Changes in the quality of cancer care as assessed through performance indicators during the first wave of the COVID-19 pandemic in 2020: a Scoping Review

Abstract

Objectives: Summarize performance indicators used in the literature to evaluate the impact of the COVID-19 pandemic on cancer care (January-June 2020), and to assess changes in the quality of care as assessed via selected indicators. Methods: Scoping review. Indicators and their reported trends were collated following the cancer care pathway. Results: Database searches retrieved 6277 articles, 838 articles met the inclusion criteria, and 135 articles were included after full-text screening, from which 917 indicators were retrieved. Indicators assessing the diagnostic process showed a decreasing trend: from 33 indicators reporting on screening, 30 (91%) signalled a decrease during the pandemic (n=30 indicators, 91%). A reduction was also observed in the number of diagnostic procedures (n=64, 58%) and in the diagnoses (n=130, 89%). The proportion of diagnoses in the emergency setting and waiting times showed an increasing trend (n=8, 89% and n=14, 56%, respectively). Nine indicators (64%) showed stability in cancer stages distribution. A decreasing trend in the proportion of earliest stage cancers was reported by 63% of indicators (n=9), and 70% (n=43) of indicators showed an increasing trend in the proportion of advanced-stage cancers. Indicators reflecting the treatment process signalled a reduction in the number of procedures: 79% (n=82) of indicators concerning surgeries, 72% (n=41) of indicators assessing trends in radiotherapy, and 93% (n=40) of indicators related to systemic therapies. Modifications in cancer treatment were frequently reported: 64% (n=195) of indicators revealed changes in treatment. Ten indicators (83%) signalled a decreasing number of hospital admissions. Conclusion: Health systems struggled to ensure continuity of cancer care. As this pandemic keeps evolving, the trends reported over the first 6 months of 2020 provide an argument to monitor these changes closely. This information needs to be transparent, standardised, and timely, allowing to monitor quality and outcomes of care during crises and inform policy responses.

The impact of lag time to cancer diagnosis and treatment on clinical outcomes prior to the COVID-19 pandemic: a scoping review of systematic reviews and meta-analyses

“…The copyright holder for this preprint this version posted June 22, 2022. ; https://doi.org/10.1101/2022.06. 21.22276569 doi: medRxiv preprint a recent scoping review summarizing the impact of the pandemic on time to cancer diagnosis and treatment (8), a pre-pandemic perspective of the effect of lag time on oncologic outcomes among patients undergoing cancer screening, diagnosis, and staging is of paramount importance.…”

“…New and previously diagnosed cancer cases have been subject to risk-based prioritization and treatment triaging that differ from standard clinical practice (7). For cancers that were diagnosed in the first six months of the pandemic, an increasing trend in diagnosis of late-stage cancers and a decreasing trend in diagnosis of early-stage cancers were observed, as a reflection of the initial effects of extended lag times to diagnosis (8).…”

“…Pandemic-induced changes have brought forth the rising concern within the cancer care community as to whether current lag times to diagnosis and treatment that deviate from standard-of-care practice will lead to poorer outcomes for cancer patients. With modelling studies forecasting the tolerability of these lag times based on estimated long-term outcomes (13-15) and a recent scoping review summarizing the impact of the pandemic on time to cancer diagnosis and treatment (8), a pre-pandemic perspective of the effect of lag time on oncologic outcomes among patients undergoing cancer screening, diagnosis, and staging is of paramount importance. Retrospective, pre-pandemic data can help our understanding of the influence of lag time on patient outcomes, which would be imperative for planning cancer control and care services in the future.…”

Acute care pathway assessed through performance indicators during the COVID-19 pandemic in OECD countries (2020-2021): a scoping review

“…Furthermore, it enables the synthesis and communication of emerging evidence (30, 33) and the identi cation of knowledge gaps (35). This methodology has been described by the authors in two previous studies (36,37), where different clinical areas were studied. The PRISMA checklist -extension for scoping reviews (38) was used for reporting (Additional le 1).…”

Impact of the COVID-19 pandemic on cancer care in OECD countries

“…Based on a provider-based survey, the Japan Lung Cancer Society found that the number of newly diagnosed primary lung cancer patient decreased by 6.6% across 118 hospitals surveyed in January-October 2020 compared to the same period in 2019 (Japan Times, 2020 [46]). In the United Kingdom, a patient survey was conducted and found that of people with potential cancer symptoms, 45% did not contact their GP for their symptoms between March and August 2020 (Cancer Research UK, 2021 [47]).…”