COVID-19 and its impact on gynaecologic oncology practice in India—results of a nationwide survey

Abstract

The COVID-19 pandemic sweeping across the world has caused major disruptions in healthcare delivery and practice. A survey was conducted to assess the changes in the care of gynaecologic oncology patients in India. Methods: An online survey enquiring about the patient volumes and surgical load, and changes in practice protocols for endometrial, ovarian, cervical and vulval cancers was conducted in May, 2020. Results: The total number of responses received was 153. Barring duplicates, 148 were analysed. There was a significant drop in gynaecologic oncology patients attending government hospitals as compared to the non-government sector. The drop was not significantly different in areas having low versus high COVID-19 case volumes. The treatment of endometrial cancers remained the same although there was a marked shift from minimal access surgery to conventional surgery. Advanced ovarian cancer was mostly managed by neoadjuvant chemotherapy. Cervical and vulval cancer management remained the same, but radiotherapy protocols were modified by most. Conclusion: Based on clinician responses, it appears that most practices across India have suffered a fall in patient volumes. The responses from government sectors point towards a bigger hit in this segment of practice. While the management of endometrial cancers and cervical cancers was mostly unchanged, most cases of advanced ovarian cancer received neoadjuvant chemotherapy. Cervical cancer, when managed by chemoradiation, was likely to have altered radiation schedules.

Impact of COVID-19 in gynaecological oncology care: a systematic rapid review

“…According to an online survey in India, it appeared that the volume of patients in cancer centers had reduced, with risk of patients having delayed diagnosis and presenting at more advanced and potentially incurable stages of disease [ 22 ].…”

Treatment delay and treatment pattern modifications among epithelial ovarian cancer patients during the COVID‐19 pandemic: A retrospective cohort study

“…Another study, a survey among healthcare professionals in India involved in the care of gynecologic cancer patients, assessed the difference between government and private hospitals. 18 This study identified that government hospitals had higher patient concentration rates than private hospitals before the pandemic. Government hospitals in this study reported higher proportions of practice decrease during the pandemic.…”

“…Treatment private hospitals. 18 This study identified that government hospitals had higher patient concentration rates than private hospitals before the pandemic. Government hospitals in this study reported higher proportions of practice decrease during the pandemic.…”

“…Treatment modification in that study was fundamentally associated with postponed or canceled surgery. Another study, a survey among healthcare professionals in India involved in the care of gynecologic cancer patients, assessed the difference between government and private hospitals 18 . This study identified that government hospitals had higher patient concentration rates than private hospitals before the pandemic.…”

Impact of COVID-19 pandemic on cancer care delivery : A Real World Experience

“…A survey done on clinicians practising gynaecologic oncology found significant fall in patient volumes, especially in government hospitals after COVID lockdown. 11 In an early analysis reported by Patil et al showed drop in footfalls in a retrospective audit of adult medical head neck cancer unit of apex tertiary cancer hospital. 12 Indian Association of Surgical Oncology mandated routine COVID-19 testing before any surgery.…”