Impact of COVID-19 on small biopsy diagnostic procedures and cancer resection surgeries in the North-West of Ireland

O'Connor, Eoghan; O’Dowd, Gerard J.; Phelan, Sine

doi:10.1136/jclinpath-2021-207425

Cited by 10 publications

(10 citation statements)

References 11 publications

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“… 3 Reductions in cancer diagnoses similar to those in Ontario have been reported elsewhere. 4 , 5 , 7 , 12 , 13 , 14 , 15 , 16 , 17 In line with our findings, a study from Italy reported a 17% reduction in radiotherapy. 18 Another study from Spain reported reductions of 37% in new oncology referrals and 38% in new treatments, 19 substantially greater reductions than those observed in Ontario.…”

Section: Discussionsupporting

confidence: 92%

Delivery of Cancer Care in Ontario, Canada, During the First Year of the COVID-19 Pandemic

et al. 2022

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Key Points Question Did the delivery of services within a cancer system change during the first year of the COVID-19 pandemic? Findings This population-based cohort study conducted in Ontario, Canada, found a total of 4 476 693 cancer care services during the first year of the COVID-19 pandemic, compared with 5 644 105 services in the year prior, representing a reduction of 20.7% and suggesting a backlog of 1 167 412 cancer services during the first pandemic year. Limited change was observed in systemic treatments and emergency or urgent imaging examinations and surgical procedures, while major reductions were observed in cancer screening tests, biopsies, surgical treatments, and new consultations for systemic and radiation treatment. Meaning These findings provide evidence on the deficits in cancer care that occurred during the first year of the COVID-19 pandemic that are likely to inform continued delivery of care, recovery, and future pandemic planning.

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Section: Discussionsupporting

confidence: 92%

Delivery of Cancer Care in Ontario, Canada, During the First Year of the COVID-19 Pandemic

et al. 2022

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“…Concerning surgeries and loco-regional therapies, 106 indicators were identified from 30 articles [42,48–51,55,62,65,65,75,81,90,92–94,97–99,101–103,111,118–125]. Of those, 82 indicators (79%) showed a reduction in the number of treatment procedures, namely in Italy, France, Germany, Ireland, Netherlands, Spain, Turkey, UK, US, Australia, and in 1 international study.…”

Section: Resultsmentioning

confidence: 99%

“…The next stage of the care pathway focuses on diagnosis and staging. The "number of diagnostic, surveillance and staging procedures" was reported in 17 articles [41,[43][44][45][48][49][50][51][52][53][54][55][56][57][58][59][60] (from the UK, Italy, US, France, Australia, the Netherlands, Turkey, Ireland, and Slovenia), comprising a total of 90 indicators. Most of those indicators (n=58, 64%) showed a decreasing trend in the number of procedures, namely cystoscopy, diagnostic mammograms, breast cancer wire-guided biopsy, gastroscopy, colonoscopy, computed tomography (CT), magnetic resonance imaging (MRI), and endoscopic retrograde cholangiopancreatography.…”

Section: Discussionmentioning

confidence: 99%

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

Carvalho

Fernandes

Lange

et al. 2022

Preprint

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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.

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“…Specifically, a reduction was observed in the pathology diagnoses of neoplasms of the lip, oral cavity, and pharynx; larynx, colon, rectum, and anus; kidney, melanoma, prostate, and urinary system; as well as the central nervous system. With particular regard to tumors of the central nervous system and the head and neck, it is possible that much of the diagnoses were based solely on imaging tests and that more conservative treatments with radiation therapy were opted for given the reduction in the number of surgeries, and the difficulty of accessing high-tech operating rooms and consequently in obtaining tumor samples in certain locations during COVID-19 [ 28 , 29 ]. Nevertheless, discrepant data have been found on the use of radiation therapy during the pandemic to date.…”

Section: Discussionmentioning

confidence: 99%

Differences in the Impact of COVID-19 on Pathology Laboratories and Cancer Diagnosis in Girona

Sanvisens

Puigdemont

Rubió‐Casadevall

et al. 2021

IJERPH

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Introduction: The recent COVID-19 pandemic has compromised socio-health care, with consequences for the diagnosis and follow-up of other pathologies. The aim of this study was to evaluate the impact of COVID-19 on cancer diagnosis in Girona, Spain. Methodology: Observational study of samples received in two pathology laboratories during 2019–2020 (tertiary hospital in Girona and county hospital in Figueres). Date, sample type, and location and morphology were available. Samples were recoded to determine malignancy and grouped by location. Comparisons were made by calendar year and period of exposure to COVID-19. Results: 102,360 samples were included: 80,517 from Girona and 21,843 from Figueres. The reduction in activity in the pathology laboratories in 2020 compared to the previous year was 25.4% in Girona and 27.5% in Figueres. The reduction in cancer diagnoses in 2020 compared to 2019 was 6.8% in Girona and 21% in Figueres. In both laboratories, a decrease was observed in the diagnoses of neoplasms of the lip, oral cavity and pharynx, larynx, colon, rectum and anus, kidney and urinary system, melanoma, and central nervous system. A statistically significant higher probability of a sample received in the pathology laboratory displaying malignancy during COVID-19 was found (Girona: OR = 1.28, 95% CI: 1.23–1.34; Figueres: OR = 1.10, 95% CI: 1.01–1.20) with respect to the COVID-19-free period. Conclusions: The COVID-19 pandemic has resulted in a reduction in cancer diagnoses by pathology departments that varies according to tumor location and type of hospital. Despite this, the optimization of care resources and the recovery effort have partially reduced the impact of the pandemic in certain neoplasms.

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Impact of COVID-19 on small biopsy diagnostic procedures and cancer resection surgeries in the North-West of Ireland

Cited by 10 publications

References 11 publications

Delivery of Cancer Care in Ontario, Canada, During the First Year of the COVID-19 Pandemic

Delivery of Cancer Care in Ontario, Canada, During the First Year of the COVID-19 Pandemic

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

Differences in the Impact of COVID-19 on Pathology Laboratories and Cancer Diagnosis in Girona

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