COVID and Cancer, Lessons Learned: AACR Call to Action

Sharon Worcester

February 11, 2022

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

From life-threatening delays in cancer screenings and treatment, to staggering delays in clinical trial activations and disruptions of ongoing trials, the toll of the COVID-19 pandemic on cancer care and research has been well documented.

Now, as the lessons learned come into sharper focus, the American Association for Cancer Research (AACR) has developed a new report and call to action.

The pandemic has "exposed the need for greater investments in public health and medical research and led to a watershed moment for modernizing how patients receive care," it states.

An example is the rapid ramp-up of telehealth services amid the pandemic.

In July 2021, the use of telehealth was 38% times' higher than before the pandemic, the report notes. The Centers for Medicare & Medicare Services (CMS) was permitted to expand telehealth services during the public health emergency by the Coronavirus Aid, Relief, and Economic Security (CARES) Act.

But when "the public health emergency ends, so would CMS coverage of expanded telehealth," the report warns, unless there is congressional action.

The AACR report was unveiled during a virtual Congressional Briefing on February 9. AACR leaders, patients, and advocates spoke about the impact of the pandemic on cancer care and research and summarized the report and Call to Action.

"Research clearly indicates that [patients with cancer] have an increased risk of COVID-19 infection and severe disease," said 2020-21 AACR president Antoni Ribas, MD, PhD. "In addition, many people put off critical cancer screenings, diagnostic tests, and treatments, potentially causing worse cancer-related outcomes in coming years."

There were nearly 10 million missed cancer screenings from January to July 2020, he noted. In addition, the number of people diagnosed with inoperable or metastatic cancer increased by 11% from March to December 2020, compared to 2019.

"These backlogs have yet to be addressed and raise serious concerns of higher cancer mortality rates in coming years," he added, noting that the effects have hit underserved populations the hardest.

The report highlights these various effects of the pandemic on cancer research and researchers, cancer patients, and patient care. The data show, for example, that patients with cancer who are most at risk for COVID-19 and severe disease are those with hematologic cancers, those with lung cancer, and those receiving B-cell targeted treatment. Other data collected in a survey show that 99% of researchers reported that the pandemic interrupted their research and/or clinical practice.

This AACR Call to Action "builds on what was learned during the public health emergency and lists steps that should be taken to rebuild our public health infrastructure, enhance medical research, and modernize how patients receive care and enroll in clinical trials."

These steps include the following:

Investing in medical research and the workforce. Among several proposals that aim to ensure that the United States "will be in a better position to combat future pandemics," the association calls specifically for congress to provide "at least $10 billion for NIH [National Institutes of Health] and its grantees in emergency supplemental funding as proposed in the Research Investment to Spark the Economy (RISE) Act of 2021 "to offset pandemic related research costs. It also calls for increased investments in cancer research ― an increase of $3.5 billion for the NIH and $1.1 billion for the National Cancer Institute (NCI) , for a total funding level of $46.4 billion for the NIH and $7.6 billion for the NCI in fiscal year 2022.

Expanding access to healthcare and telehealth services. This includes enactment of policies that "broaden health care coverage and recue inequities in access to health care, such as expanding Medicaid," and delivery of a permanent extension of the CMS-approved telehealth services along with funding to support greater access to telehealth.

Strengthening and modernizing clinical trial development. The AACR calls for support of the US Food and Drug Administration's regulatory science initiative and for budget increases to "advance the development of oncology products."Efforts should also continue to increase diversity in clinical trials and to" alleviate the financial burden on prospective trial participants by reimbursing patients for ancillary trial-related costs, such as transportation and lodging, as contained in the DIVERSE Trials Act."

"It is clear that COVID-19 has caused and will continue to cause unprecedented challenges for cancer research and clinical care," the AACR report notes. "In order to restore momentum against cancer, it is vital for Congress to provide essential funding for medical research supported by the NIH and NCI.

"Robust, sustained, and predictable annual funding increases for the NIH and NCI will foster future scientific advances, maximize returns from prior investments in cancer research, drive economic prosperity, and support new lifesaving cures. It is important to learn from the lessons of this grave chapter in history to improve health equity and prevent a similar crisis in the future," the report concludes.

AACR. A Snapshot of the Impact of the COVID-19 Pandemic on Cancer Research and Patient Care. Full text

Sharon Worcester is an award-winning medical journalist at MDedge News, part of the Medscape Professional Network.

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