REVIEW OF THE IMPACT OF COVID-19 FIRST WAVE RESTRICTIONS ON CANCER CARE

CG Original Research

By and Tom Jefferson, Carl Heneghan et al.

Published  1 June 2021

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Summary: The COVID-19 pandemic led to wide-scale global disruption of cancer care across a broad range of cancers. Sixty-nine studies from 23 countries report changes in the patterns of screenings, diagnoses, waiting lists and treatments for cancer related to restrictions during the COVID-19 pandemic in 2020. Fourteen studies report an increase in later-stage cancer presentations. Future restrictions should consider the disruptions to cancer care pathways and plan to prevent the unnecessary harms.

Results
We found 69 published studies that compared
changes in the patterns of screenings, diagnoses,
waiting lists and treatments for cancer during the
pandemic period in 2020 with pre-pandemic levels.
Studies were conducted in 23 countries: Austria,
Cameroon, Canada, Croatia, Denmark, Hong Kong,
Korea, Japan, Poland and Slovenia (n=1 study
each); France, Germany, India, Portugal and Taiwan
(n=2 studies each); Brazil, China, The Netherlands
and Spain (n=3 studies each); Turkey (n=4); UK
(n=9); Italy (n=10); and US (n=14).
We found analyses for the following types
of cancer: eye, gynaecological, liver, lung,
maxillofacial, radiotherapy and surgical cancer
delay (n=1 study each); cervical, screening
programmes and urology (n=2 studies each); head
& Neck and lung (n=3 studies each); skin and oral
(n=4 studies each); breast (n=7) that include breast
& colorectal and breast/gynaecological studies
cancer diagnosis (n=7); colorectal (n=9) and 14
studies that analysed all cancer types. We found
three studies specifically done in paediatric
populations, including solid tumours and
leukaemia. Fourteen studies report an increase in

later-stage cancer presentations (See the table of
included studies).




Conclusions


Restrictive measures in the first wave of the COVID19 pandemic in 2019-20 led to wide-scale, global disruption of cancer care. Future restrictions should consider disruptions to the cancer care pathways and plan to prevent unnecessary harms.

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