Inequalities in the decline and recovery of pathological cancer diagnoses during the first six months of the COVID-19 pandemic: a population-based study

Hamilton, Ashleigh C.; Donnelly, David; Loughrey, Maurice B.; Turkington, Richard; Fox, Colin; Fitzpatrick, Deirdre; O’Neill, Ciarán; Gavin, Anna; Coleman, Helen

doi:10.1101/2021.02.23.21252276

Cited by 3 publications

(1 citation statement)

References 19 publications

(21 reference statements)

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“…Infectious diseases may change the model of clinical services, especially in cancer screening, diagnostics, and treatment [ 31 ]. A prospective cohort study that compared the epidemiology, clinical features and outcomes of influenza A (H1N1) 2009 pneumonia between the pandemic period and the first post-pandemic influenza season showed that patients during the post-pandemic period were older and more likely to have chronic obstructive pulmonary disease, chronic kidney disease and cancer than the others [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Global, regional, and national burden of kidney, bladder, and prostate cancers and their attributable risk factors, 1990–2019

Leng

et al. 2021

Military Med Res

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Background The burden of kidney, bladder, and prostate cancers has changed in recent decades. This study aims to investigate the global and regional burden of, and attributable risk factors for genitourinary cancers during the past 30 years. Methods We extracted data of kidney, bladder, and prostate cancers from the Global Burden of Disease 2019 database, including incidence, mortality, disability-adjusted life-years (DALYs), and attributable risk factors from 1990 to 2019. Estimated annual percentage changes (EAPC) were calculated to assess the changes in age-standardized incidence rate, age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR). The associations between cancers burden and socio-demographic index (SDI) were also analyzed. Results Compared with 1990, the global incident cases in 2019 were higher by 154.78%, 123.34%, and 169.11% for kidney, bladder, and prostate cancers, respectively. During the 30-year study period, there was a downward trend in ASMR and ASDR for bladder cancer (EAPC = − 0.68 and − 0.83, respectively) and prostate cancer (EAPC = − 0.75 and − 0.71, respectively), but an upward trend for kidney cancer (EAPC = 0.35 and 0.12, respectively). Regions and countries with higher SDI had higher incidence, mortality, and DALYs for all three types of cancers. The burden of bladder and prostate cancers was mainly distributed among older men, whereas the burden of kidney cancer increased among middle-aged men. Smoking related mortality and DALYs decreased, but high body mass index (BMI) and high fasting plasma glucose (FPG) related mortality and DALYs increased among kidney, bladder, and prostate cancers during the study period. Conclusions Kidney, bladder, and prostate cancers remain major global public health challenges, but with distinct trend for different disease entity across different regions and socioeconomic status. More proactive intervention strategies, at both the administrative and academic levels, based on the dynamic changes, are needed.

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Section: Discussionmentioning

confidence: 99%

Global, regional, and national burden of kidney, bladder, and prostate cancers and their attributable risk factors, 1990–2019

Leng

et al. 2021

Military Med Res

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Impact of COVID‐19 on cancer incidence, presentation, diagnosis, treatment and survival in Northern Ireland

Bennett,

Murray,

Mitchell

et al. 2024

Intl Journal of Cancer

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The COVID‐19 pandemic had a major impact on cancer patients and services but has been difficult to quantify. We examined how the entire cancer pathway—from incidence, presentation, diagnosis, stage, treatment and survival—was affected in Northern Ireland during April–December 2020 compared to equivalent 2018–2019 periods using retrospective, observational cancer registry data from the Northern Ireland Cancer Registry (NICR). There were 6748 cancer cases in April–December 2020 and an average 7724 patients in April–December 2018–2019. Incident cases decreased by 13% (almost 1000). Significant differences were found across age cohorts and deprivation quintiles, with reductions greatest for younger people (<55 years; 19% decrease) and less deprived (22% decrease). A higher proportion had emergency admission (16%‐to‐20%) with lower proportions diagnosed pathologically (85%‐to‐83%). There was a significant stage shift, with lower proportions of early stage (29%‐to‐25%) and higher late‐stage (21%‐to‐23%). Lower proportions received surgery (41%‐to‐38%) and radiotherapy (24%‐to‐22%) with a higher proportion not receiving treatment (29%‐to‐33%). One‐year observed‐survival decreased from 73.7% to 69.8% and 1‐year net‐survival decreased from 76.1% to 72.9%, with differences driven by five tumours; Lung (40.3%‐to‐35.0%), Head‐and‐Neck (77.4%‐to‐68.4%), Oesophageal (53.5%‐to‐42.3%), Lymphoma (81.1%‐to‐75.2%) and Uterine cancer (87.4%‐to‐80.4%). Our study reveals profound adverse impact of COVID‐19 on the entire cancer patient pathway, with 13% fewer cases, greater emergency admissions and significant stage‐shift from early to more advanced‐stage disease. There was major treatment impact with lower rates of surgery and radiotherapy and higher proportions receiving no treatment. There were significant reductions in 1‐year survival. Our study will support service recovery and protect cancer services in future pandemics or disruptions.

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Impact of COVID-19 control on lung, breast, and colorectal pathological cancer diagnoses. A comparison between the Netherlands, Aotearoa New Zealand, and Northern Ireland

Mitchell

McLean²,

Gavin

et al. 2023

BMC Cancer

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Background The COVID-19 pandemic was managed in Aotearoa New Zealand (NZ) by a COVID-19 elimination policy, involving border closure and an initial national lockdown. This was different to most other countries including Northern Ireland (NI) and the Netherlands (NED). We quantify the effect of these policies on the diagnosis of three major cancers, comparing NZ with these two European countries. Method Data from NED, NZ and NI population-based cancer registries were used to assess trends in all pathologically diagnosed (PD) lung, breast, and colorectal cancers from March to December 2020 (pandemic period) and compared to the similar pre-pandemic period (2017–2019). Trend data were also collated on COVID-19 cases and deaths per 100,000 in each population. Results Comparing the pre-pandemic period to the pandemic period there were statistically significant reductions in numbers of lung (↓23%) and colorectal (↓15%) PD cancers in NI and numbers of breast (↓18%) and colorectal cancer (↓18.5%) diagnosed in the NED. In NZ there was no significant change in the number of lung (↑10%) or breast cancers (↑0.2%) but a statistically significant increase in numbers of colorectal cancer diagnosed (↑5%). Conclusion The impact of COVID-19 on cancer services was mitigated in NZ as services continued as usual reflecting minimal healthcare disruption and protected cancer services linked with the elimination approach adopted. The reduction in PD cases diagnosed in NED and NI were linked with higher COVID-19 rates and reflect societal restrictions which resulted in delayed patient presentation to primary and secondary care, disruption to screening and healthcare services as a result of COVID-19 infections on staff and the need to shift intensive care to COVID-19 patients. Reductions in PD cancers in NI and the NED and in particularly lung cancers in NI, highlight the need for targeted public health campaigns to identify and treat ‘missing’ patients. Protecting cancer services should be a priority in any future pandemic or systemic healthcare system disruption.

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Inequalities in the decline and recovery of pathological cancer diagnoses during the first six months of the COVID-19 pandemic: a population-based study

Cited by 3 publications

References 19 publications

Global, regional, and national burden of kidney, bladder, and prostate cancers and their attributable risk factors, 1990–2019

Global, regional, and national burden of kidney, bladder, and prostate cancers and their attributable risk factors, 1990–2019

Impact of COVID‐19 on cancer incidence, presentation, diagnosis, treatment and survival in Northern Ireland

Impact of COVID-19 control on lung, breast, and colorectal pathological cancer diagnoses. A comparison between the Netherlands, Aotearoa New Zealand, and Northern Ireland

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