One in seven patients worldwide missed cancer surgery in COVID blockade study
One in seven cancer patients worldwide has missed potentially life-saving surgeries during COVID-19 lockdowns, according to a study that used data from 65 countries, including India. The study, published Wednesday in the journal The Lancet Oncology, found that planned cancer surgery was affected by blockages regardless of local COVID-19 rates at the time, with patients in low-income countries being the more likely to miss their surgery.
While the blockages have been critical in protecting the general public from the spread of infections, they have had a collateral impact on the care of other patients and on health issues, the researchers said.
In one of the first studies that measured these effects directly, researchers led by the University of Birmingham in the UK showed that blockages lead to significant delays in cancer surgery and potentially more cancer deaths.
These could have been avoided if the operations had been carried out on time, they noted.
The study analyzed data on the 15 most common types of solid cancer in 20,000 patients in 466 hospitals in 61 countries. It included data from 1,566 patients at 15 centers in India.
The researchers compared cancellations and delays before cancer surgery during blockages to those during periods with only mild restrictions.
During full closures, one in seven patients (15%) did not receive their planned operation after a median of 5.3 months from diagnosis – all with a COVID-19-related reason for non-operation, have- they stated.
However, during periods of light restriction, the non-logging rate was very low (0.6%).
Patients waiting for surgery for more than six weeks during full lockdown were significantly less likely to have their scheduled cancer surgery.
Frail patients, those with advanced cancer, and those awaiting surgery in lower-middle-income countries were all less likely to have urgently needed cancer surgery.
“Our research reveals the collateral impact of blockages on patients awaiting cancer surgery during the pandemic,” said study co-author James Glasbey of the University of Birmingham.
“While blockages are essential to save lives and reduce the spread of the virus, ensuring the capacity for safe elective cancer surgery should be part of every country’s plan to ensure the continued health of the entire population. population, ”Glasbey said.
In order to avoid further damage during future lockdowns, the researchers noted that the systems around elective surgery must be made more resilient.
They also focused on protecting elective surgery beds and operating theaters, and adequately staffing ‘surge’ capabilities for times of high demand in the hospital, whether it be. COVID, flu, or other public health emergencies.
“The patients most vulnerable to the effects of the lockdown were those in low-income countries, where the capacity issues that were present before the pandemic worsened during the lockdown restrictions,” said lead co-author Aneel Bhangu, of the University of Birmingham.
“Patients in these environments were at the greatest risk of cancellation, although they are younger and have fewer comorbidities,” Bhangu said.
While the researchers followed patients who experienced a delay for a short period of time, evidence from other research suggests that these patients may be at a higher risk of recurrence, the researchers said.
To help alleviate this, surgeons and oncologists should consider closer monitoring of patients experiencing delays before surgery, they said.
Researchers analyzed data from adult patients with types of cancer including colorectal, esophageal, gastric, head and neck, thoracic, hepatic, pancreatic, prostate, bladder, renal, gynecologic, breast, soft tissue sarcoma , bone sarcoma and intracranial malignancies.
The team believes this data can help inform governments when making decisions about extending or reducing restrictions.
Blockages at the country level have a direct impact on hospital procedures and planning, as health systems change to reflect strict government policies restricting movement, the researchers said.
They found that full and moderate lockdowns independently increased the likelihood of no-operation after adjusting for local COVID-19 case notification rates.