Patients' perspectives on the effect of the COVID-19 pandemic on access to cancer care and social contacts in Sweden and the UK: a cross-sectional study.

PURPOSE: We aimed to determine whether there was a difference in access to cancer-related healthcare between people living in Sweden and the United Kingdom (UK) during the COVID-19 pandemic. We also describe how the pandemic affected social contact of patients undergoing treatment. METHODS: This cross-sectional study used survey data collected through the War on Cancer mobile phone application between September 5, 2020, and January 6, 2021. We included individuals with cancer diagnoses living in Sweden or the UK. The association between difficulty accessing cancer-related healthcare and country was examined using logistic regression. Frequencies were used to describe the effect of the pandemic on social contact. RESULTS: Of 491 individuals included in the study, 183 were living in the UK and 308 in Sweden. Living in the UK was associated with greater difficulty accessing cancer-related healthcare (n = 99/183, 54.1%) than living in Sweden (n = 100/308, 32.5%) (odds ratio 2.12, 95% CI 1.39-3.23, p < 0.001). The pandemic affected social contact for almost all patients (n = 218/238, 91.6%) undergoing treatment. CONCLUSION: This study highlights the differential impact that the pandemic may have had on patients' access to cancer-related care in the UK and Sweden. In both countries, the pandemic overwhelmingly affected social contact of individuals undergoing cancer treatment. New ways must be found to improve access to cancer-related care and reduce social isolation for patients with cancer during a pandemic.

Severity of the clinical presentation of hepatitis A in five European countries from 1995 to 2014.

OBJECTIVES: We analysed hepatitis A (HepA) notifications and hospitalisations in Italy, the Netherlands, Norway, Spain, and Sweden for available periods between 1995 and 2014. We aimed to investigate whether decreasing HepA incidence is associated with increasing age at infection and worsening HepA presentation and to identify groups at risk of severe disease. METHODS: We performed a retrospective cohort study including 36 734 notified and 36 849 hospitalised patients. We used negative binomial regressions to identify over time: i) trends in hospitalisation and notification rates; ii) proportion of hospitalised and notified patients aged ≥40 years; iii) proportion of "severe hospitalisations"; and iv) risk factors for severe hospitalisation. RESULTS: During the study period both HepA notifications and hospitalisations decreased, with notification rates decreasing faster, patients aged ≥40 years increased, however, the proportion of severe HepA hospitalisations remained stable. Older patients and patients with comorbidities, particularly liver diseases, were more likely to experience severe disease. CONCLUSIONS: We used digitalised health information to confirm decreasing trends in HepA hospitalisations and notifications, and the increasing age of patients with HepA in Europe. We did not identify an increase in the severity of the clinical presentation of patients with HepA. Older patients with liver diseases are at increased risk of severe disease and should be prioritised for vaccination.