Burnout in health care professionals (HCPs) results from exposure to psychosocial risks at work. Left unaddressed, burnout can lead to chronic health problems, increased staff turnover, reduced work hours, absenteeism, and early retirement from clinical practice, thus impacting patient care. The European Society for Medical Oncology (ESMO) Resilience Task Force (RTF) was established in December 2019 to support the well-being of oncology HCPs globally. This ESMO RTF position paper aims to provide a set of recommendations to optimise well-being and mitigate burnout in oncology, and to help individuals and institutions maintain the delivery of optimal cancer care. Recommendations were developed by a diverse multinational panel of interprofessional experts based on the key findings from three previously reported ESMO RTF surveys. Several recurrent work-related psychosocial risks in oncology were identified; in particular, concerns about workload and professional development. The need for flexible work patterns, continued use of virtual resources, well-being resources, and targeted support for at-risk groups were highlighted as key considerations to safeguard HCPs' health and prevent burnout. In total, 11 recommendations relating to three priority themes were developed: (i) information and training; (ii) resources; (iii) activism and advocacy. Optimising the well-being of oncology HCPs is essential for the provision of high-quality, sustainable care for patients globally. The ESMO RTF will continue its mission and is rolling out several initiatives and activities to support the implementation of these recommendations.

To assess for associations of known psychometric scales GAD-7, PHQ-9, pc-PTSD-5 with demographics and clinical characteristics of cancer patients as well as identify their value in screening for distress and in guiding Psycho-Oncology evaluation. This prospective feasibility study employed three psychological testing questionnaires, specifically the GAD-7, PHQ-9, and PC-PTSD-5, for the purpose of distress screening. Patients with a diagnosis of colorectal cancer who scored highly on at least one psychometric scale (defined in previous studies of non-cancer populations as a GAD-7 score of 10 or above, a PHQ-9 score of 10 or above, or a PC-PTSD-5 score of 4 or above) were offered a referral for further assessment in the Psycho-Oncology service and triaged via a semi-structured interview. The relationship between patients’ demographics and clinical characteristics and scores and outcomes was evaluated using the chi-square test. Fifty-four patients (30 females) of median age 60 years (range 36–81) were evaluated in the study. Thirty-four patients (63%) scored high on GAD-7, 40 (74%) on PHQ-9, and 8 (15%) on PC-PTSD-5 scales, respectively. Twenty-nine out of the 54 patients who underwent initial assessment with the psychometric scales (53.7%) accepted to be referred to the Psycho-Oncology service and were triaged via semi-structured interview while the rest 25/54 (46.3%) patients declined further assessment. Twenty-two of the patients who were interviewed (76%) required further specialist Psycho-Oncology intervention and the rest were signposted to community services. Patients younger than 65 years of age were more likely to score high according to the GAD-7 tool (p = 0.036). White Caucasian patients tended to score higher in the PHQ-9 questionnaire compared to non-white ones (p = 0.07). Prior history of mental disorder was significantly associated with higher scores in both GAD-7 (p = 0.041) and PC-PTSD-5 tools (p = 0.016). Patients who accepted a referral for psycho-oncology intervention demonstrated statistically elevated levels of anxiety on GAD-7 (p = 0.007) and diminished levels of depression on PHQ-9 (p = 0.042) compared to those who declined the referral. A clinical pathway involving a stepwise approach of psychometric scale evaluation and semi-structured interview can appropriately identify cancer patients with distress requiring further psychological support.

Background: Significant changes in the accessibility and viability of health services have been observed during the COVID-19 period, particularly in vulnerable groups such as cancer patients. In this study, we described the impact of radical practice and perceived changes on cancer patients’ mental well-being and investigated potential outcome descriptors. Methods: Generalized anxiety disorder assessment (GAD-7), patient health (PHQ-9), and World Health Organization-five well-being index (WHO-5) questionnaires were used to assess anxiety, depression, and mental well-being. Information on participants, disease baseline information, and COVID-19-related questions were collected, and related explanatory variables were included for statistical analysis. Results: The mean score values for anxiety, depression, and mental well-being were 4.7 ± 5.53, 4.9 ± 6.42, and 72.2 ± 18.53, respectively. GAD-7 and PHQ-9 scores were statistically associated (p < 0.001), while high values of GAD-7 and PHQ-9 questionnaires were related to low values of WHO-5 (p < 0.001).Using the GAD-7 scale, 16.2% of participants were classified as having mild anxiety (GAD-7 score: 5–9).Mild to more severe anxiety was significantly associated with a history of mental health conditions (p = 0.01, OR = 3.74, 95% CI [1.372–10.21]), and stage category (stage III/IV vs. I/II, p = 0.01, OR = 3.83, 95% CI [1.38–10.64]. From the participants, 36.2% were considered to have depression (PHQ-9 score ≥ 5). Depression was related with older patients (p = 0.05, OR = 1.63, 95% CI [1.16–2.3]), those with previous mental health conditions (p = 0.03, OR = 14.24, 95% CI [2.47–81.84]), those concerned about the COVID-19 impact on their cancer treatment (p = 0.027, OR = 0.19, 95% CI [0.045–0.82]) or those who felt that COVID-19 pandemic has affected mental health (p = 0.013, OR = 3.56, 95% CI [1.30–9.72]). Additionally, most participants (86.7%) had a good well-being score (WHO-5 score ≥ 50). Mental well-being seemed more reduced among stage I–III patients than stage IV patients (p = 0.014, OR = 0.12, 95% CI [0.023–0.65]). Conclusion: There is a necessity for comprehensive cancer care improvement. These patients’ main concern related to cancer therapy, yet the group of patients who were mentally affected by the pandemic should be identified and supported.