Evaluating the Impact of the COVID-19 Pandemic on New Cancer Diagnoses and Oncology Care in Manitoba

Abstract

Individuals with cancer are vulnerable to infection with SARS-CoV-2, the virus causing COVID-19. Physical distancing, the reallocation of health care resources, and the implementation of procedures to reduce the spread of COVID-19 may also have serious consequences for people with cancer. We evaluated the impact of COVID-19 on new cancer diagnoses and oncology care in Manitoba, Canada using an interrupted time series design and data from the Manitoba Cancer Registry and CancerCare Manitoba’s (CCMB) electronic medical record. In April 2020, there was a 23% decrease in new cancer diagnoses, a 21% decrease in pathology reports, and a 43% reduction in surgical resections. There was no difference in new cancer diagnoses by August 2020, surgery by July 2020, and pathology reports by September 2020. From April 2020 to June 2021, there was a 13% decrease in radiotherapy (RT) fractions, an 18% decrease in UCC visits, and a 52% decrease in in-person visits. There was no change in intravenous chemotherapy visits per month, first RT visits, or overall patient visits. The impact of COVID-19 on shifts in the stage at diagnosis and survival will be assessed in future analyses.

Delivery of Cancer Care in Ontario, Canada, During the First Year of the COVID-19 Pandemic

“… 3 Reductions in cancer diagnoses similar to those in Ontario have been reported elsewhere. 4 , 5 , 7 , 12 , 13 , 14 , 15 , 16 , 17 In line with our findings, a study from Italy reported a 17% reduction in radiotherapy. 18 Another study from Spain reported reductions of 37% in new oncology referrals and 38% in new treatments, 19 substantially greater reductions than those observed in Ontario.…”

“…In contrast to our findings, which demonstrated that systemic treatment visits were largely unchanged, a national study from Scotland reported a 29% reduction in systemic therapy visits in March 2020. 20 However, a study from the Canadian province of Manitoba reported little change in parenteral chemotherapy visits, 17 where similar interim measures were used (eg, shorter regimens). Such differences are expected, given the variability in timing of pandemic waves, policy directives, and clinical guidance.…”

Mitigating COVID-19’s impact on missed and delayed cancer diagnoses

“…11 Analysis of the Manitoba Cancer Registry showed a 23% decrease in new cancer diagnoses in April 2020, accompanied by a 21% decrease in the volume of pathology reports and a 43% drop in surgical resections. 12 Quebec data revealed a 5% decrease in pathology results positive for malignancy in 2020 to 2021 compared with the previous year. 4 Canada-wide, the number of cancer surgeries decreased by about 20% in 2020 compared with 2019.…”

Impact of COVID-19 on the incidence of CT-diagnosed appendicitis and its complications in the UK and Sweden

“…There are multiple reports of delay in diagnosis and treatment of patients with chronic diseases, including cancer [ 21 , 22 ]. The increased mortality and morbidity from delay in diagnosis and treatment may only emerge at a later stage [ 23 – 25 ].…”