Impact of COVID-19 Pandemic on Cancer-Related Hospitalizations in Brazil

Abstract

Background Alongside the SARS-CoV-2 (COVID-19) pandemic, Brazil also faces an ongoing rise in cancer burden. In 2020, there were approximately 592 000 new cancer cases and 260 000 cancer deaths. Considering the heterogeneities across Brazil, this study aimed to estimate the impact of the COVID-19 pandemic on cancer-related hospital admissions at a national and regional level. Methods The national, regional, and state-specific monthly average of cancer-related hospital admission rates per 100 000 inhabitants and 95% confidence intervals (95% CIs) were calculated from March to July (2019: pre-COVID-19; and 2020: COVID-19 period). Thematic maps were constructed to compare the rates between periods and regions. Results Cancer-related hospital admissions were reduced by 26% and 28% for clinical and surgical purposes, respectively. In Brazil, the average hospitalization rates decreased from 13.9 in 2019 to 10.2 in 2020 per 100,000 inhabitants, representing a rate difference of −3.7 (per 100,000 inhabitants; 95% CI: −3.9 to −3.5) for cancer-related (clinical) hospital admissions. Surgical hospital admissions showed a rate decline of −5.8 per 100,000 (95% CI: −6.0 to −5.5). The reduction in cancer-related admissions for the surgical procedure varies across regions ranging between −2.2 and −10.8 per 100 000 inhabitants, with the most significant decrease observed in the south and southeastern Brazil. Conclusions We observed a substantial decrease in cancer-related hospital admissions during the COVID-19 pandemic with marked differences across regions. Delays in treatment may negatively impact cancer survival in the future; hence, cancer control strategies to mitigate the impact are needed.

Changes in inpatient admissions before and during COVID-19 outbreak in a large tertiary hospital in Shanghai

“…Similarly, the number of cancer patients seeking traditional Chinese medicine treatment increased by approximately 50% during the COVID-19 outbreak in Taiwan, China (17). The observed trend regarding admissions due to cancer care during the outbreak is consistent with reports from Brazil (18) and the UK (8). Previous evidence has shown that a decrease in cancer patients seeking treatment may have negative effects on their survival and mortality in the near future (19).…”

Analysis of the impact of coronavirus disease 19 on hospitalization rates for chronic non-communicable diseases in Brazil

“…Social distancing strategies have affected patient management in health services, resulting in a lower demand for access to health services, reduced number of appointments, and suspension of care activities, elective primary care, and highly complex health procedures. Additionally, overwhelming of health services by patients suspected of having COVID-19 have compromised the care and treatment of patients with NCDs, especially in low-and middle-income countries [12][13][14][15][16][17].…”

The impact of the COVID-19 pandemic in the healthcare utilization in Korea: Analysis of a nationwide survey

“…Delays in screenings or non-urgent medical visits may reduce the rate of early disease detection, and patients with chronic diseases are more likely to experience severe complications if treatment is delayed or discontinued [29] , [30] , [31] . Several studies reported that reductions in cancer screening have a considerable impact on cancer incidence and prognosis [19] , [22] , [30] . A study that simulated the interruption of colorectal cancer screening programs worldwide during the COVID-19 pandemic found that even if screening is reduced or stopped for only six months, colorectal cancer deaths may increase by 0.4-1.0% for 30 years to 2050 [7] .…”

“…However, although COVID-19 may have a significant impact on healthcare utilization in the general population, early studies focused on the impact of COVID-19 on the healthcare utilization of infected patients, such as hospitalizations or ICU admissions [14] , [15] , [16] . Most previous studies investigated only on restrictions on the healthcare utilization of specific population groups [17] , [18] , [19] . Although there were studies on general population, most of the studies are on specific situations such as specific screening or emergency care [20] , [21] , [22] .…”