COVID-19 Disrupting Cancer Care and Clinical Research

By Megan Brooks

July 31, 2020

NEW YORK (Reuters Health) - The COVID-19 pandemic has had a huge impact on cancer care and research, according to research presented earlier this month during the American Association for Cancer Research (AACR) COVID-19 and Cancer virtual meeting.

"People fearful of exposure to COVID-19 or overburdening healthcare services may postpone routine healthcare, including cancer screenings and diagnosis," Dr. Lisa Richardson, director of cancer prevention and control at the Centers for Disease Control and Prevention (CDC), noted in her presentation.

In a recent survey, nearly one in three members of the public said they were past due for preventive care. Thirty-five percent were past due for their wellness visit and 19% had not had their chronic-illness visit, she reported.

The fact that millions of people are still losing their jobs each week is compounding the problem, leading to more people uninsured and less apt to receive health services, including cancer care, Dr. Richardson said.

The pandemic has also destabilized primary-care practices, where cancer survivors often receive follow-up care.

Recent data show that about 40% of practices have laid off or furloughed staff, 7% are at least temporarily closed and "as more data come in, more and more primary care practices are saying they may close permanently and the majority report operating under severe stress, emotionally and financially," Dr. Richardson said.

She noted that a recent study by electronic records vendor Epic Health Network found that screening appointments for cancers of the cervix, colon and breast were down between 86% and 94% in March, compared with average volumes from the three years prior to the first confirmed case of COVID-19 in the United States.

For all specialties and patient age groups, outpatient visits in March declined nearly 60% across all regions of the United States. Patient volumes began to rebound in early May, and continued to rise through early June, but have plateaued and are still below pre-crisis levels, Dr. Richardson reported.

Cancer research around the world has also been "seriously disrupted" by the pandemic, she said.

According to the National Cancer Institute, the number of new patients entering phase-2 and phase-3 cancer trials in the United States plummeted by about 48% in the last two weeks of March, but started to improve the last week of May and first week of June, though enrollment is still down 25% to 30% from pre-COVID levels.

"Clinical trials are how we make progress for patients with cancer and these decreases in clinical trial enrollment or completion will translate into fewer new approaches for patients," Dr. Richardson said.

"Over the last 20 years cancer mortality has dropped 26%. The COVID-19 pandemic may put this progress on hold or reverse it," she warned.

Session moderator Dr. Karen Knudsen of the Sidney Kimmel Cancer Center at Jefferson, in Philadelphia, called Dr. Richardson's data "striking," adding, "the metrics on delays and care are really breathtaking."

SOURCE: AACR Virtual Meeting: COVID-19 and Cancer, held July 20-22, 2020.