The Impact of the COVID-19 Pandemic and the Associated Belgian Governmental Measures on Cancer Screening, Surgical Pathology and Cytopathology

Abstract

Introduction The severe acute respiratory syndrome coronavirus 2 caused a pandemic of coronavirus disease 2019 (COVID-19). Unprecedented public health actions were introduced, including social distancing, travel restrictions and quarantine. The Belgian government announced a national emergency plan, thereby postponing all non-urgent medical consultations and operations. This report analyses the impact of these measures on cancer screening, through assessment of the workload of a laboratory for histopathology and cytopathology. Methods Data on monthly numbers of histological and cytological samples, immunohistochemistry and molecular tests were extracted from the laboratory information management system. Results The global histopathological and cytological workload was substantially reduced. The impact on oncology-related surgical procedures was rather limited. The anti-COVID-19 measures significantly diminished all screening-related samples, such as colon biopsies, breast biopsies and cervical cytology, and strongly reduced the number of samples related to “functional” pathology, such as thyroidectomies and gastric biopsies. Conclusions Since many health care interventions are reflected in the workload of a pathology laboratory, this study enabled us to identify areas for “deconfinement” health care actions. Our findings indicate that various areas in medicine were affected, but the impact seemed largest for cancer screening. Health care professionals should assure that consultations related to cancer screening are postponed instead of cancelled.

Global impact of the COVID‐19 pandemic on cytopathology practice: Results from an international survey of laboratories in 23 countries

“…To our knowledge to date, the effect of COVID-19 on cytological practice has been documented by only a few reports reflecting single-institution experience. 7,8 The results of the current study demonstrated that the COVID-19 pandemic impacted cytology practices around the world by dramatically reducing the cytological specimen volume across specimen types by 45.3%. There are a number of explanations.…”

“…Currently, the only available data have been reported by single institutions, and demonstrate a decrease in cytological workload. 7,8 It is interesting to note that, despite the reduced activity, the rate of malignant diagnoses significantly increased. 8 However, single-institution reports are not robust enough to draw reliable conclusions on a global scale or for assessment of the effect of the prioritization of cytological samples from patients considered to be at high risk of malignancy.…”

Dramatic Changes in Oncology Care Pathways During the COVID-19 Pandemic: The French ONCOCARE-COV Study

“…To the best of our knowledge, this is the first study assessing the overall management of cancers from screening to treatment. Screening and number of screening-related samples drop was observed in Belgium 3 . Reduction in cancer diagnoses has been noted in other European countries, particularly for colon and skin cancers 4,5 .…”

The Two Sides of Cytopathology during the COVID-19 Health Emergency: Screening versus Diagnosis

“…Undoubtedly, the aggressive containment measures implemented at the beginning of the outbreak by nearly all European governments were meant to prevent the fast spread of the virus and to flatten the curve of infection, which indeed they did. On the other hand, they led to a drastic reduction, if not interruption, in the volume of health care procedures, in particular cancer screening programs, as de Pelsemaeker et al [ 4 ] consistently detail in this journal. These authors adopted the global histopathological and cytological workload as the main health care system activity indicator.…”

“…The role of cytopathology is however de-emphasized by de Pelsemaeker et al [ 4 ]. A possible explanation is that their cytological workload analyzes only cervical smears, which are reduced up to 80%, and pulmonary biopsies by endobronchial ultrasound, which are reduced up to 82%.…”