The impact of COVID-19 pandemic on cancer care: A global collaborative study

ABSTRACT

Background: COVID-19 pandemic impacted healthcare systems globally and resulted in the interruption of usual care in many healthcare facilities exposing vulnerable cancer patients to significant risks. Our study aimed to evaluate the impact of this pandemic on cancer care worldwide. Methods: We conducted a cross-sectional study using validated electronic questionnaire of 51 items via SurveyMonkey©. The tool was distributed to leaders in oncology centers worldwide. The questionnaire obtained information on the capacity and services offered at these centers, magnitude of interruption of care, reasons for interruption, challenges faced, interventions implemented, and the estimation of patient harm during the pandemic. Results: 356 centers from 54 countries across six continents participated between April 21 and May 8, 2020. These centers serve about 700,000 new cancer patients a year. Most of them (88%) reported facing challenges in providing care during the pandemic. 54% and 45% of centers reported cases of COVID-19 infection among their patients and staff, respectively. Although 51% reduced services as part of a preemptive strategy, other common reasons included overwhelmed system (20%), lack of personal protective equipment (19%), staff shortage (18%), and restricted access to medications (9.7%). Missing at least one cycle of therapy by more than 10% of patients was reported in 46% of the centers. Most centers implemented virtual clinics (83.6%) and virtual tumor boards (93%) and participants believed these will persist beyond the pandemic (55.5% and 60%, respectively). Centers performed routine tests in laboratories near patients’ homes (76%) and shipped medications to patients (68.6%). Participants reported patients’ exposure to harm from interruption of cancer-specific care (36.5%) and non-cancer related care (39%) with some centers estimating up to 80% of their patients exposed to some harm. Only 16% of the centers reported services are back to baseline at the time of completing the survey. Conclusions: The detrimental impact of COVID-19 pandemic on cancer care is widespread with varying magnitude among centers worldwide. Further research to assess this impact at the patient level is required. A “new normal” of cancer care emerged with emphasis on telehealth and care delivery closer to home. Legal entity responsible for the study The authors. Funding: Has not received any funding. Disclosure A.R. Jazieh Research grant/Funding (self) MSD. C.D. Rolfo Speaker Bureau/Expert testimony AstraZeneca;Advisory/Consultancy Inivata;Archer;MD Serono;Mylan;Oncompass;Honoraria (self) Elsevier. All other authors have declared no conflicts of interest.