OBJECTIVES: The impact of COVID-19 on Health-Related Quality of Life (HRQoL) of cancer patients is substantial. Less attention has been given to its impact on their caregivers. The objective of this study was to examine the humanistic burden of caregivers of cancer patients in Japan and China, pre- and post-COVID-19.

METHODS: This analysis utilized the population-based Japan National Health and Wellness Survey (NHWS) for 2019 (n=30,006), 2020 (n=30,092), 2021 (n=30,015), and the China NHWS in 2017 (n=19,994) and 2020 (n=20,051). Demographic characteristics, HRQoL, work productivity and activity impairment (WPAI) were assessed for caregivers of cancer patients and the general population.

RESULTS: Caregivers in Japan and China displayed worse health outcomes, both pre- and post-COVID, compared to the general population. In the latest data, a higher proportion of caregivers exhibited symptoms of depression or anxiety (e.g., General Anxiety Disorder-7 [GAD-7]≥10: Japan: 15.8% vs. 7.6%; China: 20.2% vs. 6.5%). Caregivers also have lower HRQoL (e.g., Mental Component Summary [MCS]: Japan: 44.97 vs. 48.91; China: 46.80 vs. 49.17) and higher WPAI (e.g., Total Work Productivity: Japan: 33.98% vs. 20.95%; China: 38.88% vs. 22.98%) than the general population. In both the general population and caregivers, there were minimal changes in health outcomes pre- and post-COVID-19. However, in Japan, absenteeism was significantly lower after COVID-19 (13.22% in 2019 vs. 6.85% in 2020 vs. 7.97% in 2021, P<0.05). There is also an increase in MCS (44.60 in 2017 vs. 48.80 in 2020, P<0.01) after COVID-19 in China.

CONCLUSIONS: In Japan and China, the humanistic burden of caregivers of cancer patients remained consistently higher than the general population regardless of the COVID-19 pandemic, highlighting the unmet needs for caregivers. Interestingly, this study indicated that changes in lifestyle under COVID-19 (e.g., flexible work-from-home arrangements) could potentially alleviate the humanistic burden for caregivers.