Delayed care for patients with newly diagnosed cancer due to COVID-19 and estimated impact on cancer mortality in France

Abstract

Background: The impact of the first coronavirus disease 2019 (COVID-19) wave on cancer patient management was measured within the nationwide network of the Unicancer comprehensive cancer centers in France.Patients and methods: The number of patients diagnosed and treated within 17 of the 18 Unicancer centers was collected in 2020 and compared with that during the same periods between 2016 and 2019. Unicancer centers treat close to 20% of cancer patients in France yearly. The reduction in the number of patients attending the Unicancer centers was analyzed per regions and cancer types. The impact of delayed care on cancer-related deaths was calculated based on different hypotheses. Results: A 6.8% decrease in patients managed within Unicancer in the first 7 months of 2020 versus 2019 was observed. This reduction reached 21% during April and May, and was not compensated in June and July, nor later until November 2020. This reduction was observed only for newly diagnosed patients, while the clinical activity for previously diagnosed patients increased by 4% similar to previous years. The reduction was more pronounced in women, in breast and prostate cancers, and for patients without metastasis. Using an estimated hazard ratio of 1.06 per month of delay in diagnosis and treatment of new patients, we calculated that the delays observed in the 5-month period from March to July 2020 may result in an excess mortality due to cancer of 1000-6000 patients in coming years. Conclusions: In this study, the delays in cancer patient management were observed only for newly diagnosed patients, more frequently in women, for breast cancer, prostate cancer, and nonmetastatic cancers. These delays may result is an excess risk of cancer-related deaths in the coming years.

Impacto do COVID-19 morbimortalidade de pacientes oncológicos em Teresina-PI

“…Associado a isso, alguns estudos têm se dedicado a estimar, por meio de modelagem, o impacto futuro da pandemia por COVID-19 na mortalidade devido ao retardo no diagnóstico durante o período pandêmico (Blay et al 2021;Degeling et al 2021;Gupta et al 2021) . No Reino Unido, nos próximos cinco anos estimou-se 15,3 a 16,6% de mortes adicionais por câncer colorretal, e de 7,9-9,6% por câncer de mama, 5,8-6,0% por câncer de esôfago e 4,8-5,3% por câncer de pulmão (Degeling et al 2021).…”

“…Dessa maneira, espera-se que futuramente o impacto seja negativo, consequentemente tendo um aumento ''rebote'' tanto na internação quanto na mortalidade como reflexo do déficit no tratamento dos pacientes com câncer durante esse período (Blay et al 2021;Degeling et al 2021;Gupta et al 2021)…”

The Impact of the COVID-19 Pandemic on Cancer Patient’s Management—Lithuanian Cancer Center Experience

“…Several studies [16,17] already noted the trend toward cancer diagnosis at later stages, but this tendency may become more evident in the near future. Evident cancer-specific symptoms, such as a new palpable lump and unusual bleeding, are recognized as alarming signs leading to the medical consultations [18] and probably were not ignored despite the COVID-19 pandemic. Therefore, at the NCI, the number of cancer cases with advanced disease at diagnosis was not impacted by pandemic management measures.…”

Double-Layer Fatty Acid Nanoparticles as a Multiplatform for Diagnostics and Therapy

“…The observed SAR values scale well with the physical and magnetic diameters of the inorganic core, and their magnetic properties. A larger magnetic moment µ = π/6d 3 MAG M S indeed corresponds to a higher hyperthermic efficiency. In this respect, OA@NP exhibit the larger magnetic volume compared to the other two samples and similar saturation magnetization.…”

“…While they were focusing their resources on COVID-19 patients, others suffered from severe delays. In particular, undiagnosed cancers might emerge in the next few years with incremented risk due to these screening gaps [2,3]. Unquestionably, any disease, especially cancer, should be diagnosed and treated without delay: treatments are simpler and more effective at an initial stage.…”