Cancer care in India hit widely by COVID-19
medwireNews: Delivery of all aspects of cancer care fell by between 23% and 54% in India at the start of the COVID-19 pandemic, compared with the same period in 2019, show data published in The Lancet Oncology.
C S Pramesh (Tata Memorial Centre, Mumbai) and co-authors say their findings show that “[t]he COVID-19 pandemic has had considerable impact on the delivery of oncology services in India.”
They add: “The long-term impact of cessation of cancer screening and delayed hospital visits on cancer stage migration and outcomes are likely to be substantial.”
Pramesh et al found that, across the 41 high-volume Indian cancer centers they studied, the COVID-19 pandemic had the greatest impact on new patients registered. Specifically, between March 1 and May 31, 2020 there were 51,760 new patient registrations, which was 54% lower than the 122,270 registrations that occurred between March 1 and May 31, 2019.
In addition, there was a 52% reduction in minor surgeries (18,004 to 8630), a 49% reduction in major surgeries (17,120 to 8677), a 46% reduction in follow-up visits (634,745 to 340,984), a 43% reduction in the number of radiologic diagnostic tests (93,449 to 53,560), and a 38% reduction in pathologic diagnostic tests (398,373 to 246,616).
Outpatient chemotherapy visits fell by 37% (173,634 to 109,107) in March–May 2020 versus 2019, hospital admissions decreased by 36% (88,801 to 56,885), and palliative referrals fell by 29% (19,474 to 13,890), while the number of patients accessing radiotherapy dropped by 23% (51,142 to 39,365).
And the researchers note that the proportional reductions were even greater when they only considered the months of April and May, were higher in larger cities relative to smaller ones, and were larger in public and charitable hospitals compared with private hospitals.
Pramesh and team also obtained estimates from participating centers on cancer screening services. They found that 69% of institutions had either “stopped or substantially reduced” screening activities in March–May 2020 compared with the previous year, 86% had implemented “a conscious staff sparing strategy”, and 67% had initiated telephone or video consultations.
Finally, the investigators estimated that the reductions in oncology services due to COVID-19 will lead to between 83,600 and 111,500 missed cancer diagnoses and between 98,650 and 131,500 excess cancer-related deaths over the next 5 years.
They say: “The cancer care system needs to be prepared for this patient backlog and urgent measures to increase the diagnostic capacity and increase the efficiency of care pathways are necessary.”
Pramesh and co-authors conclude that global healthcare systems “need to be strengthened to ensure that the treatment of diseases, such as cancer, is not disrupted during future pandemics.”
They add that “[p]ublic messaging should reiterate the importance of accessing cancer treatment in comparison to the hypothetical risk of acquiring COVID-19.”
medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2021 Springer Healthcare Ltd, part of the Springer Nature Group
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