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The COVID-19 pandemic disrupted cancer-related healthcare, which may have impacted self-management self-efficacy. We investigated self-efficacy reported by cancer survivors during COVID-19, including associations with healthcare disruptions, distress, and general health.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Between 2020 and 2021, 1902 individuals aged 18\u201380\u00a0years with a recent cancer diagnosis completed a survey regarding the effects of COVID-19 on healthcare, self-efficacy for managing cancer and social interactions, cancer-related distress, and perceived general health. Linear and logistic models estimated odds ratios and 95% confidence intervals (CIs) between self-efficacy scores, healthcare disruptions, significant distress, and general health.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Mean self-efficacy for managing cancer was 7.58 out of 10. Greater self-efficacy was associated with lower odds for distress (OR 0.18 [95% CI 0.13\u20130.26], quartile 4 vs. 1) and for worse general health (0.05 [0.03\u20130.09]). Participants with disruptions to cancer-related healthcare had lower self-efficacy for managing cancer compared to those without (6.62 vs. 7.09, respectively, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and higher odds for distress (1.70 [1.36\u20132.14]), but not worse general health (1.13 [0.39\u20131.44]). Lower self-efficacy mediated 27% of the association between healthcare disruptions and increased distress (15\u201347%). Associations with self-efficacy for managing social interactions trended in the same direction.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>During COVID-19, disruptions to cancer-related healthcare were associated with lower self-efficacy, increased distress, and worse general health. Psychosocial interventions designed to overcome barriers and target self-efficacy may be important for enhancing outcomes among cancer survivors experiencing disruptions in healthcare access.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00520-025-09905-9","type":"journal-article","created":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T14:43:30Z","timestamp":1757515410000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Self-efficacy for cancer self-management in the context of COVID-19: a cross-sectional survey study"],"prefix":"10.1007","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7532-0389","authenticated-orcid":false,"given":"Thomas","family":"Lawler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristine","family":"Kwekkeboom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaneda","family":"Warren Andersen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajay K.","family":"Sethi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amye J.","family":"Tevaarwerk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"Litzelman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priyanka A.","family":"Pophali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald E.","family":"Gangnon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Hampton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noelle K.","family":"LoConte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Trentham-Dietz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,9,10]]},"reference":[{"issue":"4","key":"9905_CR1","doi-asserted-by":"publisher","first-page":"308","DOI":"10.3322\/caac.70011","volume":"75","author":"NS Wagle","year":"2025","unstructured":"Wagle NS, Nogueira L, Devasia TP, Mariotto AB, Yabroff KR, Islami F et al (2025) Cancer treatment and survivorship statistics, 2025. 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