One-year COVID-19 outcomes on the oncology care patient pathway: Results of a French descriptive, cross-sectional comprehensive study (ONCOCARE-COV).
COVID-19 pandemic
backlog
cancer care pathway
lockdowns
Journal
Cancer medicine
ISSN: 2045-7634
Titre abrégé: Cancer Med
Pays: United States
ID NLM: 101595310
Informations de publication
Date de publication:
12 2022
12 2022
Historique:
revised:
03
05
2022
received:
23
01
2022
accepted:
04
05
2022
pubmed:
21
5
2022
medline:
21
12
2022
entrez:
20
5
2022
Statut:
ppublish
Résumé
The COVID-19 pandemic led to a widely documented disruption in cancer care pathway. Since a resurgence of the pandemic was expected after the first lockdown in France, the global impact on the cancer care pathway over the year 2020 was investigated. This study aimed to describe the changes in the oncology care pathway for cancer screening, diagnosis, assessment, diagnosis annoucement procedure and treatment over a one-year period. The ONCOCARE-COV study was a comprehensive, retrospective, descriptive, and cross-sectional study comparing the years 2019 and 2020. All key indicators along the cancer care pathway assessing the oncological activity over four periods were described. This study was set in a high-volume, public, single tertiary care center divided in two complementary sites (Reims University Hospital and Godinot Cancer Institute, Reims, France) which was located in a high COVID-19 incidence area during both peaks of the outbreak. A total of 26,566 patient's files were active during the year 2020. Breast screening (-19.5%), announcement dedicated consultations (-9.2%), Intravenous and Hyperthermic Intraoperative Intraperitoneal Chemotherapy (HIPECs) (-25%), and oncogeriatric evaluations (-14.8%) were heavily disrupted in regard to 2020 activity. We identified a clear second outbreak wave impact on medical announcement procedures (October, -14.4%), radiotherapy sessions (October, -16%), number of new health record discussed in multidisciplinary tumor board meeting (November, -14.6%) and HIPECs (November, -100%). Moreover, 2020 cancer care activity stagnated compared to 2019. The oncological care pathway was heavily disrupted during the first and second peaks of the COVID-19 outbreak. Between lockdowns, we observed a remarkable but non-compensatory recovery as well as a lesser impact from the pandemic resurgence. However, in absence of an increase in activity, a backlog persisted. Public health efforts are needed to deal with the consequences of the COVID-19 pandemic on the oncology care pathway.
Sections du résumé
BACKGROUND
The COVID-19 pandemic led to a widely documented disruption in cancer care pathway. Since a resurgence of the pandemic was expected after the first lockdown in France, the global impact on the cancer care pathway over the year 2020 was investigated.
AIMS
This study aimed to describe the changes in the oncology care pathway for cancer screening, diagnosis, assessment, diagnosis annoucement procedure and treatment over a one-year period.
MATERIALS & METHODS
The ONCOCARE-COV study was a comprehensive, retrospective, descriptive, and cross-sectional study comparing the years 2019 and 2020. All key indicators along the cancer care pathway assessing the oncological activity over four periods were described. This study was set in a high-volume, public, single tertiary care center divided in two complementary sites (Reims University Hospital and Godinot Cancer Institute, Reims, France) which was located in a high COVID-19 incidence area during both peaks of the outbreak.
RESULTS
A total of 26,566 patient's files were active during the year 2020. Breast screening (-19.5%), announcement dedicated consultations (-9.2%), Intravenous and Hyperthermic Intraoperative Intraperitoneal Chemotherapy (HIPECs) (-25%), and oncogeriatric evaluations (-14.8%) were heavily disrupted in regard to 2020 activity. We identified a clear second outbreak wave impact on medical announcement procedures (October, -14.4%), radiotherapy sessions (October, -16%), number of new health record discussed in multidisciplinary tumor board meeting (November, -14.6%) and HIPECs (November, -100%). Moreover, 2020 cancer care activity stagnated compared to 2019.
DISCUSSION
The oncological care pathway was heavily disrupted during the first and second peaks of the COVID-19 outbreak. Between lockdowns, we observed a remarkable but non-compensatory recovery as well as a lesser impact from the pandemic resurgence. However, in absence of an increase in activity, a backlog persisted.
CONCLUSION
Public health efforts are needed to deal with the consequences of the COVID-19 pandemic on the oncology care pathway.
Identifiants
pubmed: 35593199
doi: 10.1002/cam4.4817
pmc: PMC9348299
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
4865-4879Informations de copyright
© 2022 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
Références
Timeline: WHO's COVID-19 response [Internet]. Accessed December 16, 2020. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/interactive-timeline
SPF. COVID-19: point épidémiologique du 7 janvier 2021 [Internet]. Accessed February 23, 2021. https://www.santepubliquefrance.fr/maladies-et-traumatismes/maladies-et-infections-respiratoires/infection-a-coronavirus/documents/bulletin-national/covid-19-point-epidemiologique-du-7-janvier-2021
Blecker S, Jones SA, Petrilli CM, et al. Hospitalizations for chronic disease and acute conditions in the time of COVID-19. JAMA Intern Med. 2021;181(2):269-271.
Baum A, Schwartz MD. Admissions to Veterans Affairs hospitals for emergency conditions during the COVID-19 pandemic. JAMA. 2020;324(1):96-99.
Bodilsen J, Nielsen PB, Søgaard M, et al. Hospital admission and mortality rates for non-covid diseases in Denmark during covid-19 pandemic: nationwide population based cohort study. BMJ. 2021;373:n1135.
Statement - catastrophic impact of COVID-19 on cancer care [Internet]. Accessed May 5, 2021. https://www.euro.who.int/en/media-centre/sections/statements/2021/statement-catastrophic-impact-of-covid-19-on-cancer-care
CoronavirusCancerManagement.pdf [Internet]. Accessed February 23, 2021. https://www.uhb.nhs.uk/coronavirus-staff/downloads/pdf/CoronavirusCancerManagement.pdf
de Azambuja E, Trapani D, Loibl S, et al. ESMO management and treatment adapted recommendations in the COVID-19 era: breast cancer. ESMO Open. 2020;5(suppl 3):e000793.
Coronavirus » Advice to Trusts on maintaining cancer treatment during the COVID-19 response [Internet]. Accessed March 7, 2021. https://www.england.nhs.uk/coronavirus/publication/advice-to-trusts-on-maintaining-cancer-treatment-during-the-covid-19-response/
Di Fiore F, Bouché O, Lepage C, et al. COVID-19 epidemic: proposed alternatives in the management of digestive cancers: a French intergroup clinical point of view (SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO, SFR). Dig Liver Dis. 2020;52(6):597-603.
Brugel M, Carlier C, Essner C, et al. Dramatic changes in oncology care pathways during the COVID-19 pandemic: the French ONCOCARE-COV study. Oncologist. 2020;26(2):e338-e341.
Riera R, Bagattini ÂM, Pacheco RL, Pachito DV, Roitberg F, Ilbawi A. Delays and disruptions in cancer health care due to COVID-19 pandemic: systematic review. JCO Glob Oncol. 2021. doi:10.1200/GO.20.00639
Dinmohamed AG, Visser O, Verhoeven RHA, et al. Fewer cancer diagnoses during the COVID-19 epidemic in The Netherlands. Lancet Oncol. 2020;21(6):750-751.
Manso L, De Velasco G, Paz-Ares L. Impact of the COVID-19 outbreak on cancer patient flow and management: experience from a large university hospital in Spain. ESMO Open. 2020;4(suppl 2):e000828.
Le Plan cancer 2003-2007 - Les Plans cancer [Internet]. Accessed June 16, 2021. https://www.e-cancer.fr/Institut-national-du-cancer/Strategie-de-lutte-contre-les-cancers-en-France/Les-Plans-cancer/Le-Plan-cancer-2003-2007
Ricciardiello L, Ferrari C, Cameletti M, et al. Impact of SARS-CoV-2 pandemic on colorectal cancer screening delay: effect on stage shift and increased mortality. Clin Gastroenterol Hepatol. 2021;19(7):1410-1417.e9.
Lai AG, Pasea L, Banerjee A, et al. Estimated impact of the COVID-19 pandemic on cancer services and excess 1-year mortality in people with cancer and multimorbidity: near real-time data on cancer care, cancer deaths and a population-based cohort study. BMJ Open. 2020;10(11):e043828.
Toss A, Isca C, Venturelli M, et al. Two-month stop in mammographic screening significantly impacts on breast cancer stage at diagnosis and upfront treatment in the COVID era. ESMO Open. 2021;6(2). Accessed February 20, 2021. https://www.esmoopen.com/article/S2059-7029(21)00009-0/abstract
Mizuno R, Ganeko R, Takeuchi G, et al. The number of obstructive colorectal cancers in Japan has increased during the COVID-19 pandemic: a retrospective single-center cohort study. Ann Med Surg. 2020;60:675-679.
de Jonge L, Worthington J, van Wifferen F, et al. Impact of the COVID-19 pandemic on faecal immunochemical test-based colorectal cancer screening programmes in Australia, Canada, and The Netherlands: a comparative modelling study. Lancet Gastroenterol Hepatol. 2021;6(4):304-314.
McBain RK, Cantor JH, Jena AB, Pera MF, Bravata DM, Whaley CM. Decline and rebound in routine cancer screening rates during the COVID-19 pandemic. J Gen Intern Med. 2021;36:1829-1831. doi:10.1007/s11606-021-06660-5
Chen RC, Haynes K, Du S, Barron J, Katz AJ. Association of cancer screening deficit in the United States with the COVID-19 pandemic. JAMA Oncol. 2021. Accessed June 5, 2021. https://jamanetwork.com/journals/jamaoncology/fullarticle/2778916
Toes-Zoutendijk E, Vink G, Nagtegaal ID, et al. Impact of COVID-19 and suspension of colorectal cancer screening on incidence and stage distribution of colorectal cancers in The Netherlands. Eur J Cancer. 2022;161:38-43.
Kempf E, Lamé G, Layese R, et al. New cancer cases at the time of SARS-Cov2 pandemic and related public health policies: a persistent and concerning decrease long after the end of the national lockdown. Eur J Cancer. 2021;150:260-267.
Horita N. Impact of the COVID-19 pandemic on cancer diagnosis and resection in a COVID-19 low-burden country: nationwide registration study in Japan. Eur J Cancer. 2022;0(0). Accessed February 18, 2022. https://www.ejcancer.com/article/S0959-8049(22)00060-0/fulltext
Coma E, Guiriguet C, Mora N, et al. Impact of the COVID-19 pandemic and related control measures on cancer diagnosis in Catalonia: a time-series analysis of primary care electronic health records covering about five million people. BMJ Open. 2021;11(5):e047567.
Yabroff KR, Wu XC, Negoita S, et al. Association of the COVID-19 pandemic with patterns of statewide cancer services. J Natl Cancer Inst. 2021. doi:10.1093/jnci/djab122
Blay JY, Boucher S, Vu BL, et al. Delayed care for patients with newly diagnosed cancer due to COVID-19 and estimated impact on cancer mortality in France. ESMO Open. 2021;6(3). Accessed May 18, 2021. https://www.esmoopen.com/article/S2059-7029(21)00093-4/abstract
Shinkwin M, Silva L, Vogel I, et al. COVID-19 and the emergency presentation of colorectal cancer. Colorectal Dis. 2021;23(8):2014-2019.
Maringe C, Spicer J, Morris M, et al. The impact of the COVID-19 pandemic on cancer deaths due to delays in diagnosis in England, UK: a national, population-based, modelling study. Lancet Oncol. 2020;21(8):1023-1034.
Grippaudo FR, Migliano E, Redi U, et al. The impact of COVID-19 in plastic surgery departments: a comparative retrospective study in a COVID-19 and in a non-COVID-19 hospital. Eur J Plast Surg. 2020;43(5):645-650.
To N, Bekker HL, Henry K, et al. COVID-19 restrictions on multidisciplinary team meeting decision-making: service evaluation in a major UK cancer centre. Br J Surg. 2021;108(4):e162-e163.
Guckenberger M, Belka C, Bezjak A, et al. Practice recommendations for lung cancer radiotherapy during the COVID-19 pandemic: an ESTRO-ASTRO consensus statement. Radiother Oncol. 2020;146:223-229.
Slimano F, Baudouin A, Zerbit J, et al. Cancer, immune suppression and coronavirus disease-19 (COVID-19): need to manage drug safety (French Society for Oncology Pharmacy [SFPO] guidelines). Cancer Treat Rev. 2020;88:102063.
Lee AJX, Purshouse K. COVID-19 and cancer registries: learning from the first peak of the SARS-CoV-2 pandemic. Br J Cancer. 2021;124(11):1777-1784.
Laurent-Badr Q, Barbe C, Brugel M, et al. Time intervals to diagnosis and chemotherapy do not influence survival outcome in patients with advanced pancreatic adenocarcinoma. Dig Liver Dis. 2020;52(6):658-667.
Brugel M, Letrillart L, Evrard C, et al. Impact of the COVID-19 pandemic on disease stage and treatment for patients with pancreatic adenocarcinoma: a French comprehensive multicentre ambispective observational cohort study (CAPANCOVID). Eur J Cancer. 2022;0(0). Accessed February 18, 2022. https://www.ejcancer.com/article/S0959-8049(22)00073-9/fulltext
Purdy AC, Smith BR, Hohmann SF, Nguyen NT. The impact of the novel coronavirus pandemic on gastrointestinal operative volume in the United States. Surg Endosc. 2021;36:1943-1949. doi:10.1007/s00464-021-08477-z
Filipe M, de Bock E, Geitenbeek R, et al. Impact of the COVID-19 pandemic on surgical colorectal cancer care in The Netherlands: a multicenter retrospective cohort study. J Gastrointest Surg. 2021. doi:10.1007/s11605-021-04936-z
Iezzi R, Valente I, Cina A, et al. Longitudinal study of interventional radiology activity in a large metropolitan Italian tertiary care hospital: how the COVID-19 pandemic emergency has changed our activity. Eur Radiol. 2020;30(12):6940-6949.
Zhong J, Datta A, Gordon T, et al. The impact of COVID-19 on interventional radiology services in the UK. Cardiovasc Intervent Radiol. 2021;44(1):134-140.
Hanna TP, King WD, Thibodeau S, et al. Mortality due to cancer treatment delay: systematic review and meta-analysis. BMJ. 2020;371:m4087.
Gheorghe A, Maringe C, Spice J, et al. Economic impact of avoidable cancer deaths caused by diagnostic delay during the COVID-19 pandemic: a national population-based modelling study in England, UK. Eur J Cancer. 2021;152:233-242.
Sud A, Jones M, Broggio J, et al. Collateral damage: the impact on outcomes from cancer surgery of the COVID-19 pandemic. Ann Oncol. 2020;31(8):1065-1074.