{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T01:56:41Z","timestamp":1793757401089,"version":"4.6.1"},"reference-count":49,"publisher":"Wiley","issue":"19","license":[{"start":{"date-parts":[[2021,6,23]],"date-time":"2021-06-23T00:00:00Z","timestamp":1624406400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["K01CA212056"],"award-info":[{"award-number":["K01CA212056"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["K08CA241337"],"award-info":[{"award-number":["K08CA241337"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["P30CA008748"],"award-info":[{"award-number":["P30CA008748"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R01CA129769"],"award-info":[{"award-number":["R01CA129769"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R01CA172119"],"award-info":[{"award-number":["R01CA172119"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R01CA244673"],"award-info":[{"award-number":["R01CA244673"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R35CA197289"],"award-info":[{"award-number":["R35CA197289"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["U54CA137788"],"award-info":[{"award-number":["U54CA137788"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008337","name":"Norman Cousins Center for Psychoneuroimmunology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008337","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000071","name":"National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["K12HD001441"],"award-info":[{"award-number":["K12HD001441"]}],"id":[{"id":"10.13039\/100000071","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["K01AG065485"],"award-info":[{"award-number":["K01AG065485"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["P30AG010133"],"award-info":[{"award-number":["P30AG010133"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["P30AG028716"],"award-info":[{"award-number":["P30AG028716"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG068193"],"award-info":[{"award-number":["R01AG068193"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000048","name":"American Cancer Society","doi-asserted-by":"publisher","award":["128660\u2010RSG\u201015\u2010187\u201001\u2010PCS"],"award-info":[{"award-number":["128660\u2010RSG\u201015\u2010187\u201001\u2010PCS"]}],"id":[{"id":"10.13039\/100000048","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000048","name":"American Cancer Society","doi-asserted-by":"publisher","award":["17\u2010023\u201001\u2010CPPB"],"award-info":[{"award-number":["17\u2010023\u201001\u2010CPPB"]}],"id":[{"id":"10.13039\/100000048","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The coronavirus disease 2019 (COVID\u201019) pandemic has had wide\u2010ranging health effects and increased isolation. Older with cancer patients might be especially vulnerable to loneliness and poor mental health during the pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The authors included active participants enrolled in the longitudinal Thinking and Living With Cancer study of nonmetastatic breast cancer survivors aged 60 to 89 years (n = 262) and matched controls (n = 165) from 5 US regions. Participants completed questionnaires at parent study enrollment and then annually, including a web\u2010based or telephone COVID\u201019 survey, between May 27 and September 11, 2020. Mixed\u2010effects models were used to examine changes in loneliness (a single item on the Center for Epidemiologic Studies\u2013Depression [CES\u2010D] scale) from before to during the pandemic in survivors versus controls and to test survivor\u2010control differences in the associations between changes in loneliness and changes in mental health, including depression (CES\u2010D, excluding the loneliness item), anxiety (the State\u2010Trait Anxiety Inventory), and perceived stress (the Perceived Stress Scale). Models were adjusted for age, race, county COVID\u201019 death rates, and time between assessments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Loneliness increased from before to during the pandemic (0.211;\n                      <jats:italic>P<\/jats:italic>\n                      = .001), with no survivor\u2010control differences. Increased loneliness was associated with worsening depression (3.958;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001) and anxiety (3.242;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001) symptoms and higher stress (1.172;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001) during the pandemic, also with no survivor\u2010control differences.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Cancer survivors reported changes in loneliness and mental health similar to those reported by women without cancer. However, both groups reported increased loneliness from before to during the pandemic that was related to worsening mental health, suggesting that screening for loneliness during medical care interactions will be important for identifying all older women at risk for adverse mental health effects of the pandemic.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.33687","type":"journal-article","created":{"date-parts":[[2021,6,23]],"date-time":"2021-06-23T13:41:31Z","timestamp":1624455691000},"page":"3671-3679","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":77,"title":["Loneliness and mental health during the COVID\u201019 pandemic in older breast cancer survivors and noncancer controls"],"prefix":"10.1002","volume":"127","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1887-3953","authenticated-orcid":false,"given":"Kelly E.","family":"Rentscher","sequence":"first","affiliation":[{"name":"Cousins Center for Psychoneuroimmunology University of California, Los Angeles Los Angeles California"},{"name":"Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences University of California, Los Angeles Los Angeles California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5164-125X","authenticated-orcid":false,"given":"Xingtao","family":"Zhou","sequence":"additional","affiliation":[{"name":"Lombardi Comprehensive Cancer Center Georgetown University Washington District of Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brent J.","family":"Small","sequence":"additional","affiliation":[{"name":"School of Aging Studies University of South Florida Tampa Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harvey J.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Center for the Study of Aging and Human Development Duke University Medical Center Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asma A.","family":"Dilawari","sequence":"additional","affiliation":[{"name":"Lombardi Comprehensive Cancer Center Georgetown University Washington District of Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9023-8391","authenticated-orcid":false,"given":"Sunita K.","family":"Patel","sequence":"additional","affiliation":[{"name":"Outcomes Division, Population Sciences City of Hope National Medical Center Los Angeles California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3205-2078","authenticated-orcid":false,"given":"Traci N.","family":"Bethea","sequence":"additional","affiliation":[{"name":"Lombardi Comprehensive Cancer Center Georgetown University Washington District of Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1500-930X","authenticated-orcid":false,"given":"Kathleen M.","family":"Van Dyk","sequence":"additional","affiliation":[{"name":"Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences University of California, Los Angeles Los Angeles California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9695-1457","authenticated-orcid":false,"given":"Zev M.","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of North Carolina\u2010Chapel Hill Chapel Hill North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaeil","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Bioinformatics, and Biomathematics Georgetown University Washington District of Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanting","family":"Zhai","sequence":"additional","affiliation":[{"name":"Lombardi Comprehensive Cancer Center Georgetown University Washington District of Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim A.","family":"Ahles","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Memorial Sloan Kettering Cancer Center New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7353-3711","authenticated-orcid":false,"given":"Heather S. L.","family":"Jim","sequence":"additional","affiliation":[{"name":"Moffitt Cancer Center Tampa Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenna C.","family":"McDonald","sequence":"additional","affiliation":[{"name":"Department of Radiology and Imaging Sciences Indiana University School of Medicine and Indiana University Melvin and Bren Simon Cancer Center Indianapolis Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Saykin","sequence":"additional","affiliation":[{"name":"Department of Radiology and Imaging Sciences Indiana University School of Medicine and Indiana University Melvin and Bren Simon Cancer Center Indianapolis Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James C.","family":"Root","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Memorial Sloan Kettering Cancer Center New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deena M. A.","family":"Graham","sequence":"additional","affiliation":[{"name":"John Theurer Cancer Center Hackensack University Medical Center Hackensack New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5516-0819","authenticated-orcid":false,"given":"Judith E.","family":"Carroll","sequence":"additional","affiliation":[{"name":"Cousins Center for Psychoneuroimmunology University of California, Los Angeles Los Angeles California"},{"name":"Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences University of California, Los Angeles Los Angeles California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2490-005X","authenticated-orcid":false,"given":"Jeanne S.","family":"Mandelblatt","sequence":"additional","affiliation":[{"name":"Lombardi Comprehensive Cancer Center Georgetown University Washington District of Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,6,23]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6932a1"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2020.113347"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2020.113392"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp20X713021"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2020.02033"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12992-020-00589-w"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0239698"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2020.113117"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2020.113267"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.17061\/phrp3022008"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/0164027504268574"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/geronb\/gbaa110"},{"key":"e_1_2_8_14_1","article-title":"Loneliness and mental health during the COVID\u201019 pandemic: a study among Dutch older adults","author":"Tilburg TG","year":"2020","journal-title":"J Gerontol B Psychol Sci Soc Sci"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1159\/000441651"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/1745691614568352"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.3544"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.39.4411"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2020.04.021"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.5459"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.5588"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.18.00140"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djab003"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/014662167700100306"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/gps.4495"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/0164027511423258"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/PSY.0b013e3181b40efc"},{"key":"e_1_2_8_28_1","volume-title":"Manual for the State\u2010Trait Anxiety Inventory (STAI: Form Y)","author":"Spielberger C","year":"1983"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0010837"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1177\/1359105313508346"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.5376"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.32489"},{"key":"e_1_2_8_33_1","unstructured":"The New York Times.Coronavirus (COVID\u201019) Data in the United States. Accessed December 2 2020.https:\/\/github.com\/rearc\u2010data\/covid\u201019\u2010nyt\u2010data\u2010in\u2010usa"},{"key":"e_1_2_8_34_1","volume-title":"Population Estimates for the U.S., States, and Counties, 2010\u201019","author":"US Department of Agriculture Economic Research Services (USDA ERS)","year":"2020"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/0277-9536(91)90150-B"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apnu.2008.11.002"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1037\/amp0000690"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.16865"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.5437"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.21753"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2011.07.031"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-024719"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6603057"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1186\/gb-2007-8-9-r189"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2015.07.001"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1514249112"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1177\/0956797612464059"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1093\/jncics\/pky029"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.33060"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.30440"}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.33687","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cncr.33687","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.33687","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T21:00:45Z","timestamp":1760302845000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.33687"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,23]]},"references-count":49,"journal-issue":{"issue":"19","published-print":{"date-parts":[[2021,10]]}},"alternative-id":["10.1002\/cncr.33687"],"URL":"https:\/\/doi.org\/10.1002\/cncr.33687","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"value":"0008-543X","type":"print"},{"value":"1097-0142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,23]]},"assertion":[{"value":"2021-03-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}