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Impact of COVID-19 on cancer care in India: a cohort study.
Ranganathan, Priya; Sengar, Manju; Chinnaswamy, Girish; Agrawal, Gaurav; Arumugham, Rajkumar; Bhatt, Rajiv; Bilimagga, Ramesh; Chakrabarti, Jayanta; Chandrasekharan, Arun; Chaturvedi, Harit Kumar; Choudhrie, Rajiv; Dandekar, Mitali; Das, Ashok; Goel, Vineeta; Harris, Caleb; Hegde, Sujai Kolnadguthu; Hulikal, Narendra; Joseph, Deepa; Kantharia, Rajesh; Khan, Azizullah; Kharde, Rohan; Khattry, Navin; Lone, Maqbool M; Mahantshetty, Umesh; Malhotra, Hemant; Menon, Hari; Mishra, Deepti; Nair, Rekha A; Pandya, Shashank J; Patni, Nidhi; Pautu, Jeremy; Pavamani, Simon; Pradhan, Satyajit; Thammineedi, Subramanyeshwar Rao; Selvaluxmy, G; Sharan, Krishna; Sharma, B K; Sharma, Jayesh; Singh, Suresh; Srungavarapu, Gowtham Chandra; Subramaniam, R; Toprani, Rajendra; Raman, Ramanan Venkat; Badwe, Rajendra Achyut; Pramesh, C S.
  • Ranganathan P; Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.
  • Sengar M; Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.
  • Chinnaswamy G; Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.
  • Agrawal G; Birla Institute of Medical Research Hospital, Gwalior, India.
  • Arumugham R; G Kuppuswamy Naidu Memorial Hospital, Coimbatore, India.
  • Bhatt R; Healthcare Global Cancer Centre, Vadodara, India.
  • Bilimagga R; Healthcare Global Cancer Centre, Bengaluru, India.
  • Chakrabarti J; Chittaranjan National Cancer Institute, Kolkata, India.
  • Chandrasekharan A; Aster Malabar Institute of Medical Sciences, Calicut, India.
  • Chaturvedi HK; Max Super Speciality Hospital, Saket, New Delhi, India.
  • Choudhrie R; Padhar Hospital, Betul, India.
  • Dandekar M; Paras Cancer Centre, Patna, India.
  • Das A; Bhubaneswar Borooah Cancer Institute, Guwahati, India.
  • Goel V; Max Super Speciality Hospital, Shalimar Bagh, New Delhi, India.
  • Harris C; North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India.
  • Hegde SK; Ruby Hall Clinic, Pune, India.
  • Hulikal N; Sri Venkateswara Institute of Medical Sciences, Tirupati, India.
  • Joseph D; All India Institute of Medical Sciences, Rishikesh, India.
  • Kantharia R; Kailash Cancer Hospital and Research Centre, Goraj, India.
  • Khan A; Prince Aly Khan Hospital, Mumbai, India.
  • Kharde R; Dr Vikhe Patil Radiation and Cancer Centre, Ahmednagar, India.
  • Khattry N; Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.
  • Lone MM; Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India.
  • Mahantshetty U; Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, India.
  • Malhotra H; Sri Ram Cancer Center, Mahatma Gandhi Medical College Hospital, Jaipur, India.
  • Menon H; Cytecare Cancer Hospitals, Bengaluru, India.
  • Mishra D; Thangam Hospital, Namakkal, India.
  • Nair RA; Regional Cancer Centre, Thiruvananthapuram, India.
  • Pandya SJ; Gujarat Cancer and Research Institute, Ahmedabad, India.
  • Patni N; Bhagwan Mahaveer Cancer Hospital and Research Centre, Jaipur, India.
  • Pautu J; Mizoram State Cancer Institute, Aizawl, India.
  • Pavamani S; Christian Medical College, Vellore, India.
  • Pradhan S; Homi Bhabha Cancer Hospital and Mahamana Pandit Madan Mohan Malaviya Cancer Centre, Varanasi, India.
  • Thammineedi SR; Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, India.
  • Selvaluxmy G; Cancer Institute (WIA), Chennai, India.
  • Sharan K; Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India.
  • Sharma BK; Rashtrasant Tukdoji Tertiary Care Cancer Centre, Nagpur, India.
  • Sharma J; Balco Medical Centre, Raipur, India.
  • Singh S; Sawai Man Singh Hospital, Jaipur, India.
  • Srungavarapu GC; Cachar Cancer Hospital and Research Centre, Silchar, India.
  • Subramaniam R; Kovai Medical Center and Hospital, Coimbatore, India.
  • Toprani R; Healthcare Global Cancer Centre, Ahmedabad, India.
  • Raman RV; Tata Medical Center, Kolkata, India.
  • Badwe RA; Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.
  • Pramesh CS; Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India. Electronic address: prameshcs@tmc.gov.in.
Lancet Oncol ; 22(7): 970-976, 2021 07.
Article in English | MEDLINE | ID: covidwho-1331315
ABSTRACT

BACKGROUND:

The COVID-19 pandemic has disrupted health-care systems, leading to concerns about its subsequent impact on non-COVID disease conditions. The diagnosis and management of cancer is time sensitive and is likely to be substantially affected by these disruptions. We aimed to assess the impact of the COVID-19 pandemic on cancer care in India.

METHODS:

We did an ambidirectional cohort study at 41 cancer centres across India that were members of the National Cancer Grid of India to compare provision of oncology services between March 1 and May 31, 2020, with the same time period in 2019. We collected data on new patient registrations, number of patients visiting outpatient clinics, hospital admissions, day care admissions for chemotherapy, minor and major surgeries, patients accessing radiotherapy, diagnostic tests done (pathology reports, CT scans, MRI scans), and palliative care referrals. We also obtained estimates from participating centres on cancer screening, research, and educational activities (teaching of postgraduate students and trainees). We calculated proportional reductions in the provision of oncology services in 2020, compared with 2019.

FINDINGS:

Between March 1 and May 31, 2020, the number of new patients registered decreased from 112 270 to 51 760 (54% reduction), patients who had follow-up visits decreased from 634 745 to 340 984 (46% reduction), hospital admissions decreased from 88 801 to 56 885 (36% reduction), outpatient chemotherapy decreased from 173634 to 109 107 (37% reduction), the number of major surgeries decreased from 17 120 to 8677 (49% reduction), minor surgeries from 18 004 to 8630 (52% reduction), patients accessing radiotherapy from 51 142 to 39 365 (23% reduction), pathological diagnostic tests from 398 373 to 246 616 (38% reduction), number of radiological diagnostic tests from 93 449 to 53 560 (43% reduction), and palliative care referrals from 19 474 to 13 890 (29% reduction). These reductions were even more marked between April and May, 2020. Cancer screening was stopped completely or was functioning at less than 25% of usual capacity at more than 70% of centres during these months. Reductions in the provision of oncology services were higher for centres in tier 1 cities (larger cities) than tier 2 and 3 cities (smaller cities).

INTERPRETATION:

The COVID-19 pandemic has had considerable impact on the delivery of oncology services in India. The long-term impact of cessation of cancer screening and delayed hospital visits on cancer stage migration and outcomes are likely to be substantial.

FUNDING:

None. TRANSLATION For the Hindi translation of the abstract see Supplementary Materials section.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Delivery of Health Care, Integrated / COVID-19 / Health Services Accessibility / Medical Oncology / Neoplasms Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Humans Country/Region as subject: Asia Language: English Journal: Lancet Oncol Journal subject: Neoplasms Year: 2021 Document Type: Article Affiliation country: S1470-2045(21)00240-0

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Delivery of Health Care, Integrated / COVID-19 / Health Services Accessibility / Medical Oncology / Neoplasms Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Humans Country/Region as subject: Asia Language: English Journal: Lancet Oncol Journal subject: Neoplasms Year: 2021 Document Type: Article Affiliation country: S1470-2045(21)00240-0