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Impact of COVID-19 on healthcare organisation and cancer outcomes.
Bardet, Aurelie; Fraslin, Alderic M; Marghadi, Jamila; Borget, Isabelle; Faron, Matthieu; Honoré, Charles; Delaloge, Suzette; Albiges, Laurence; Planchard, David; Ducreux, Michel; Hadoux, Julien; Colomba, Emeline; Robert, Caroline; Bouhir, Samia; Massard, Christophe; Micol, Jean-Baptiste; Ter-Minassian, Lucile; Michiels, Stefan; Auperin, Anne; Barlesi, Fabrice; Bonastre, Julia.
  • Bardet A; Department of Biostatistics and Epidemiology, Gustave Roussy, Paris-Saclay University, Villejuif, France; Oncostat U1018, Inserm, Paris-Saclay University, Labeled Ligue Contre le Cancer, Villejuif, France. Electronic address: Aurelie.BARDET@gustaveroussy.fr.
  • Fraslin AM; Department of Biostatistics and Epidemiology, Gustave Roussy, Paris-Saclay University, Villejuif, France; Oncostat U1018, Inserm, Paris-Saclay University, Labeled Ligue Contre le Cancer, Villejuif, France.
  • Marghadi J; Service of Medical Information, Gustave Roussy, Villejuif, France.
  • Borget I; Department of Biostatistics and Epidemiology, Gustave Roussy, Paris-Saclay University, Villejuif, France; Oncostat U1018, Inserm, Paris-Saclay University, Labeled Ligue Contre le Cancer, Villejuif, France.
  • Faron M; Department of Biostatistics and Epidemiology, Gustave Roussy, Paris-Saclay University, Villejuif, France; Oncostat U1018, Inserm, Paris-Saclay University, Labeled Ligue Contre le Cancer, Villejuif, France; Department of Surgical Oncology, Gustave Roussy, Villejuif, France.
  • Honoré C; Department of Surgical Oncology, Gustave Roussy, Villejuif, France.
  • Delaloge S; Department of Cancer Medicine, Gustave Roussy, Paris-Saclay University, Villejuif, France.
  • Albiges L; Department of Cancer Medicine, Gustave Roussy, Paris-Saclay University, Villejuif, France.
  • Planchard D; Department of Cancer Medicine, Thoracic Oncology Unit, Gustave Roussy, Villejuif, France.
  • Ducreux M; Department of Cancer Medicine, Gustave Roussy, Paris-Saclay University, Villejuif, France; INSERM U1279, Villejuif, France.
  • Hadoux J; Department of Endocrinology, Imaging Department, Gustave Roussy, Villejuif, France.
  • Colomba E; Department of Cancer Medicine, Gustave Roussy, Paris-Saclay University, Villejuif, France.
  • Robert C; Department of Cancer Medicine, Gustave Roussy, Paris-Saclay University, Villejuif, France.
  • Bouhir S; Department of Head and Neck Oncology, Gustave Roussy, Paris-Saclay University, Villejuif, France.
  • Massard C; Department of Drug Development (DITEP), Gustave Roussy, Paris-Saclay University, Villejuif, France.
  • Micol JB; Department of Hematology, Gustave Roussy, Paris-Saclay University, Villejuif, France; INSERM U1287, Villejuif, France.
  • Ter-Minassian L; Department of Statistics, Oxford University, Oxford, United Kingdom.
  • Michiels S; Department of Biostatistics and Epidemiology, Gustave Roussy, Paris-Saclay University, Villejuif, France; Oncostat U1018, Inserm, Paris-Saclay University, Labeled Ligue Contre le Cancer, Villejuif, France.
  • Auperin A; Department of Biostatistics and Epidemiology, Gustave Roussy, Paris-Saclay University, Villejuif, France; Oncostat U1018, Inserm, Paris-Saclay University, Labeled Ligue Contre le Cancer, Villejuif, France.
  • Barlesi F; Department of Cancer Medicine, Gustave Roussy, Paris-Saclay University, Villejuif, France; Aix Marseille University, CNRS, INSERM, CRCM, Marseille, France.
  • Bonastre J; Department of Biostatistics and Epidemiology, Gustave Roussy, Paris-Saclay University, Villejuif, France; Oncostat U1018, Inserm, Paris-Saclay University, Labeled Ligue Contre le Cancer, Villejuif, France.
Eur J Cancer ; 153: 123-132, 2021 08.
Article in English | MEDLINE | ID: covidwho-1275290
ABSTRACT

BACKGROUND:

Changes in the management of patients with cancer and delays in treatment delivery during the COVID-19 pandemic may impact the use of hospital resources and cancer mortality. PATIENTS AND

METHODS:

Patient flows, patient pathways and use of hospital resources during the pandemic were simulated using a discrete event simulation model and patient-level data from a large French comprehensive cancer centre's discharge database, considering two scenarios of delays massive return of patients from November 2020 (early-return) or March 2021 (late-return). Expected additional cancer deaths at 5 years and mortality rate were estimated using individual hazard ratios based on literature.

RESULTS:

The number of patients requiring hospital care during the simulation period was 13,000. In both scenarios, 6-8% of patients were estimated to present a delay of >2 months. The overall additional cancer deaths at 5 years were estimated at 88 in early-return and 145 in late-return scenario, with increased additional deaths estimated for sarcomas, gynaecological, liver, head and neck, breast cancer and acute leukaemia. This represents a relative additional cancer mortality rate at 5 years of 4.4 and 6.8% for patients expected in year 2020, 0.5 and 1.3% in 2021 and 0.5 and 0.5% in 2022 for each scenario, respectively.

CONCLUSIONS:

Pandemic-related diagnostic and treatment delays in patients with cancer are expected to impact patient survival. In the perspective of recurrent pandemics or alternative events requiring an intensive use of limited hospital resources, patients should be informed not to postpone care, and medical resources for patients with cancer should be sanctuarised.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Neoplasms Type of study: Experimental Studies / Observational study / Prognostic study Limits: Humans Language: English Journal: Eur J Cancer Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Neoplasms Type of study: Experimental Studies / Observational study / Prognostic study Limits: Humans Language: English Journal: Eur J Cancer Year: 2021 Document Type: Article