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INTRODUCTION: COVID-19 has disrupted the global health care system since March 2020. Lung cancer (LC) patients (pts) represent a vulnerable population highly affected by the pandemic. This multicenter Italian study aimed to evaluate whether the COVID-19 outbreak had an impact on access to cancer diagnosis and treatment of LC pts compared with pre-pandemic time. METHODS: Consecutive newly diagnosed LC pts referred to 25 Italian Oncology Departments between March and December 2020 were included. Access rate and temporal intervals between date of symptoms onset and diagnostic and therapeutic services were compared with the same period in 2019. Differences between the 2 years were analyzed using the chi-square test for categorical variables and the Mann-Whitney U test for continuous variables. RESULTS: A slight reduction (-6.9%) in newly diagnosed LC cases was observed in 2020 compared with 2019 (1523 versus 1637, P = 0.09). Newly diagnosed LC pts in 2020 were more likely to be diagnosed with stage IV disease (P < 0.01) and to be current smokers (someone who has smoked more than 100 cigarettes, including hand-rolled cigarettes, cigars, cigarillos, in their lifetime and has smoked in the last 28 days) (P < 0.01). The drop in terms of new diagnoses was greater in the lockdown period (percentage drop -12% versus -3.2%) compared with the other months included. More LC pts were referred to a low/medium volume hospital in 2020 compared with 2019 (P = 0.01). No differences emerged in terms of interval between symptoms onset and radiological diagnosis (P = 0.94), symptoms onset and cytohistological diagnosis (P = 0.92), symptoms onset and treatment start (P = 0.40), and treatment start and first radiological revaluation (P = 0.36). CONCLUSIONS: Our study pointed out a reduction of new diagnoses with a shift towards higher stage at diagnosis for LC pts in 2020. Despite this, the measures adopted by Italian Oncology Departments ensured the maintenance of the diagnostic-therapeutic pathways of LC pts.
Subject(s)
COVID-19 , Lung Neoplasms , Communicable Disease Control , Humans , Italy/epidemiology , Lung Neoplasms/diagnosis , Lung Neoplasms/epidemiology , Lung Neoplasms/therapy , PandemicsABSTRACT
Background: The long-term impact of COVID-19 in cancer patients (pts) is undefined. Methods: Among 2795 consecutive pts with COVID-19 and cancer registered to OnCovid between 01/2020 and 02/2021, we examined clinical outcomes of pts reassessed post COVID-19 recovery. Results: Among 1557 COVID-19 survivors, 234 (15%) reported sequelae including respiratory symptoms (49.6%), fatigue (41%) and cognitive/psychological dysfunction (4.3%). Persisting COVID-19 sequelae were more likely found in males (p=0.0407) aged ≥65 years (p=0.0489) with ≥2 comorbidities (p=0.0006) and positive smoking history (p=0.0004). Sequelae were associated with history of prior hospitalisation (p<0.0001), complicated disease (p<0.0001) and COVID-19 therapy (p=0.0002). With a median post-COVID-19 follow up of 128 days (95%CI 113-148), multivariable analysis of survival revealed COVID-19 sequelae to be associated with an increased risk of death (HR 1.76, 95%CI 1.16-2.66) after adjusting for sex, age, comorbidities, tumour characteristics, anticancer therapy and COVID-19 severity. Out of 473 patients who were on systemic anticancer therapy (SACT) at COVID-19 diagnosis;62 (13.1%) permanently discontinued therapy and 75 (15.8%) received SACT adjustments, respectively. Discontinuations were due to worsening performance status (45.1%), disease progression (16.1%) and residual organ disfunction (6.3%). SACT adjustments were pursued to avoid hospital attendance (40%), prevent immunosuppression (57.3%) or adverse events (20.3%). Multivariable analyses showed permanent discontinuation to be associated with an increased risk of death (HR 4.2, 95%CI: 1.62-10.7), whereas SACT adjustments did not adversely affect survival. Conclusions: Sequelae post-COVID-19 affect up to 15% of patients with cancer and adversely influence survival and oncological outcomes after recovery. SACT adjustments can be safely pursued to preserve oncological outcomes in patients who remain eligible to treatment.
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Background: The coronavirus disease (COVID-19) has imposed an unprecedented challenge on the Health Care System. With the reallocation of crucial health resources to effectively exit the crisis, the pandemic has profoundly affected cancer patients' (pts) management. Breast cancer (BC) diagnosis results, especially in the early stage, from screening programs temporarily paused during COVID-19 outbreak. The aim of our multicenter study is to investigate the impact of COVID-19 on the likelihood of receiving timely diagnosis, staging and treatment for BC pts compared to pre-pandemic period. Material (patients) and methods: Medical records of all consecutive newly diagnosed BC pts referred to 4 Italian Oncology Departments between March and December 2020 were assessed. Monthly access rate and temporal intervals between date of symptoms onset, radiological, cytohistological diagnosis and treatment start were analyzed and compared with those of the same period in 2019. Differences between the two years were analyzed using Fisher's exact or chi-square test for categorical variables and unpaired Student t test, or the Mann-Whitney U test for continuous variables. Results: A significant reduction (23%) in newly diagnosed BC pts was seen when compared with 2019 (552 vs 719). Newly BC pts in 2020 were less likely to be diagnosed with early stage (stage I-II) BC (77% vs 84%, p < 0.01), had a worsened ECOG PS (19% had PS > 0 in 2020 vs 16% in 2019, p = 0.15) and were more symptomatic at diagnosis (43% vs 23%, p < 0.01). Other clinical and tumor characteristics (such as histotype [p = 0.23] and molecular subtype [p = 0.71]) were similar regardless of the year. Looking at pts management, time intervals between symptom onset and radiological diagnosis (median 17 days in 2020 vs 21 in 2019, p = 0.04), symptom onset and cytohistological diagnosis (26 vs 35 days, p = 0.06), cytohistological diagnosis and treatment start (median 62 vs 76 days, p < 0.01) were maintained or even improved. However, less BC cases were discussed in multidisciplinary tumor meetings during the 2020 (52% vs 69%, p < 0.01). Conclusions: While the COVID-19 effects on cancer care will be likely felt for years to come, our data indicate a sharp decline in BC detection in 2020 with major impact on early stage diagnosis. Despite the upheaval generated by this global Health Care crisis, our study proves the effectiveness of the actions taken by Oncology Departments to guarantee diagnostic-therapeutic pathways.
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Background: Since March 2020, Coronavirus disease 2019 (COVID-19) has rapidly spread worldwide causing a massive Health Care crisis with Italy among the most affected countries. Oncology care has been widely derailed and cancer screening programs halted to effectively face the pandemic. Aim of our multicenter study is to assess how COVID-19 has impacted on the likelihood of receiving timely diagnosis, staging and treatment for colorectal cancer (CRC) patients (pts) during the 2020 compared to pre-pandemic period. Material (patients) and methods: All consecutive medical records of newly diagnosed CRC pts referred to 4 Italian Oncology Departments between March and December 2020 were evaluated. Monthly access rate and temporal intervals between date of symptoms onset, radiological and cytohistological diagnosis, treatment start and first radiological evaluation were analyzed and compared with the same months of 2019. Differences between the two years were evaluated using Fisher's exact or chisquare test for categorical variables and unpaired Student t test, or the Mann-Whitney U test for continuous variables. Results: A considerable drop (20%) in newly diagnosed CRC cases emerged compared to 2019 (214 vs 268). The lockdown period was more impacted by such decrease compared to the other months (percentage drop 40% vs 12%). New CRC diagnoses in 2020 were less likely to be diagnosed with early stage (stage I-II-III) CRC (67% vs 72%). Other clinical and tumor characteristics such as age, gender, sidedness and mutational status were similar regardless of the year. Looking at pts management, no differences were seen in terms of interval between symptom onset and radiological diagnosis (median 19 days in 2020 vs 28 days in 2019, p=0.88), symptom onset and cytohistological diagnosis (25 vs 36 days, p=0.27), symptom onset and treatment start (median 86 vs 100 days, p=0.79). However, less CRC were discussed in multidisciplinary tumor meetings during the 2020 (45% vs 54%, p=0.07). Conclusions: While COVID-19 effects on cancer pts' outcome might unfold in the years to come, our preliminary data show a remarkable drop in early stage CRC diagnoses throughout 2020. The Italian Oncology Departments managed to optimally tackle the quality care issue ensuring prompt diagnosis and treatment despite the pandemic evolving scenario. Further investigation, including larger case series, are warranted to offer a more exhaustive picture of the impact of COVID-19 emergency on cancer care.
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Background: The coronavirus disease 2019 (COVID-19) had an unprecedent impact on the global health care system since March 2020. Lung cancer (LC) patients (pts) represent a vulnerable population, and diagnostic/therapeutic delays might affect the years to come. Aim of the multicenter, real-world, Italian COVID-DELAY study was to evaluate how the 2020 COVID-19 pandemic impacted on LC pts' access to diagnosis and treatment compared to pre-pandemic time. Patients and methods: All consecutive newly diagnosed LC pts referred to 25 Italian Oncology Departments between March and December 2020 were reviewed. Monthly access rate and temporal intervals between date of symptom onset, diagnosis and treatment start were analyzed and compared to the same period of 2019. Differences between the two years were analyzed using Fisher's exact test or chi-square test for categorical variables and unpaired Student t test, or the Mann-Whitney U test for continuous variables. Results: Less LC cases (1523 vs 1637, -6.9%) were diagnosed during the 2020 pandemic compared to 2019. LC pts in 2020 were more likely to be diagnosed with stage IV disease (p < 0.01) and to be current smokers (p < 0.01). A major drop of new LC cases was seen during the lockdown period (percentage drop -13.2% vs -5.1%) compared to the other months included. Moreover, a geographic migration was observed with more LC patients referring to low/ medium volume hospital in 2020 compared to 2019 (p = 0.01). Looking at pts management, no differences emerged in terms of interval between symptom onset and radiological diagnosis (p = 0.94), symptom onset and cytohistological diagnosis (p = 0.92), symptoms onset and treatment start (p = 0.40), treatment start and first radiological revaluation (p = 0.36). However, less LC patients were treated in the context of clinical trials during 2020 (5% vs 7%, p = 0.07). Conclusions: Our study pointed out a decrease of new LC cases and a shift towards a higher stage at diagnosis in 2020. Despite this, the efforts put in place by the Italian Oncology Departments ensured the maintenance of the diagnostic-therapeutic pathways of LC patients.
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Background: By the end of 2020, coronavirus disease 2019 (COVID-19) would have indelibly marked the cancer care setting. With Italy at the forefront of pandemic, unprecedented measures were adopted to tackle the quality care issue. As a result of pausing screening programs, diagnostic delays might affect the years to come. Aim of our multicenter Italian study is to evaluate whether the COVID-19 outbreak has impacted on likelihood of receiving timely diagnosis, staging and treatment for colorectal cancer (CRC) patients (pts) after March 2020 compared to pre-pandemic time. Methods: Medical records of all consecutive newly diagnosed CRC pts referred to 4 Italian Oncology Departments between March and December 2020 were examined. Access rate (number of pts/days) and temporal intervals between date of symptoms onset, radiological and cytohistological diagnosis, treatment start and first radiological evaluation were analyzed and compared with the same months of 2019. Differences between the two years were evaluated using Fisher’s exact test or chi-square test for categorical variables and unpaired Student t test, or the Mann-Whitney U test for continuous variables. Results: A reduction (20%) in newly diagnosed CRC cases was seen when compared with 2019 (214 vs 268). The decline was greater in the lockdown period compared to the other months (percentage drop 40 % vs 12%). Newly CRC pts in 2020 were less likely to be diagnosed with early stage (stage I-II-III) CRC (67% vs 72%). Other clinical and tumor characteristics were similar regardless of the year. Looking at pts management, no differences emerged in terms of interval between symptom onset and radiological diagnosis (median 19 days in 2020 vs 28 days in 2019, p = 0.88), symptom onset and cytohistological diagnosis (25 vs 36 days, p = 0.27), symptom onset and treatment start (median 86 vs 100 days, p = 0.79). However, less CRC were discussed in multidisciplinary tumor meetings during the 2020 (45% vs 54%, p = 0.07). Conclusions: While COVID-19 repercussions will be likely felt for decades to come, our data suggest an alarming drop in early-stage CRC diagnoses during the first pandemic year. Conversely, our study draws the attention on the efforts made to ensure diagnostic-therapeutic pathways proper operation. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence in cancer patients may vary widely dependent on the geographic area and this has significant implications for oncological care. The aim of this observational, prospective study was to assess the seroprevalence of SARS-CoV-2 IgM/IgG antibodies in solid cancer patients referred to the academic institution of the Marche Region, Italy, between 1 July and 26 October 2020 and to determine the accuracy of the rapid serological test. After performing 3767 GCCOV-402a rapid serological tests on a total of 949 patients, seroconversion was initially observed in 13 patients (1.4%). Ten (77% of the total positive) were IgG-positive, 1 (8%) were IgM-positive and 2 (15%) IgM-positive/IgG-positive. However, only 7 out of 13 were confirmed as positive at the reference serological test (true positives), thus seroprevalence after cross-checking was 0.7%. No false negatives were reported. The kappa value of the consistency analysis was 0.71. Due to rapid serological test high false positive rate, its role in assessing seroconversion rate is limited, and the standard serological tests should remain the gold standard. However, as rapid test negative predictive value is high, GCCOV-402a may instead be useful to monitor patient immunity over time, thus helping to assist ongoing vaccination programs.
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Background: COVID 19 pandemic was a health emergency that required a rapid response by the Italian National Health System. Healthcare professionals needed to be properly trained and informed about their patients' procedures and proper management. During an emergency, the information must be exhaustive, clear and timely to allow correct diagnostic and therapeutic continuity. It is also important that all health workers are promptly and homogeneously trained to guarantee the best treatment path even during pandemic. Our survey aimed to investigate the level of information and training of health workers in oncology during the pandemic and, in particular, the difference in perception between under and over 35 years operators. Material and Methods: An on-line multiple choices survey was submitted to oncology health workers during the pandemic to investigate individual perception of resources, information and staff training management by hospital centers. No open questions were included. Results: A total of 383 health workers replied to the survey (116 under 35 years versus 267 over 35 years). In the under 35s group a total of 65% declared they had been timely and sufficiently informed to understand the extent of the problem compared to 50% of over 35 (p=0.007). About 80% of young professionals were adequately informed and two thirds (63%) was formed about procedures/ recommendations to be followed during the pandemic. But in professionals over 35 only 56% declared to have the right information and over 65% did not feel adequately trained (p= <0.01). Furthermore, 44% of over 35 felt not sufficiently prepared for the management of the cancer patient during an epidemic compared to only 28% of the under 35 (p=0.015). Conclusions: The survey showed a different perception of information and training of healthcare professionals based on the age group. This could be determined by a different degree of task and responsibility but also by the greater and faster readiness of the younger operators to acquire new information and to draw a renewed ability to face an emergency by reorganizing themselves quickly and actively.
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Background: The coronavirus disease 2019 (COVID-19) outbreak has been declared global pandemic and Italy is one of the first and heavily affected countries. Cancer patients are a population at higher risk from COVID-19 both for intrinsic fragility bound to their underlying disease and oncologic treatment delay. Aim of our survey was to investigate how cancer patients perceived their health condition, their clinical management and information communication by their medical oncologists during the pandemic. Methods: Between 15th April and 1st May 2020 a survey was submitted to cancer patients under treatment at hospitals of Marche Region which had been invested by the pandemic. It consisted of questions regarding the perception of personal safety, continuity of cancer care and information quality provided by the Oncology Department and individual psychological distress. Results: A total of 661 patients participated in the survey;60.2% was female and 40.4% was aged between 46 and 65. Almost all of the attendees (97.7%) stated that the Oncologic Department complied with the appropriate safety standards and 78% was reassured about their concerns during the medical interview, but 41% was worried of being at higher risk of infection upon entry into the Oncology Department and 53.3% felt being at greater risk of infection because of chemotherapy treatment in general. The majority of the participants (62.2%) felt that postponing cancer treatment could reduce its efficacy, however 80% declared they did not feel abandoned at the time of treatment delay. 79.4% of the attendees felt more worried for their underlying disease in this emergency situation, but the mood worsened only for 34.2% of the participants. Conclusions: Our survey reveals that Oncology Departments have been considered worthy of the emergency in terms of safety standards and care management by cancer patients. However, the majority of attendees perceived the mutual negative influence between their underlying oncologic disease and risk of Sars-CoV-2 infection and manifested concerns about their health condition highlighting the need for special measures to ensure safe continuity of care.
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Background: The spread of Coronavirus disease brought the need to reorganize clinical activity in oncology. Cancer patients are very vulnerable and it is well known that their treatment has to be strictly planned. The most critical considerations still relate to the entry of the virus into hospitals, the heart of healthcare, where cancer patients are protected. Instead, during COVID19 pandemic the oncologic department had to limit access to care to protect patients from a more dangerous disease for them, witnessing a paradox of health care. This brought with it worries in oncologic healthcare professionals in replanning activities in order to guarantee therapeutic continuity and quality of care. It is well known that physicians and nurses have different role concepts and role expectations. The purpose of our study was to investigate doctors and nurses' perception on cancer patient reorganization during the COVID19 pandemic in a sample of Italian healthcare professionals in oncology. Methods: We submitted a survey to oncologic healthcare workers (physicians and nurses) of Italian National Health Care System during Pandemic to investigate clinical activity reorganization and cancer patient management through 12 closed questions. The survey promoted by Clinica Oncologica, AOU Riuniti di Ancona-Universita Politecnica delle Marche was electronic and anonymous. Results: A total of 383 oncology health workers completed the survey, 60 nurses (15%) and 323 physicians (85%). 60% of interviewed physicians perceived qualitatively lower than usual the therapeutic path of patients taken in charge in this historical moment, while 45% of nurses declared it was the same (p<0.01). The continuity of the multidisciplinary team was defined as guaranteed for 68% of oncologists, while almost 40% of nurses declared to not know it. Almost all physicians (95%) answered that their clinical activity was reorganized, compared to a lower portion of nurses (80%) that replanned their care role (p<0.01). Deferring treatments caused fear and anxiety in 62% of physicians and 46% of nurses (p=0.027). Conclusions: The survey underlined the need to integrate skills and involve all professional figures in planning cancer patients' treatment to guarantee optimal therapeutic strategies and a global take in charge in all its details, even during emergencies.
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Background: After COVID-19 was declared a pandemic by the World Health Organization, a response from the Italian Health System to react to an unprecedented condition became necessary and sudden. COVID-19 pandemic required oncologists to redefine clinical organization and management of cancer patients. The aim of our study was to take a picture of the situation of Italian oncologies and to evaluate the difficulties in patients management. Methods: Between 18th March and 9th April 2020 we conducted an online survey (Google Forms). It consisted of 45 questions ranging from individual perception of pandemic management by oncological centers to physicians and nurses psychological distress and patient care. The survey was anonymous and broadcasted to oncology health workers by mailing contacts, word of mouth and social networks. Results: A total of 383 oncology health workers participated in the survey. The majority was female (72%) and from central Italy (46%). Impressively, a total of 357 (93%) participants declared the Oncologic Department reorganized routine clinical activity, but only 41% was adequately trained about the required procedures. 20% of the survey attendees think they have not received adequate and timely protective devices with respect to clinical needs and according to 58% the supply of these devices was only partial. 34% of professionals declared they do not have or know a defined common guideline to reschedule patients' treatments. More than 80% of interviewees declared to feel worry about being at greater risk of contagion than the general population, 92% feared to transmit virus to family members. Deferring treatments has caused fear / anxiety in 228 of the interviewed (60%). Symptoms of stressful situations emerged with a deterioration in sleep quality in 62% of professionals, worsening of mood (69%) and lower concentration ability (49%). Conclusions: Our survey demonstrated the flexibility of oncologic teams. However, the emergency response quality has been heterogeneous, and several drawbacks emerged from this first analyses. Information, protection, testing and training of healthcare professionals are keywords that should be kept in mind to encourage recovery after this tragedy and to be ready to face a similar emergency in the next future.
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Background: After COVID-19 was declared a pandemic by the World Health Organization, a response from theItalian Health System to react to an unprecedented condition became necessary and sudden. COVID- 19 pandemicrequired oncologists to redefine clinical organization and management of cancer patients. The aim of our study wasto take a picture of the situation of Italian oncologies and to evaluate the difficulties in patients' management. Methods: Between 18th March and 9th April 2020 we conducted an online survey (Google Forms). It consisted of45 questions ranging from individual perception of pandemic management by oncologic centers to physicians' andnurses' psychological distress and patient care. The survey was anonymous and broadcast to oncology healthworkers by mailing contacts, word of mouth, and social networks. Results: A total of 383 oncology health workers participated in the survey. The majority was female (72%) and fromcentral Italy (46%). Impressively, a total of 357 (93%) participants declared the Oncologic Department reorganizedroutine clinical activity, but only 41% were adequately trained about the required procedures. 20% of the surveyattendees thought they had not received adequate and timely protective devices with respect to clinical needs, andaccording to 58% the supply of these devices was only partial. 34% of professionals declared that they did not haveor know a defined common guideline to reschedule patients' treatments. More than 80% of interviewees declaredfeeling worried about being at greater risk of contagion than the general population, and 92% feared to transmitvirus to family members. Deferring treatments has caused fear/anxiety in 228 of the interviewed (60%). Symptomsof stressful situations emerged with a deterioration in sleep quality in 62% of professionals, worsening of mood(69%), and lower concentration ability (49%). Conclusions: Our survey demonstrated the flexibility of oncologic teams. However, the emergency response qualityhas been heterogeneous, and several drawbacks emerged from this first analysis. Information, protection, testing, and training of health care professionals are keywords that should be kept in mind to encourage recovery after thistragedy and to be ready to face a similar emergency in the near future.
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Background: The COVID-19 pandemic was a health emergency that required a rapid response by the ItalianNational Health System. Health care professionals needed to be properly trained and informed about their patients'procedures and proper management. During an emergency, the information must be exhaustive, clear, and timely toallow correct diagnostic and therapeutic continuity. It is also important that all health workers are promptly andhomogeneously trained to guarantee the best treatment path even during the pandemic. Our survey aimed toinvestigate the level of information and training of health workers in oncology during the pandemic and, in particular, the difference in perception between operators under and over 35 years of age. Materials and Methods: An on-line multiple-choice survey was submitted to oncology health workers during thepandemic, investigating individual perception of resources, information, and staff training management by hospitalcenters. No open questions were included. Results: A total of 383 health workers replied to the survey (116 under 35 years versus 267 over 35 years). In theunder-35 group, a total of 65% declared they had been timely and sufficiently informed to understand the extent ofthe problem compared to 50% of those over 35 (P=0.007). About 80% of young professionals were adequatelyinformed and two thirds (63%) were informed about procedures/recommendations to be followed during thepandemic. However, in professionals over 35, only 56% declared they had the right information and over 65% didnot feel adequately trained (P= <0.01). Furthermore, 44% of those over 35 felt not sufficiently prepared for themanagement of the cancer patient during an epidemic compared to only 28% of those under 35 (P=0.015). Conclusion: The survey showed a different perception of information and training of health care professionalsbased on the age group. This could be determined by a different degree of task and responsibility but also by thegreater and faster readiness of the younger operators to acquire new information and to draw on a renewed abilityto face an emergency by reorganizing themselves quickly and actively.
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Background: The spread of coronavirus disease brought the need to reorganize clinical activity in oncology. Cancerpatients are very vulnerable, and it is well known that their treatment has to be strictly planned. The most criticalconsiderations still relate to the entry of the virus into hospitals, the heart of health care, where cancer patients areprotected. Instead, during the COVID19 pandemic the oncologic department had to limit access to care to protectpatients from a more dangerous disease for them, witnessing a paradox of health care. This brought with it worriesin oncologic health care professionals in replanning activities in order to guarantee therapeutic continuity and qualityof care. It is well known that physicians and nurses have different role concepts and role expectations. The purposeof our study was to investigate doctors' and nurses' perception of cancer patient reorganization during the COVID19pandemic in a sample of Italian health care professionals in oncology. Methods: We submitted a survey to oncologic health care workers (physicians and nurses) of Italian NationalHealth Care System during the pandemic to investigate clinical activity reorganization and cancer patientmanagement through 12 closed questions. The survey promoted by Clinica Oncologica, AOU Riuniti di Ancona-Università Politecnica delle Marche was electronic and anonymous. Results: A total of 383 oncology health workers completed the survey, 60 nurses (15%) and 323 physicians (85%).60% of interviewed physicians perceived qualitatively lower than usual the therapeutic path of patients taken incharge in this historical moment, while 45% of nurses declared it was the same (P<0.01). The continuity of themultidisciplinary team was defined as guaranteed for 68% of oncologists, while almost 40% of nurses declared tonot know it. Almost all physicians (95%) answered that their clinical activity was reorganized, compared to a lowerportion of nurses (80%) who replanned their care role (p<0.01). Deferring treatments caused fear and anxiety in62% of physicians and 46% of nurses (P=0.027). Conclusion: The survey underlined the need to integrate skills and involve all professional figures in planningcancer patients' treatment to guarantee optimal therapeutic strategies and a global take in charge in all its details, even during emergencies.
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Background: The coronavirus disease 2019 (COVID-19) outbreak has been declared a global pandemic, and Italyis one of the first and most heavily affected countries. Cancer patients are a population at higher risk from COVID-19 both for intrinsic fragility bound to their underlying disease and oncologic treatment delay. The aim of our survey was to investigate how cancer patients perceived their health condition, their clinical management, and informationcommunication by their medical oncologists during the pandemic. Methods: Between 15th April and 1st May, 2020, a survey was submitted to cancer patients under treatment athospitals of Marche Region that had been invested by the pandemic. It consisted of questions regarding theperception of personal safety, continuity of cancer care, and information quality provided by the OncologyDepartment and individual psychological distress. Results: A total of 661 patients participated in the survey;60.2% were female and 40.4% were aged between 46and 65. Almost all of the attendees (97.7%) stated that the Oncologic Department complied with the appropriatesafety standards, and 78% were reassured about their concerns during the medical interview, but 41% were worriedof being at higher risk of infection upon entry into the Oncology Department and 53.3% felt at greater risk of infectionbecause of chemotherapy treatment in general. The majority of the participants (62.2%) felt that postponing cancertreatment could reduce its efficacy;however, 80% declared they did not feel abandoned at the time of treatmentdelay. 79.4% of the attendees felt more worried for their underlying disease in this emergency situation, but themood worsened for only 34.2% of the participants. Conclusions: Our survey reveals that Oncology Departments have been considered worthy of the emergency interms of safety standards and care management by cancer patients. However, the majority of attendees perceivedthe mutual negative influence between their underlying oncologic disease and risk of Sars-CoV-2 infection andmanifested concerns about their health condition, highlighting the need for special measures to ensure safecontinuity of care.
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Background: COVID-19 pandemic was a health emergency that required a rapid response by the Italian National Health System. Healthcare professionals needed to be properly trained and informed about their patients' procedures and proper management. During an emergency, the information must be exhaustive, clear and timely to allow correct diagnostic and therapeutic continuity. It is also important that all health workers are promptly and homogeneously trained to guarantee the best treatment path even during pandemic. Our survey aimed to investigate the level of information and training of health workers in oncology during the pandemic and, in particular, the difference in perception between under and over 35 years operators. Methods: An on-line multiple choices survey was submitted to oncology health workers during the pandemic to investigate individual perception of resources, information and staff training management by hospital centers. No open questions were included. Results: A total of 383 health workers replied to the survey (116 under 35 years versus 267 over 35 years). In the under 35s group a total of 65% declared they had been timely and sufficiently informed to understand the extent of the problem compared to 50% of over 35 (p=0.007). About 80% of young professionals were adequately informed and two thirds (63%) was formed about procedures/recommendations to be followed during the pandemic. But in professionals over 35 only 56% declared to have the right information and over 65% did not feel adequately trained (p= <0.01). Furthermore, 44% of over 35 felt not sufficiently prepared for the management of the cancer patient during an epidemic compared to only 28% of the under 35 (p=0.015). Conclusions: The survey showed a different perception of information and training of healthcare professionals based on the age group. This could be determined by a different degree of task and responsibility but also by the greater and faster readiness of the younger operators to acquire new information and to draw a renewed ability to face an emergency by reorganizing themselves quickly and actively. Legal entity responsible for the study: Università Politecnica delle Marche - AOU Ospedali Riuniti di Ancona. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.