One in 7 Cancer Operations Delayed Due to COVID-19

Tim Locke

October 06, 2021

The global impact of delays in cancer treatment due to the pandemic have been highlighted in University of Birmingham led international research.

Analysis of data from 61 countries for 15 common cancer operations from 466 hospitals showed 1 in 7 procedures were postponed under full lockdowns by a median of 5.3 months from diagnosis, potentially resulting in more cancer deaths.

UK data came from 6160 patients across 113 centres. US data covered 1219 patients across 21 centres.

Last month, the Institute for Public Policy Research (IPPS) think tank and the CF health consultancy estimated that it could take over a decade to clear England's COVID cancer treatment backlog.

Fragile

"Cancer surgery systems worldwide were fragile to lockdowns," the authors of the new study wrote in The Lancet Oncology.

Patients who were frail, had advanced cancer, and those awaiting operations in lower-middle income countries, were less likely have their operations.

Co-lead Author, Mr James Glasbey, University of Birmingham, said in a statement: "Whilst lockdowns are critical to saving lives and reducing the spread of the virus, ensuring capacity for safe elective cancer surgery should be part of every country’s plan to ensure continued health across the whole population."

Co-lead Author Mr Aneel Bhangu, University of Birmingham, highlighted lockdowns in lower income countries with existing cancer capacity problems. "Patients in these environments were at highest risk of cancellation, despite being younger and having fewer co-morbidities," he said.

"Whilst we only followed patients that underwent a delay for a short period of time, evidence from other research suggests that these patients may be at higher risk of recurrence. To help mitigate against this, surgeons and cancer doctors should consider closer follow-up for patients that were subject to delays before surgery."

Building Back

Cancer types in the study included colorectal, oesophageal, gastric, head and neck, thoracic, liver, pancreatic, prostate, bladder, renal, gynaecological, breast, soft-tissue sarcoma, bony sarcoma, and intracranial malignancies.

The authors wrote: “This study demonstrates the need for system strengthening in elective surgery across all settings to mitigate against impending COVID-19 lockdowns and future pandemics. This should include both global reorganisation to provide protected COVID-19-free elective surgical pathways (and staffing) that sustainably allow safe surgery to continue, and improved surge capacity for acute care during public health emergencies."

The study was part of the National Institute for Health Research (NIHR) funded COVIDSurg collaborative.

Professor Lucy Chappell, NIHR CEO, and chief scientific adviser to the Department of Health and Social Care, said: "We are proud of how our Global Health Research Units and Groups responded swiftly and adapted to tackle the impacts of the global COVID-19 pandemic. These findings will help build the evidence base for how surgical services can ‘build back better’ and, working with the World Health Organisation and national coordinating bodies including the Royal College of Surgeons, develop guidance for global surgery."

Effect of COVID-19 pandemic lockdowns on planned cancer surgery for 15 tumour types in 61 countries: an international, prospective, cohort study. Lancet Oncology. Published:October 05, 2021 DOI:https://doi.org/10.1016/S1470-2045(21)00493-9

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