Covid-19: Urgent cancer referrals fall by 60%, showing “brutal” impact of pandemic

Mahase, Elisabeth

doi:10.1136/bmj.m2386

Cited by 41 publications

(40 citation statements)

References 2 publications

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“… 12 Also in the UK, others have shown that in the whole country, urgent referrals for cancer from GPs fell by 60% in April. 13 In Italy, the referrals for BRCA testing to a genetic laboratory had decreased by about 60%. 14 …”

Section: Resultsmentioning

confidence: 99%

Impact of COVID-19 on cancer diagnosis and management in Slovenia – preliminary results

Zadnik

Mihor

Tomšič

et al. 2020

Radiology and Oncology

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BackgroundThe COVID-19 pandemic has disrupted the provision and use of healthcare services throughout the world. In Slovenia, an epidemic was officially declared between mid-March and mid-May 2020. Although all non-essential health care services were put on hold by government decree, oncological services were listed as an exception. Nevertheless, as cancer control depends also on other health services and additionally major changes in people’s behaviour likely occurred, we aimed to analyse whether cancer diagnosis and management were affected during the COVID-19 epidemic in Slovenia.MethodsWe analysed routine data for the period November 2019 through May 2020 from three sources: (1) from the Slovenian Cancer Registry we analysed data on pathohistological and clinical practice cancer notifications from two major cancer centres in Ljubljana and Maribor; (2) from the e-referral system we analysed data on all referrals in Slovenia issued for oncological services, stratified by type of referral; and (3) from the administrative data of the Institute of Oncology Ljubljana we analysed data on outpatient visits by type as well as on diagnostic imaging performed.ResultsCompared to the November 2019 – February 2020 average, the decrease in April 2020 was about 43% and 29% for pathohistological and clinical cancer notifications; 33%, 46% and 85% for first, control and genetic counselling referrals; 19% (53%), 43% (72%) and 20% (21%) for first (and control) outpatient visits at the radiotherapy, surgery and medical oncology sectors at the Institute of Oncology Ljubljana, and 48%, 76%, and 42% for X-rays, mammograms and ultrasounds performed at the Institute, respectively. The number of CT and MRI scans performed was not affected.ConclusionsSignificant drops in first referrals for oncological services, first visits and imaging studies performed at the Institute, as well as cancer notifications in April 2020 point to a possibility of a delayed cancer diagnosis for some patients during the first surge of SARS-CoV-2 cases in Slovenia. The reasons for the delay cannot be ascertained with certainty and could be linked to health-seeking behaviour of the patients, the beliefs and practices of doctors and/ or the health system management during the epidemic. Drops in control referrals and control visits were expected and are most likely due to the Institute of Oncology Ljubljana postponing non-essential follow-ups through May 2020.

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Section: Resultsmentioning

confidence: 99%

Impact of COVID-19 on cancer diagnosis and management in Slovenia – preliminary results

Zadnik

Mihor

Tomšič

et al. 2020

Radiology and Oncology

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“…Notwithstanding, the true success of any strategy in the cancer setting can only be appropriately assessed several years downstream in terms of clinical outcomes; potential health‐related quality‐of‐life deficits should not be forgotten, and we are planning follow‐up surveys to attempt to capture the physical and psychological burden of the treatment disruptions and postponements. Furthermore, we should be aware that new suspected cancer referrals have also dramatically reduced during the pandemic [8], and so there is a long road to recovery ahead and for none more so than patients with BC.…”

Section: Treatment Status N %mentioning

confidence: 99%

The experience of UK patients with bladder cancer during the COVID‐19 pandemic: a survey‐based snapshot

et al. 2020

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“…The COVID-19 pandemic caused by the SARS-CoV-2 coronavirus infection has resulted in an unprecedented challenge on healthcare systems worldwide [1,2]. The reduction in clinical activity and elective surgical work has been due to a number of factors including access to primary care, risk of nosocomial infection and the redeployment of staff [3,4]. As outpatient services adopt new strategies for the delivery of care, many face-to-face appointments have been cancelled, causing a significant backlog of surgical work.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 and the return to head and neck outpatient activity in the United Kingdom: what is the new normal?

Bola

Jaikaransingh

Winter

2020

Eur Arch Otorhinolaryngol

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Purpose As surgical specialties now begin the graduated return to elective activity and face-to-face clinics, this paper investigates the current head and neck outpatient practices across the United Kingdom. Methods A cross-sectional study comprised of an online 20-item survey was distributed to members of the British Association of Head & Neck Oncologists (BAHNO). The survey was open on a web-based platform and covered topics including safety measures for patients, protective equipment for healthcare staff and protocols for the use of flexible nasendoscopy in the clinic. Results The survey was completed by 117 participants covering 66 NHS Trusts across the UK. There was a significant reduction in face-to-face Otolaryngology, Maxillofacial and Speech and Language clinic patients when compared to pre-pandemic numbers (p < 0.0001). Risk assessments for flexible nasendoscopy were done for 69% of clinics and 58% had an established protocol. Room downtime after flexible nasendoscopy ranged from 0 to 6 h and there was a significant increase in allocated downtime after a patient had coughed/sneezed (p < 0.001). Natural ventilation existed in 36% of clinics and the majority of responders didn’t know the Air Change Per Hour (ACPH) of the clinic room (77%). Where ACPH was known, it often did not match the allocated room downtime. Conclusion There is a wide variation in outpatient activity across the United Kingdom, but adaptations are being made to try and maintain staff and patient safety. However, more can still be done by liaising with allied teams to clarify outpatient protocols.

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Covid-19: Urgent cancer referrals fall by 60%, showing “brutal” impact of pandemic

Cited by 41 publications

References 2 publications

Impact of COVID-19 on cancer diagnosis and management in Slovenia – preliminary results

Impact of COVID-19 on cancer diagnosis and management in Slovenia – preliminary results

The experience of UK patients with bladder cancer during the COVID‐19 pandemic: a survey‐based snapshot

COVID-19 and the return to head and neck outpatient activity in the United Kingdom: what is the new normal?

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