Impact of COVID-19 on cancer service delivery: a follow-up international survey of oncology clinicians

G Chazan; F Franchini; M Alexander; S Banerjee; L Mileshkin; P Blinman; R Zielinski; D Karikios; N Pavlakis; S Peters; F Lordick; D Ball; G Wright; M IJzerman; B J Solomon

doi:10.1016/j.esmoop.2021.100224

Impact of COVID-19 on cancer service delivery: a follow-up international survey of oncology clinicians

ESMO Open. 2021 Oct;6(5):100224. doi: 10.1016/j.esmoop.2021.100224. Epub 2021 Jul 9.

Authors

G Chazan¹, F Franchini², M Alexander³, S Banerjee⁴, L Mileshkin⁵, P Blinman⁶, R Zielinski⁷, D Karikios⁸, N Pavlakis⁹, S Peters¹⁰, F Lordick¹¹, D Ball¹², G Wright¹³, M IJzerman¹⁴, B J Solomon¹⁵

Affiliations

¹ Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Australia.
² Centre for Cancer Research and Centre for Health Policy, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia; Melbourne School of Public and Global Health, Faculty of Medicine, Dentistry and Health Sciences, Parkville, Australia; Department of Cancer Research, Peter MacCallum Cancer Centre, Melbourne, Australia.
³ Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Australia; Department of Pharmacy, Peter MacCallum Cancer Centre, Melbourne, Australia.
⁴ Gynaecology Unit, The Royal Marsden NHS Foundation Trust, London, UK; Division of Clinical Studies, The Institute of Cancer Research, London, UK.
⁵ Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Australia; Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia.
⁶ Faculty of Medicine, University of Sydney, Sydney, Australia; Medical Oncology, Concord Repatriation General Hospital, Concord, Australia.
⁷ Medical Oncology, Western Sydney University, Sydney, Australia; Medical Oncology, Orange Hospital, Western New South Wales Local Health District, Orange, Australia.
⁸ Medical Oncology, Nepean Hospital, Sydney, Australia; Nepean Clinical School, University of Sydney, Sydney, Australia.
⁹ Medical Oncology, Royal North Shore Hospital, Sydney, Australia.
¹⁰ Medical Oncology, Lausanne University Hospital CHUV, Lausanne, Switzerland.
¹¹ University Cancer Centre Leipzig, University Medicine Leipzig, Leipzig, Germany.
¹² Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Australia; Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia.
¹³ St Vincent's Hospital, Victorian Comprehensive Cancer Centre, Fitzroy, Australia; Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia; Department of Surgery, University of Melbourne, Parkville, Australia.
¹⁴ Centre for Cancer Research and Centre for Health Policy, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia; Department of Cancer Research, Peter MacCallum Cancer Centre, Melbourne, Australia; University of Twente, Health Technology & Services Research, Enschede, The Netherlands.
¹⁵ Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Australia; Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia. Electronic address: Ben.solomon@petermac.org.

Abstract

Background: The COVID-19 pandemic has had a vast impact on cancer service delivery around the world. Previously reported results from our international survey of oncology clinicians, conducted through March-April 2020, found that clinicians reported altering management in both the curative and palliative settings and not in proportion to the COVID-19 case burden in their region of practice. This follow-up survey, conducted from 27^th September to 7^th November 2020, aimed to explore how attitudes and practices evolved over the 2020 pandemic period.

Participants and methods: Participants were medical, radiation and surgical oncologist and trainees. Surveys were distributed electronically via ESMO and other collaborating professional societies. Participants were asked to compare their practice prior to the pandemic to both the period of March-April 2020, referred to as the 'early' period, and the current survey period, referred to as the 'later' period.

Results: One hundred and seventy-two oncology clinicians completed the survey. The majority of respondents were medical oncologists (n = 136, 79%) and many were from Europe (n = 82, 48%). In the 'early' period, 88% (n = 133) of clinicians reported altering their practice compared to 63% (n = 96) in the 'later' period. Compared to prior to the pandemic, clinicians reported fewer new patient presentations in the 'early' period and a trend towards more patients presenting with advanced disease in the 'later' period.

Conclusions: Results indicate a swing back towards pre-COVID-19 practices despite an increase in the rate of cumulative COVID-19 cases across 2020. The impact of these changes on cancer associated morbidity and mortality remains to be measured over the months and years to come.

Keywords: COVID-19; oncology; service delivery; telehealth.

MeSH terms

COVID-19*
Follow-Up Studies
Humans
Neoplasms* / epidemiology
Neoplasms* / therapy
Pandemics
SARS-CoV-2
Surveys and Questionnaires