COVID‐19 and gynecological cancers: Asia and Oceania Federation of Obstetrics and Gynecology oncology committee opinion

Abstract

Since the outbreak of COVID‐19, there have already been over 26 million people being infected and it is expected that the pandemic will not end in near future. Not only the daily activities and lifestyles of individuals have been affected, the medical practice has also been modified to cope with this emergency catastrophe. In particular, the cancer services have faced an unprecedented challenge. While the services may have been cut by the national authorities or hospitals due to shortage of manpower and resources, the medical need of cancer patients has increased. Cancer patients who are receiving active treatment may develop various kinds of complications especially immunosuppression from chemotherapy, and they and their carers will need additional protection against COVID‐19. Besides, there is also evidence that cancer patients are more prone to deteriorate from COVID‐19 if they contract the viral infection. Therefore, it is crucial to establish guidelines so that healthcare providers can triage their resources to take care of the most needed patients, reduce less important hospitalization and visit, and to avoid potential complications from treatment. The Asia and Oceania Federation of Obstetrics and Gynecology (AOFOG) hereby issued this opinion statement on the management of gynecological cancer patients during the COVID‐19.

Impact of the COVID-19 Pandemic on Gyne-Oncological Treatment—A Retrospective Single-Center Analysis of a German University Hospital with 30,525 Patients

“…Keeping in mind that gyne-oncology accounts not only for 35.1% of overall gynecology patients (GYN* 1 ) but also for 52.9% of the department’s revenue generation (GYN* 2 ), the feared medical damage relating to diagnostics and treatment delays, failing screening procedures, and related worsened treatment outcome is accompanied with a possibly fierce recess in the economic performance. While the data expand previous observations by confirming the total patient number of gyne-oncology to decrease for the whole COVID-19 pandemic, it depicts a varying effect on the specific malignant main diagnoses [ 9 , 10 , 14 , 30 ].…”

“…The visualization of the relative monthly development of patient numbers leads to the following observations that expand the previous scientific status quo [ 9 , 10 , 12 , 14 , 16 , 30 ]. Obstetric care appears to not have been affected to a large extent by the effects of the COVID-19 pandemic in terms of admitted cases at Marburg University Hospital, this expands the finding to the second year of the pandemic [ 12 ].…”

The Effectiveness of Pap and Visual Inspection With Acetic Acid (VIAA) Tests in Cervical Dysplasia Screenings During the COVID-19 Pandemic

“…These effects has been sufficiently severe that some consider the screening programs for this disease to be in a state of crisis [8][9][10]. Other studies have also shown an increasing number of women diagnosed with premalignant lesions [11][12][13]. Although many reasons may explain these negative effects, the decreased number of patients undergoing screening may be part of the problem [10,[14][15][16].…”

British Gynaecological Cancer Society Recommendations for Women With Gynecological Cancer Who Received Non-standard Care During the COVID-19 Pandemic

“…1 There have been occasions when it was necessary for treatment to deviate from what would be considered standard of care, due to clinical resource availability, increased risk from COVID-19 infection and prioritisation frameworks. [2][3][4][5][6][7] In the international COVIDSurg study, 17% of 4722 women undergoing surgery for gynaecological cancer had alteration in first line treatment, including treatment delay or adaptation of surgery. 8 In the United Kingdom, the COVID-19 pandemic severely impacted on gynaecological cancer services resulting in the need for prioritisation of care 1 .…”