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

Abstract

The pandemic spread of the COVID-19 virus significantly affected daily life, but the highest pressure was piled on the health care system. Our aim was to evaluate an impact of COVID-19 pandemic management measures on cancer services at the National Cancer Institute (NCI) of Lithuania. We assessed the time period from 1 February 2020 to 31 December 2020 and compared it to the same period of 2019. Data for our analysis were extracted from the NCI Hospital Information System (HIS) and the National Health Insurance Fund (NHIF). Contingency table analysis and ANOVA were performed. The COVID-19 pandemic negatively affected the cancer services provided by NCI. Reductions in diagnostic radiology (−16%) and endoscopy (−29%) procedures were accompanied by a decreased number of patients with ongoing medical (−30%), radiation (−6%) or surgical (−10%) treatment. The changes in the number of newly diagnosed cancer patients were dependent on tumor type and disease stage, showing a rise in advanced disease at diagnosis already during the early period of the first lockdown. The extent of out-patient consultations (−14%) and disease follow-up visits (−16%) was also affected by the pandemic, and only referrals to psychological/psychiatric counselling were increased. Additionally, the COVID-19 pandemic had an impact on the structure of cancer services by fostering the application of modified systemic anticancer therapy or hypofractionated radiotherapy. The most dramatic drop occurred in the number of patients participating in cancer prevention programs; the loss was 25% for colon cancer and 62% for breast cancer screening. Marked restriction in access to preventive cancer screening and overall reduction of the whole spectrum of cancer services may negatively affect cancer survival measures in the nearest future.

A systematic review of the impact of the COVID-19 pandemic on breast cancer screening and diagnosis

“…An initial 2451 citations were identified for title and abstract screening, of which 77 were eligible for inclusion ( Fig. 1 ) [ [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , [71] , [72] , [73] , [74] , [75] ,…”

“…For 3 studies with multiple publications reporting different or complementary outcomes, we selected the most recently published for inclusion [ 34 , 57 , 59 ], and extracted relevant data (where available) from the other superseded publications [ [85] , [86] , [87] ] but did not include them as separate papers. Therefore, a total of 74 studies were included in this review [ [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , ...…”

Effects of worries about hospital treatments or follow-up appointments during COVID-19 pandemic on supportive care needs in cancer patients

“…In the years since the outbreak of COVID-19, there has been an increase in cancer patients avoiding hospital treatments, which has led to a corresponding increase in mortality rates [21]. Providing health information to cancer patients helps patients to make informed decisions and mentally prepare for cancer treatment.…”

Impact of COVID-19 on cancer screening: a global perspective

“…In studies conducted in Canada, the United States, Brazil, France, Qatar, Taiwan, and Belgium, COVID-19 had a dramatic impact on mammography and/or MRI of the breast (−10 to −100%) [ 11 , 14 , 15 , 16 ▪ , 19 ▪ , 21 ▪ , 22 ▪ , 25 , 28 , 30 ▪▪ , 34 – 37 , 40 , 43 , 44 , 46 ]. A significant drop in cancer screening computed tomography imaging in the United States (−49 to −81.7%) [ 32 , 37 ] and diagnostic radiology rates (−16%) was observed in Switzerland [ 17 ]. Reductions in cancer screening were reported for cervical cancer (−7.5 to −90%) in Canada, the United States, Brazil, France, Taiwan, Belgium, and 17 selected low- and middle-income countries (LMICs) [ 19 ▪ , 21 ▪ – 23 ▪ , 30 ▪▪ , 33 , 35 ▪ , 36 , 38 – 40 , 43 , 46 ].…”

“…Reductions in cancer screening were reported for cervical cancer (−7.5 to −90%) in Canada, the United States, Brazil, France, Taiwan, Belgium, and 17 selected low- and middle-income countries (LMICs) [ 19 ▪ , 21 ▪ – 23 ▪ , 30 ▪▪ , 33 , 35 ▪ , 36 , 38 – 40 , 43 , 46 ]. A significant drop in digestive endoscopies (−19 to −29%) was reported in Lithuania and France [ 17 , 39 ]. Reductions in colon cancer screening (−8.1 to −95%) were registered in Canada, the United States, France, Belgium, Qatar, and 17 selected LMICs [ 14 , 15 , 16 ▪ , 23 ▪ , 25 , 30 ▪▪ , 33 , 35 ▪ , 36 – 39 , 43 , 44 ].…”