Influence of the First Wave of the COVID-19 Pandemic on Cancer Care in a German Comprehensive Cancer Center

Abstract

Introduction: During the first wave of the COVID-19 pandemic in 2020, the German government implemented legal restrictions to avoid the overloading of intensive care units by patients with COVID-19. The influence of these effects on diagnosis and treatment of cancer in Germany is largely unknown.Methods: To evaluate the effect of the first wave of the COVID-19 pandemic on tumor board presentations in a high-volume tertiary referral center (the German Comprehensive Cancer Center NCT/UCC Dresden), we compared the number of presentations of gastrointestinal tumors stratified by tumor entity, tumor stage, and treatment intention during the pandemic to the respective data from previous years.Results: The number of presentations decreased by 3.2% (95% CI −8.8, 2.7) during the COVID year 2020 compared with the pre-COVID year 2019. During the first shutdown, March–May 2020, the total number of presentations was 9.4% (−18.7, 1) less than during March–May 2019. This decrease was significant for curable cases of esophageal cancer [N = 37, 25.5% (−41.8, −4.4)] and colon cancer [N = 36, 17.5% (−32.6, 1.1)] as well as for all cases of biliary tract cancer [N = 26, 50% (−69.9, −15)] during the first shutdown from March 2020 to May 2020.Conclusion: The impact of the COVID-19 pandemic on the presentation of oncological patients in a CCC in Germany was considerable and should be taken into account when making decisions regarding future pandemics.

Young Adult German Breast Cancer Patients Participating in a Three-Week Inpatient Mother–Child Rehab Program Have High Needs for Supportive Care

“…The lower proportion of women with need for supportive need with regard to ‘nausea and vomiting’ fits with the external evidence that cancer treatment and care in Germany altered with the start of the COVID-19 pandemic [ 28 , 29 ]. Over the entire pandemic period, provision of care was especially reduced in the areas of follow-up care (by 21% compared to pre-pandemic) and psycho-oncologic care (by 12%), with even higher reductions at the beginning of the pandemic in 03-04/2020 [ 28 ].…”

“…The onset of the COVID-19 pandemic represented an exceptional situation and affected essential areas of daily life, the economy, and supportive and healthcare [ 23 , 24 , 25 ] as well as mental health [ 26 ]. In the German healthcare system, resources were prioritized for potential, very sick COVID-19 patients [ 27 ], which led to changes in the oncological care in Germany—mainly in follow-up care, psycho-oncologic care, and surgery [ 28 , 29 ]. Among cancer patients, more than every second person showed symptoms of anxiety and every third reported symptoms of depression during the pandemic [ 27 ].…”

Impact of the COVID-19 pandemic on therapeutic interventional oncology procedures and diagnostic CT/MRI examinations at a German university hospital

“…Elective cancer surgery significantly decreased due to the COVID-19 outbreak, particularly during the lockdowns 13 . This development was likely multifactorial, with fewer patient presentations and admissions, staff shortages, and reduced operating room availability playing a role 9 10 11 12 13 14 . At our hospital, around 30 % of non-emergency surgical procedures were postponed and up to six operating rooms were closed.…”

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

“…During the COVID-19 pandemic, efforts continued to be pursued to improve prevention, diagnostics, treatment, and the quality of life of cancer patients and to monitor and report upon inequalities, such as the "Europe's Beating Cancer Plan" [19], the European Cancer Inequalities Registry [20] and the launch of the European Commission's Knowledge Centre on Cancer [21]. These efforts are necessary to address the backlog this pandemic is creating [22][23][24].…”