ABSTRACT
Italy introduced social distancing measures, which limited the spread of COVID-19; all the non-life-threatening treatments have been temporarily suspended, including screening programs. This decision leads to unintended effects on the ability to detected neoplasia in their first stages. Possible future outcomes of the ability to detect new breast cancer cases based on two alternative scenarios show that the reduction in organized screening activities will limit the ability to detect no <3.43% of the new cases; the economic crisis will reduce voluntary screening, increasing the undetected new cases up to 11.73%. Cases diagnosed with delay will show up in their advanced stage along with unknown effects on mortality and health care costs. Global health care policies should be implemented to counterbalance these adverse effects.
Subject(s)
Breast Neoplasms/diagnosis , COVID-19/prevention & control , Health Policy , Mass Screening , Quarantine , Female , Humans , ItalyABSTRACT
BACKGROUND/AIM: Coronavirus disease is spreading worldwide. Due to fast transmission and high fatality rate drastic emergency restrictions were issued. During the lockdown, only urgent medical services are guaranteed. All non-urgent services, as breast cancer (BC) screening, are temporarily suspended. The potential of breast cancer screening programs in increasing the survival rate and decreasing the mortality rate has been widely confirmed. Suspension could lead to worse outcomes for breast cancer patients. Our study aimed to analyse the data and provide estimates regarding the temporary BC screening suspension. PATIENTS AND METHODS: Data regarding breast cancer and respective screening programs were achieved through literature research and analysis. RESULTS: Considering three different scenarios with respect to the lockdown's impact on breast cancer screening, we estimate that approximately 10,000 patients could have a missed diagnosis during these 3 months. Considering a 6-month period, as suggested by the Imperial college model, the number of patients who will not receive a diagnosis will rise to 16,000. CONCLUSION: Breast cancer screening should be resumed as soon as possible in order to avoid further breast cancer missed diagnosis and reduce the impact of delayed diagnosis.
Subject(s)
Breast Neoplasms/diagnosis , Coronavirus Infections/epidemiology , Early Detection of Cancer , Mass Screening/trends , Pneumonia, Viral/epidemiology , Aged , Betacoronavirus/pathogenicity , Breast Neoplasms/complications , Breast Neoplasms/epidemiology , COVID-19 , Coronavirus Infections/complications , Coronavirus Infections/virology , Female , Humans , Mammography , Middle Aged , Pandemics , Pneumonia, Viral/complications , Pneumonia, Viral/virology , SARS-CoV-2ABSTRACT
The COVID-19 pandemic poses an unprecedented set of challenges to governments, policy makers and citizens; lockdowns and social distancing measures generate significant economic losses, fuel public expenditures and deficits and will no doubt significantly boost public debts. The burden of such measures is also likely to be disproportionately felt by the worse-off members of society and will weigh heavily on future generations. This is both unfair and runs the risk of politically destabilizing the recovery process. To avoid these outcomes unconventional policy measure such as taxes on private wealth and digital economic activities, but also public debt monetization, should be considered. From a political perspective, governments should realize that policy coordination is the only successful exit strategy following a systemic economic shock. While the EU is moving faster than we are accustomed to, it still seems unable to respond quickly enough given the nature of the circumstances. In this picture, the G-20, provided it acts quickly over the coming months, could emerge as the sole global policy forum left on the playing field that can avoid that national interests will prevail eventually producing collectively sub-optimal results in the long-run.