Cancer has not gone away: A primary care perspective to support a balanced approach for timely cancer diagnosis during COVID-19

Abstract

The COVID-19 pandemic has had a profound and direct impact on the health and lives of the global population and has placed a huge burden on healthcare systems (Mayor, 2020; CDC, 2020a,b; WHO, 2020a). As the pandemic spread, many countries took drastic actions aiming to curtail the spread of the disease and to avoid overwhelming local, regional and national health care services.  Much of routine health care diverted to COVID-19; non-COVID primary care and specialty care services were downscaled or completely halted. (Jones et al., 2020; The Lancet Oncology, 2020a; WHO, 2020a). Fear of contracting COVID-19 also led to patient reluctance towards attending in-person visits (CRUK, 2020; Jones et al., 2020). Consequently, timely cancer diagnosis may have been affected, with early reports suggesting that the decreased number of general practitioner (GP) consultations, combined with the minimalised capacity for non-COVID care, may have had a serious impact on the diagnostic pathway (CRUK, 2020; Richards et al., 2020; Dinmohamed et al., 2020; EHRN, 2020; WHO, 2020a). For example, in the Netherlands, the number of new weekly diagnoses of all cancers (except skin) dropped to 73% of normal and to 39% of normal for skin cancers (Dinmohamed et al., 2020). In the United States, a data set that included 2.7 million patients from 39 health systems, showed that appointments for cervical, colon and breast cancer screening decreased by 86%–95% in March 2020 (EHRN, 2020). In Australia, despite relatively few COVID-19 cases, anecdotal accounts suggest while overall GP consultations have not fallen dramatically, the switch to telemedicine has been associated with reduced pathology and radiology requests, reduced referrals for suspected cancer, and early evidence of reduced cancer incidence (Cunningham, 2020). In countries with organised cancer screening programmes, services were suspended or reduced in capacity, and in some cases, staff and laboratory resources pivoted to support COVID-19 efforts (CRUK, 2020; Dinmohamed et al., 2020).

Rights

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Cite as

Downloadable citations

Identifiers

DOI

https://doi.org/10.1111/ecc.13290

Repository URI

https://www.research.ed.ac.uk/en/publications/cancer-has-not-gone-away-a-primary-care-perspective-to-support-a-