Online Public Interest in Cancer During the COVID-19 Pandemic.

PURPOSE: Health care priorities of individuals may change during a pandemic, which may, in turn, affect health services utilization. We examined Canadians' online relative search interest in five common solid tumors (breast, colon, lung, prostate, and thyroid) during the COVID-19 pandemic to that observed in the same months in the prior 5 years. METHODS: We conducted a cross-sectional retrospective study using Google Trends aggregate anonymous online search data from Canada. We compared the respective relative search volumes for breast, colon, lung, prostate, and thyroid cancers for the months March-November 2020 with the mean for the same months in 2015-2019. Welch's two-sample t tests were performed and the raw P values were then adjusted using Benjamini-Hochberg procedure to correct for multiple comparisons. The level of statistical significance was defined by choosing false discovery rate at .05 for the primary analysis. RESULTS: We observed temporary statistically significant reductions in Canadians' relative search volumes for various cancers, largely early in the pandemic, in the spring of 2020. Specifically, significant reductions (after adjustment for multiple comparisons) were observed for breast cancer in April, May, and October 2020; colon cancer in March and April of 2020; lung cancer in April and September 2020; and prostate cancer in April and May 2020. Thyroid cancer relative search volumes were not significantly different from those observed prior to the pandemic. CONCLUSION: Although Canadians' online interest in various cancers temporarily waned early in the COVID-19 pandemic, recent relative search volumes for various cancers are largely not significantly different from prior to the pandemic.

Decision-making in Surgery or Active Surveillance for Low Risk Papillary Thyroid Cancer During the COVID-19 Pandemic.

We describe our experience conducting a prospective observational cohort study on the management of small, low risk papillary thyroid cancer during the COVID-19 pandemic. Our study participants are given the choice of active surveillance (AS) or surgery, and those in the AS arm are followed at the study center, whereas surgical patients undergo usual care. During the pandemic we have transitioned from in-person research patient visits to largely virtual care of patients under AS. As of 30 October 2020, we had enrolled 181 patients enrolled in our study (including 25 during the pandemic), of which 92.3% (167/181) consented to telephone communication and 79.0% (143/181) consented to secure videoconferencing communication. Prior to the pandemic, 74.5% (117/157) of our patients chose AS over surgery, whereas during the pandemic, 96.0% (24/25) chose AS. Of the 133 study patients who were under AS within the timeframe from 12 March 2020, to 30 October 2020, the percentage of patients who missed appointments was 8.3% (11/133, for neck ultrasound and physician visits, respectively) and delayed appointments was 23.3% (31/133). This preliminary data suggests that prospective observational research on AS of thyroid cancer can safely continue during the pandemic.