{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T12:26:32Z","timestamp":1786969592264,"version":"build-2736575974"},"reference-count":30,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"AstraZeneca Deutschland GmbH"},{"id":[{"id":"https:\/\/ror.org\/054q96n74","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Curr. Oncol.","Current Oncology"],"abstract":"<jats:p>Background\/Objectives: The COVID-19 pandemic was a major challenge for healthcare systems and social life worldwide. During the pandemic, studies focused on examining structural changes in patient care and establishing new guidelines to manage COVID-19, but very few of them addressed patients\u2019 perceptions and concerns regarding changes in cancer treatment during the pandemic. This study aimed to assess the changes in their therapy situation during three waves of the pandemic and the impact on their social life. Methods: This exploratory cross-sectional multicenter survey was conducted among patients with gynecological malignancies and breast cancer at gynecological oncology centers in Germany between October 2020 and February 2022. An anonymous paper-based 50-item questionnaire, available in German, assessed medical care, treatment modifications, mental health, and socioeconomic burden during the COVID-19 pandemic. Data were analyzed descriptively. Two subgroup analyses were conducted, comparing age groups \u226470 and &gt;70 years, as well as patients with and without a migrant background. Results: Overall, 778 patients met the inclusion criteria of the survey (median age: 59; range: 24\u201393). In the majority of the patients (77.1%), the treatment schedules remained unchanged during COVID-19 pandemic. Treatment appointments were modified in a small number of patients (9.0%). Changes in therapy schedules were slightly more common among the second- and third-generation migrants and among patients \u226470 years. Despite the uncertainty of the COVID-19 pandemic, most patients (83.4%) kept their trust in the healthcare system. Acceptance of preventive measures was high, and 85.9% were willing to be vaccinated against COVID-19. Psychological symptoms such as worries and fear were reported by more than half of the participants during the last 2 weeks previous to the survey and more common among patients \u226470 years. Only 8.6% were more afraid of a COVID-19 infection than their cancer disease. Conclusions: Despite major challenges in cancer care due to the COVID-19 pandemic, access to cancer treatment and adequate management at gynecological oncology centers in Germany remained stable. The increased psychological burden in crises requires new infrastructure and should be addressed to improve patient care in future crises. The acceptance of taking preventive measures against COVID-19 was high among cancer patients.<\/jats:p>","DOI":"10.3390\/curroncol33080484","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T11:00:05Z","timestamp":1786964405000},"page":"484","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Patients\u2019 Perspectives on Changes in Cancer Care During the COVID-19 Pandemic: Results of a Survey Among Patients with Gynecological Malignancies and Breast Cancer in Germany (NOGGO-S25\/Expression XIII)"],"prefix":"10.3390","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4228-5158","authenticated-orcid":false,"given":"Desislava","family":"Dimitrova","sequence":"first","affiliation":[{"name":"Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, Department of Gynecology with Center for Oncological Surgery, Augustenburger Platz 1, 13353 Berlin, Germany"},{"name":"North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0873-4686","authenticated-orcid":false,"given":"Jolijn Dirksje","family":"Boer","sequence":"additional","affiliation":[{"name":"North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9218-6919","authenticated-orcid":false,"given":"Dario","family":"Zocholl","sequence":"additional","affiliation":[{"name":"North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany"},{"name":"Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, Institute of Biometry and Clinical Epidemiology, 10117 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maja","family":"Krajewska","sequence":"additional","affiliation":[{"name":"Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, Institute of Biometry and Clinical Epidemiology, 10117 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8617-5535","authenticated-orcid":false,"given":"Hannah","family":"Woopen","sequence":"additional","affiliation":[{"name":"Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, Department of Gynecology with Center for Oncological Surgery, Augustenburger Platz 1, 13353 Berlin, Germany"},{"name":"North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5719-7532","authenticated-orcid":false,"given":"Sara","family":"Nasser","sequence":"additional","affiliation":[{"name":"Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, Department of Gynecology with Center for Oncological Surgery, Augustenburger Platz 1, 13353 Berlin, Germany"},{"name":"North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adak","family":"Pirmorady-Sehouli","sequence":"additional","affiliation":[{"name":"Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, Department of Psychosomatic Medicine, 12203 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heike","family":"Jansen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, TUM Klinikum Rechts der Isar, 81675 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4237-2657","authenticated-orcid":false,"given":"Marion","family":"Kiechle","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, TUM Klinikum Rechts der Isar, 81675 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5963-6623","authenticated-orcid":false,"given":"Jalid","family":"Sehouli","sequence":"additional","affiliation":[{"name":"Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, Department of Gynecology with Center for Oncological Surgery, Augustenburger Platz 1, 13353 Berlin, Germany"},{"name":"North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/S0140-6736(20)30183-5","article-title":"Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China","volume":"395","author":"Huang","year":"2020","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1001\/jamaoncol.2023.4513","article-title":"Assessment of Changes in Cancer Treatment During the First Year of the COVID-19 Pandemic in the US","volume":"10","author":"Nogueira","year":"2024","journal-title":"JAMA Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Jim\u00e9nez-Rodr\u00edguez, D., Santill\u00e1n Garc\u00eda, A., Montoro Robles, J., Rodr\u00edguez Salvador, M.D.M., Mu\u00f1oz Ronda, F.J., and Arrogante, O. (2020). Increase in Video Consultations During the COVID-19 Pandemic: Healthcare Professionals\u2019 Perceptions about Their Implementation and Adequate Management. Int. J. Environ. Res. Public Health, 7.","DOI":"10.3390\/ijerph17145112"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/S1470-2045(20)30096-6","article-title":"Cancer patients in SARS-CoV-2 infection: A nationwide analysis in China","volume":"21","author":"Liang","year":"2020","journal-title":"Lancet Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/S0140-6736(20)31182-X","article-title":"Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: An international cohort study","volume":"396","author":"Nepogodiev","year":"2020","journal-title":"Lancet"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1007\/s10654-022-00946-6","article-title":"Decrease of cancer diagnosis during COVID-19 pandemic: A systematic review and meta-analysis","volume":"38","author":"Angelini","year":"2023","journal-title":"Eur. J. Epidemiol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Fotopoulou, C., Khan, T., Bracinik, J., Glasbey, J., Abu-Rustum, N., Chiva, L., Fagotti, A., Fujiwara, K., Ghebre, R., and Gutelkin, M. (2022). Outcomes of gynecologic cancer surgery during the COVID-19 pandemic: An international, multicenter, prospective CovidSurg-Gynecologic Oncology Cancer study. Am. J. Obstet. Gynecol., 227.","DOI":"10.1136\/ijgc-2022-igcs.18"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1007\/s00404-024-07511-4","article-title":"Patient care and access to clinical trials in gynaecological oncology: Global implications of the early phase of the COVID-19 pandemic","volume":"310","author":"Nasser","year":"2024","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1002\/cam4.3605","article-title":"Perspectives, fears and expectations of patients with gynaecological cancers during the COVID-19 pandemic: A Pan-European study of the European Network of Gynaecological Cancer Advocacy Groups (ENGAGe)","volume":"10","author":"Ak","year":"2021","journal-title":"Cancer Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1007\/s00404-021-06280-8","article-title":"Impact of COVID-19 on gynaecological patient care: Results of patient\u2019s survey with 327 patients","volume":"305","author":"Recker","year":"2022","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.ejca.2020.06.019","article-title":"Impact of the coronavirus disease 2019 pandemic on cancer treatment: The patients\u2019 perspective","volume":"136","author":"Dumoulin","year":"2020","journal-title":"Eur. J. Cancer"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Lim, K.H.J., Ntellas, P., Anderson, D., Simpson, L., Braun, M., Adamou, M., Barriuso, J., Dadouli, K., Connell, J., and Williams, J. (2023). The Mental Health Burden of Patients with Colorectal Cancer Receiving Care during the COVID-19 Pandemic: Results of the PICO-SM Study. Cancers, 15.","DOI":"10.3390\/cancers15041226"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Momenimovahed, Z., Salehiniya, H., Hadavandsiri, F., Allahqoli, L., G\u00fcnther, V., and Alkatout, I. (2021). Psychological Distress Among Cancer Patients During COVID-19 Pandemic in the World: A Systematic Review. Front. Psychol., 12.","DOI":"10.3389\/fpsyg.2021.682154"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Toquero, P., Blanco Fern\u00e1ndez, C., L\u00f3pez Mart\u00ed, M.P., Hern\u00e1ndez Mar\u00edn, B., Vera Cea, E.B., Garrido Garc\u00eda, A., M\u00e9ndez Carrascosa, E., Ba\u00f1\u00f3n Torres, D., Donnay Candil, O., and Ballesteros Garc\u00eda, A.I. (2021). Emotional Distress in Cancer Patients During the First Wave of the COVID-19 Pandemic. Front. Psychol., 12.","DOI":"10.3389\/fpsyg.2021.755965"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1007\/s12029-021-00643-9","article-title":"Depression and Anxiety Among Patients with Cancer During COVID-19 Pandemic: A Systematic Review and Meta-analysis","volume":"52","author":"Ayubi","year":"2021","journal-title":"J. Gastrointest. Cancer"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Nelson, B.W., Pettitt, A., Flannery, J.E., and Allen, N.B. (2020). Rapid assessment of psychological and epidemiological correlates of COVID-19 concern, financial strain, and health-related behavior change in a large online sample. PLoS ONE, 15.","DOI":"10.31234\/osf.io\/jftze"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"100041","DOI":"10.1016\/j.jmh.2021.100041","article-title":"ESCMID Study Group for Infections in Travellers and Migrants (ESGITM). Clinical outcomes and risk factors for COVID-19 among migrant populations in high-income countries: A systematic review","volume":"3","author":"Hayward","year":"2021","journal-title":"J. Migr. Health"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Abidin, Z.U., Thirumalareddy, J., Gupta, J.S., and Abdul Jabbar, A.B. (2025). Disparities in COVID-19 mortality in the United States, 2020\u20132023. BMC Public Health, 25.","DOI":"10.1186\/s12889-025-24530-1"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1016\/j.ijid.2021.10.037","article-title":"Emerging socio-economic disparities in COVID-19-related deaths during the second pandemic wave in Germany","volume":"113","author":"Hoebel","year":"2021","journal-title":"Int. J. Infect. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1093\/annonc\/mdy037","article-title":"Expression III: Patients\u2019 expectations and preferences regarding physician-patient relationship and clinical management-results of the international NOGGO\/ENGOT-ov4-GCIG study in 1830 ovarian cancer patients from European countries","volume":"29","author":"Alavi","year":"2018","journal-title":"Ann. Oncol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1136\/ijgc-2019-000892","article-title":"Expectations and preferences of patients with primary and relapsed ovarian cancer to maintenance therapy: A NOGGO\/ENGOT-ov22 and GCIG survey (Expression IV)","volume":"30","author":"Rohr","year":"2020","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Dimitrova, D., Naghavi, B., Richter, R., Nasser, S., Chekerov, R., Braicu, E.I., David, M., Blohmer, J., Inci, G., and Torsten, U. (2021). Influence of migrant background on patient preference and expectations in breast and gynecological malignancies (NOGGO-expression V study): Results of a prospective multicentre study in 606 patients in Germany. BMC Cancer, 21.","DOI":"10.1186\/s12885-021-08731-6"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Woopen, H., Keller, M., Zocholl, D., Mittelstadt, S., Barretina-Ginesta, M.P., Heinzelmann-Schwarz, V., Lafleur, J., Koci\u00e1n, R., Baum, J., and Krabisch, P. (2023). Side Effects from Cancer Therapies and Perspective of 1044 Long-Term Ovarian Cancer Survivors-Results of Expression VI-Carolin Meets HANNA-Holistic Analysis of Long-Term Survival with Ovarian Cancer: The International NOGGO, ENGOT, and GCIG Survey. Cancers, 15.","DOI":"10.3390\/cancers15225428"},{"key":"ref_24","first-page":"213","article-title":"Die deutsche Version des NCCN Distress-Thermometers: Empirische Pr\u00fcfung eines Screening-Instruments zur Erfassung psychosozialer Belastung bei Krebspatienten","volume":"54","author":"Mehnert","year":"2006","journal-title":"Z. Psychiatr. Psychol. Psychother."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)\u2014A metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"Harris","year":"2009","journal-title":"J. Biomed. Inform."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"103208","DOI":"10.1016\/j.jbi.2019.103208","article-title":"The REDCap consortium: Building an international community of software platform partners","volume":"95","author":"Harris","year":"2019","journal-title":"J. Biomed. Inform."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Oxley, S., Kalra, A., Sideris, M., Itzkowitz, N., Evans, O., Atakpa, E.C., Brentnall, A.R., Dworschak, N., Gaba, F., and Gabe, R. (2023). Impact of Multiple COVID-19 Waves on Gynaecological Cancer Services in the UK. Cancers, 15.","DOI":"10.3390\/cancers15041273"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/s13037-022-00331-y","article-title":"Impact of the COVID-19 pandemic on delays in surgical procedures in Germany: A multi-center analysis of an administrative registry of 176,783 patients","volume":"16","author":"Hunger","year":"2022","journal-title":"Patient Saf. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e70004","DOI":"10.1002\/hup.70004","article-title":"Alcohol Consumption During the COVID-19 Pandemic: A Critical Review","volume":"40","author":"Merlo","year":"2025","journal-title":"Hum. Psychopharmacol."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Loui, H.F., Li, J., Jackson, N.J., Romero, R., Wisk, L.E., and Buhr, R.G. (2024). Tobacco consumption behavior change during the COVID-19 pandemic is associated with perceived COVID threat. BMC Public Health, 24.","DOI":"10.1186\/s12889-024-20259-5"}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/33\/8\/484\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T11:47:16Z","timestamp":1786967236000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/33\/8\/484"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,17]]},"references-count":30,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["curroncol33080484"],"URL":"https:\/\/doi.org\/10.3390\/curroncol33080484","relation":{},"ISSN":["1718-7729"],"issn-type":[{"value":"1718-7729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,17]]}}}