Impact of the COVID-19 pandemic on the care of cancer patients in Spain

Abstract

Background Studies evaluating the effects of the COVID-19 pandemic on public healthcare systems are limited, particularly in cancer management. As no such studies have been carried out in Spain, our objective is to describe and quantify the impact of the COVID-19 pandemic on cancer patients in Spanish hospitals during the first wave of the pandemic. Materials and methods This retrospective, multicenter, nationwide study collected information from hospital departments treating oncology patients. An electronic questionnaire comparing outcomes and management of oncohematological patients for the March-June 2019 and March-June 2020 periods was used. Results Information from 78 departments (36 tertiary hospitals) was analyzed. Forty-four departments implemented adapted protocols during March 2020. Most of these ( n = 38/44; 86.4%) carried out COVID-19 triage, while 26 of 44 (59.1%) carried out onsite polymerase chain reaction tests for clinically suspected cases. A shift from in-person to telephone visits was observed in 43 of 44 (97.7%) departments. Comparing the March-June 2019 and March-June 2020 periods, the number of new patients decreased by 20.8% (from 160.2 to 126.4). Decreases were also seen in the mean number of total (2858.2 versus 1686.1) and cancer (465.5 versus 367.2) biopsies, as well as the mean number of bone marrow biopsies (30.5 versus 18.6). Concerning the number of patients visiting specific cancer care departments, a decrease from 2019 to 2020 was seen for mean number of chemotherapy treatments (712.7 versus 643.8) and radiation therapy (2169.9 versus 2139.9). Finally, a reduction from 2019 to 2020 of 12.9% (from 8.6 to 7.4) in the mean number of patients included in clinical trials was noted. Conclusions This study provides the first comprehensive data concerning the impact of COVID-19 on cancer care in Spain. The pandemic caused a 20.8% decrease in newly diagnosed patients, which may impact future outcomes. Measures must be taken to ensure cancer management receives priority in times of healthcare emergencies.

Significant Decrease in Annual Cancer Diagnoses in Spain during the COVID-19 Pandemic: A Real-Data Study

“…During March and April 2020, the mean number of weekly patients diagnosed with breast, colorectal, lung, pancreatic, or gastric cancer in the US decreased by 46.6% for these 6 types of cancer combined, with the greatest reduction for breast cancer (−51.8%) and the lowest for pancreatic cancer (−24.7%) [10]. Similar findings have been reported in the number of weekly patients diagnosed during the first four months of the pandemic in the Netherlands [6], Italy [11], Germany [12], Spain [19] or Australia [26].…”

“…Between March to July 2020, a decrease in the billing frequency for chemotherapy administration was observed in comparison to 2019, with a maximum of 32% in July, according to Medicare data [8]. Data from a multicenter nationwide study from Spain that collected information from departments treating oncology patients through an electronic questionnaire, reported a decrease of 20.3% in the number of new patients' referrals and of 14.3% in the mean number of patients visiting day hospitals between March-June 2020 compared to March-June 2019 [19].…”

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

“…In addition, despite there being less activity in the pathology departments during COVID-19 than during 2019, the probability of neoplasia diagnosis during the pandemic has been statistically significantly higher. Although this could be due to changes in the prioritization protocols used by different care services and recommendations by scientific societies and expert groups to minimize the risks [ 20 , 21 , 22 ], in certain types of cancer, it could also be due to the increase in the number of scans due to COVID-19 in patients with undiagnosed cancers. In fact, patients with underlying cancers are probably more vulnerable to SARS-CoV-2 infection and display a worse progression of the disease [ 23 , 24 , 25 ].…”

Changes in the Number of Newly Diagnosed Lung Cancer Patients Before and During the COVID-19 Pandemic: A single-Center Experience

“…It has been shown that there is a 25% reduction in cancer cases in the March-May 2020 pandemic period in the Netherlands [13]. In Spain, between March and June 2020, the number of new cancer cases decreased by 20.8% compared to 2019, the number of biopsies performed for diagnosis was lower, and the number of visits for patients receiving cancer treatment decreased [14].…”