Monitoring the impact of COVID-19 in France on cancer care: a differentiated impact

Abstract

The COVID-19 pandemic has had a substantial and lasting impact on care provision, particularly in the field of cancer care. National steering has helped monitor the health situation and adapt the provision and organisation of care. Based on data from the French administrative healthcare database (SNDS) on the entire French population (67 million people), screening, diagnostic and therapeutic activity was monitored and compared 2019 on a monthly basis. A noteworthy decline in all activities (with the exception of chemotherapy) was observed during the first lockdown in France. Over the months that followed, this activity returned to normal but did not make up for the shortfall from the first lockdown. Finally, during the lockdown in late 2020, cancer care activity was conserved. In brief, in 2020, the number of mammograms decreased by 10% (− 492,500 procedures), digestive endoscopies by 19% (− 648,500), and cancer-related excision by 6% (− 23,000 surgical procedures). Hospital radiotherapy activity was down 3.8% (− 4400 patients) and that in private practice was down 1.4% (− 1600 patients). Chemotherapy activity increased by 2.2% (7200 patients), however. To summarize, COVID-19 had a very substantial impact during the first lockdown. Safeguarding cancer care activity helped limit this impact over the months that followed, but the situation remains uncertain. Further studies on the medium- and long-term impact on individuals (survival, recurrence, after-effects) will be conducted.

A systematic review of the impact of the COVID-19 pandemic on breast cancer screening and diagnosis

“…A subtotal of 41 [ 14 , 15 , 20 , 21 , 29 , 30 , [32] , [33] , [34] , 37 , 40 , 42 , 44 , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , [71] , [72] , [73] , [74] , [75] , [76] ] and 12 [ 20 , 21 , 42 , 65 , [77] , [78] , [79] , [80] , [81] , [82] , [83] , [84] ] studies reported diagnosis, and breast imaging outcomes, respectively. Key results from the individual studies are summarised narratively below, and presented in more detail in Table 2 and AppxTable F.6-F.8 ( Appendix F ).…”

“…In medical imaging studies or studies with a mixed screening and symptomatic population (AppxTable F.8a), the number of mammography examinations during the pandemic [ 20 , [77] , [78] , [79] , [80] , [81] , [82] , [83] , [84] ] generally showed a relative reduction of between 8.9% [ 84 ] and 92.7% [ 81 ], with 67% (6/9) of studies reporting cumulative (or average) reductions of 9%–37% [ 20 , [77] , [78] , [79] , 82 , 83 ]. In an additional 6 studies of symptomatic populations (AppxTable F.8b) [ 20 , 21 , 29 , 37 , 42 , 73 ], a similar reduction was found for the number of diagnostic mammography (range: 4.7%–83.8%) with half of the studies observing reductions between 4% and 21% [ 20 , 29 , 42 ].…”

Impact of COVID-19 on cancer screening: a global perspective

“…Reductions in cancer screening were reported for cervical cancer (−7.5 to −90%) in Canada, the United States, Brazil, France, Taiwan, Belgium, and 17 selected low- and middle-income countries (LMICs) [ 19 ▪ , 21 ▪ – 23 ▪ , 30 ▪▪ , 33 , 35 ▪ , 36 , 38 – 40 , 43 , 46 ]. A significant drop in digestive endoscopies (−19 to −29%) was reported in Lithuania and France [ 17 , 39 ]. Reductions in colon cancer screening (−8.1 to −95%) were registered in Canada, the United States, France, Belgium, Qatar, and 17 selected LMICs [ 14 , 15 , 16 ▪ , 23 ▪ , 25 , 30 ▪▪ , 33 , 35 ▪ , 36 – 39 , 43 , 44 ].…”

“…A significant drop in digestive endoscopies (−19 to −29%) was reported in Lithuania and France [ 17 , 39 ]. Reductions in colon cancer screening (−8.1 to −95%) were registered in Canada, the United States, France, Belgium, Qatar, and 17 selected LMICs [ 14 , 15 , 16 ▪ , 23 ▪ , 25 , 30 ▪▪ , 33 , 35 ▪ , 36 – 39 , 43 , 44 ]. LCS rates fell in Canada, the United States, Ireland, and 17 selected LMICs (−21 to −44.6%) [ 11 , 24 , 30 ▪▪ ].…”

Cervical Cancer Prevention in the Era of the COVID-19 Pandemic

“…The implementation of this strategy has become a significant challenge in the era of the coronavirus disease 2019 (COVID-19) pandemic. Impeded access to health care services, supply chain disruptions, and deteriorations in the financial health of countries are all factors that have undermined the implementation of CC-prevention measures [28][29][30][31].…”