COVID-19 and its impact on gynaecologic oncology practice in India-results of a nationwide survey.

ABSTRACT

The COVID-19 pandemic sweeping across the world has caused major disruptions in healthcare delivery and practice. A survey was conducted to assess the changes in the care of gynaecologic oncology patients in India. METHODS: An online survey enquiring about the patient volumes and surgical load, and changes in practice protocols for endometrial, ovarian, cervical and vulval cancers was conducted in May, 2020. RESULTS: The total number of responses received was 153. Barring duplicates, 148 were analysed. There was a significant drop in gynaecologic oncology patients attending government hospitals as compared to the non-government sector. The drop was not significantly different in areas having low versus high COVID-19 case volumes. The treatment of endometrial cancers remained the same although there was a marked shift from minimal access surgery to conventional surgery. Advanced ovarian cancer was mostly managed by neoadjuvant chemotherapy. Cervical and vulval cancer management remained the same, but radiotherapy protocols were modified by most. CONCLUSION: Based on clinician responses, it appears that most practices across India have suffered a fall in patient volumes. The responses from government sectors point towards a bigger hit in this segment of practice. While the management of endometrial cancers and cervical cancers was mostly unchanged, most cases of advanced ovarian cancer received neoadjuvant chemotherapy. Cervical cancer, when managed by chemoradiation, was likely to have altered radiation schedules.