures 1 and 2 show the 5-year relative survival rate of cervix and corpus uteri cancer by age category, respectively.

Simple SummaryScreening for breast, colorectal, and cervical cancer is correlated with diagnosis at an earlier stage, less extensive surgery, and reduced mortality and fewer complications. Adherence rates to cancer screening are lower for individuals with low socio-economic conditions and educational attainment. These social disparities are only partially reduced by free screening through national initiatives. Education and information and appropriate expenditure for preventive care have the potentials to increase adherence to screening for colorectal, breast, and cervical cancer with the possibility of reduced cancer mortality. The findings of our study highlight the importance of the implementation of nationally organized screening programs for several other types of cancers that are often detected after the occurrence of symptoms. Nationally organized screening programs for several types of cancers, like esophageal, gastric, and pancreatic cancer, in regions with a high prevalence may increase the possibility of diagnosis at earlier stages and improved early and late results.The objective of this study was to determine the correlation between adherence to cancer screening programs and earlier diagnosis of the 14 most common types of cancers in the adult population, before and during the COVID-19 pandemic. National data concerning number of admissions and operations in Italy for adult patients admitted with oncologic problems during the COVID-19 pandemic (2020 to 2022) and in the pre-pandemic period (2015 to 2019) were analyzed. We selected 14 types of cancer that present the most common indications for surgery in Italy. This study included 1,365,000 adult patients who had surgery for the 14 most common types of cancer in the period 2015–2022, and interviews concerning adherence rates to screening for breast, colorectal, and cervical cancer were conducted for 133,455 individuals. A higher decrease in the number of operations for the 14 types of cancer (−45%) was registered during the first three acute phases of the pandemic, and it was more evident for screenable cancers like breast, colorectal, and cervical cancer (p < 0.001). During the first year of the COVID-19 pandemic, the number of screened individuals for breast, colorectal, and cervical cancer decreased by 33.8% (from 7,507,893 to 4,969,000) and the number of diagnoses and operations for these three types of cancer decreased by 10.5% (from 107,656 to 96,405). The increase and return to normality of the number of screened individuals in the last year of the pandemic (2022) and in the first post-pandemic year (2023) was associated with a return to the pre-pandemic levels of diagnoses and operations. The adherence rates were lower for individuals living in rural areas, with low socio-economic status, and unmarried persons; however, the most statistically significant factor for reduced adherence was a lower level of educational attainment. Free screening through nationally organized programs reduced social disparities. There were no significant differences between the pre-pandemic and pandemic periods for several types of cancers (stomach, esophagus, pancreas, liver) that are diagnosed for the occurrence of symptoms and for which nationally organized programs might increase the possibility of earlier diagnosis and improved clinical outcomes. Education, information, and appropriate expenditure for preventive care have the potential to reduce cancer mortality. Nationally organized screening programs for several types of cancers, which are often detected for the occurrence of symptoms, may increase the possibility of diagnosis at earlier stages.

New research published in Cancer Epidemiology, Biomarkers & Prevention indicates that adolescent and young adult (AYA) cancer survivors have almost double the risk of hospitalization in comparison with their siblings and unrelated, age-matched people without cancer.1 According to Chelsea Anderson, PhD, MPH, a postdoctoral fellow at the American Cancer Society, few studies have investigated the health risk in the AYA population after cancer treatment. Moreover, researchers say, previous studies in this population have not well characterized hospitalization patterns in cancer types that commonly affect patients at the older end of that age group, including breast cancer, colorectal cancer, and other types of cancers. Using the Utah Population Database, Dr. Anderson and colleagues from the University of Utah and the University of North Carolina assessed the risk of first hospitalization and the total hospitalization rate. Their analysis included data from 6330 cancer survivors, 12,924 siblings, and 18,171 age-matched people without cancer. Their findings showed that the risk of a first hospitalization in AYA survivors was 1.78 times higher than the risk in their siblings and 1.93 times higher than the risk in unrelated, age-matched people without cancer. The rate of total hospitalizations increased by 56% for AYA survivors compared with age-matched people without cancer. AYA survivors of melanoma and cervical/uterine cancers had the lowest risk of a first hospitalization. The results also showed that the AYA cancer survivors had more than double the risk for other conditions, including infectious and parasitic diseases, nervous system diseases, circulatory diseases, skin diseases, respiratory conditions, injuries, and poisoning. Furthermore, they had a somewhat elevated risk for digestive, mental, musculoskeletal, and genitourinary diseases. The study's findings illustrate the importance of long-term, risk-based follow-up in this age group to prevent and treat severe late effects and other health problems and may help to guide future guidelines for follow-up care in AYA cancer survivors, Dr. Anderson notes.

IntroductionCancer causes a substantial burden to our society, both from a health and an economic perspective. To improve cancer patient outcomes and lower society expenses, early diagnosis and timely treatment are essential. The recent COVID-19 crisis has disrupted the care trajectory of cancer patients, which may affect their prognosis in a potentially negative way. The purpose of this paper is to present a flexible decision-analytic Markov model methodology allowing the evaluation of the impact of delayed cancer care caused by the COVID-19 pandemic in Belgium which can be used by researchers to respond to diverse research questions in a variety of disruptive events, contexts and settings.MethodsA decision-analytic Markov model was developed for 4 selected cancer types (i.e. breast, colorectal, lung, and head and neck), comparing the estimated costs and quality-adjusted life year losses between the pre-COVID-19 situation and the COVID-19 pandemic in Belgium. Input parameters were derived from published studies (transition probabilities, utilities and indirect costs) and administrative databases (epidemiological data and direct medical costs). One-way and probabilistic sensitivity analyses are proposed to consider uncertainty in the input parameters and to assess the robustness of the model’s results. Scenario analyses are suggested to evaluate methodological and structural assumptions.DiscussionThe results that such decision-analytic Markov model can provide are of interest to decision makers because they help them to effectively allocate resources to improve the health outcomes of cancer patients and to reduce the costs of care for both patients and healthcare systems. Our study provides insights into methodological aspects of conducting a health economic evaluation of cancer care and COVID-19 including insights on cancer type selection, the elaboration of a Markov model, data inputs and analysis.

Cancer causes a substantial burden to our society, both from a health and an economic perspective. To improve cancer patient outcomes and lower society expenses, early diagnosis and timely treatment are essential. The recent COVID-19 crisis has disrupted the care trajectory of cancer patients, which may affect their prognosis in a potentially negative way. The purpose of this paper is to present a flexible decision-analytic Markov model methodology allowing the evaluation of the impact of delayed cancer care caused by the COVID-19 pandemic in Belgium which can be used by researchers to respond to diverse research questions in a variety of disruptive events, contexts and settings. A decision-analytic Markov model was developed for 4 selected cancer types (i.e. breast, colorectal, lung, and head and neck), comparing the estimated costs and quality-adjusted life year losses between the pre-COVID-19 situation and the COVID-19 pandemic in Belgium. Input parameters were derived from published studies (transition probabilities, utilities and indirect costs) and administrative databases (epidemiological data and direct medical costs). One-way and probabilistic sensitivity analyses are proposed to consider uncertainty in the input parameters and to assess the robustness of the model's results. Scenario analyses are suggested to evaluate methodological and structural assumptions. The results that such decision-analytic Markov model can provide are of interest to decision makers because they help them to effectively allocate resources to improve the health outcomes of cancer patients and to reduce the costs of care for both patients and healthcare systems. Our study provides insights into methodological aspects of conducting a health economic evaluation of cancer care and COVID-19 including insights on cancer type selection, the elaboration of a Markov model, data inputs and analysis.

Translation and psychometric testing of the Thai version of cancer survivors’ unmet needs measure among cancer survivors

Background: Cancer survivors often experience financial hardship due to high costs associated with cancer treatment. Our objective was to (1) identify determinants of financial hardship, and to (2) evaluate the impact of financial hardship on mental health symptoms among cancer survivors during the COVID-19 pandemic. Methods: We used nationally representative data from the COVID-19 Household Impact Survey collected at three-time points: April 20-26, May 4-10, and May 30th -June 8th of 2020. Our primary exposure was cancer survivor status, based on participant’s self-report of a cancer diagnosis (n=854, 7.1%). We defined financial hardship using the following question: “Suppose you have an unexpected expense that costs $400. Based on your current financial situation, how would you pay for this expense?” Respondents were categorized as experiencing financial hardship if they chose the following options: I wouldn’t be able to pay for it right now; sell something; use a payday loan, deposit advance, or overdraft; borrow from a friend or family member. Chi-square (χ2) tests were used to compare reported financial hardship among cancer survivors to other U.S. adults. Multivariable Poisson regression was used to identify determinants of financial hardship among cancer survivors. We used multinomial logistic regression to evaluate associations of financial hardship on mental health symptoms of cancer survivors. Results: Eighteen percent of cancer survivors reported experiencing financial hardship. Cancer survivors aged 30-44 (44.8%) and 45-59 years (25.9%) more frequently reported financial hardship compared to adults without cancer (23.4%, 16.7%, respectively, χ2p&amp;lt;0.05). Compared to cancer survivors aged 60+ years, those aged 18-29 (aPR: 2.54, 95% CI; 1.51-4.28), 30-44 (aPR:3.41, 95% CI:2.26-5.16), and 45-59 years (aPR:3.66, 95% CI:2.26-5.16) were more likely to experience financial hardship. Cancer survivors on Medicaid (aPR: 1.76, 95% CI: 1.16-2.66) were more likely to experience financial hardship compared to their counterparts. Compared to those without a high school degree, cancer survivors with some college education (aPR: 0.30, 95% CI: 0.18-0.47) and with a ≥Baccalaureate degree (aPR:0.05, 95% CI: 0.02-0.14) were less likely to experience financial hardship. Rural cancer survivors had 61% higher prevalence of financial hardship compared to urban residents (aPR: 1.61, 95% CI:1.00-2.58), however, suburban residents were less likely to experience financial hardship compared to cancer survivors living in urban areas (aPR: 0.65, 95% CI:0.44-0.98). Cancer survivors who experienced financial hardship were more likely to report feeling depressed (aOR: 2.78, 95% CI: 1.39-5.56), lonely (aOR: 3.06, 95% CI: 1.39-6.72), and hopeless (aOR: 3.16, 95% CI: 1.36-7.37) 3-7 days during the last 7 days. Conclusion: Lower SES measures and younger age were determinants of experiencing financial hardship among cancer survivors. During the COVID-19 pandemic, there is a high burden of mental health symptoms among cancer survivors experiencing financial hardship. Citation Format: Jessica Y. Islam, Denise C. Vidot, Marlene Camacho-Rivera. Financial hardship and mental health among cancer survivors during the COVID-19 pandemic: An analysis of the U.S. COVID Impact Survey [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2021 Feb 3-5. Philadelphia (PA): AACR; Clin Cancer Res 2021;27(6_Suppl):Abstract nr S10-02.