Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2020 Dec;5(6):e001090.
doi: 10.1136/esmoopen-2020-001090.

Impact of COVID-19 on cancer service delivery: results from an international survey of oncology clinicians

Grace Chazan  1 , Fanny Franchini  2 , Marliese Alexander  3 , Susana Banerjee  4 , Linda Mileshkin  5 , Prunella Blinman  6 , Rob Zielinski  7 , Deme Karikios  8 , Nick Pavlakis  9 , Solange Peters  10 , Florian Lordick  11 , David Ball  12 , Gavin Wright  13 , Maarten I Jzerman  2 , Benjamin Solomon  14
Affiliations
Multicenter Study

Impact of COVID-19 on cancer service delivery: results from an international survey of oncology clinicians

Grace Chazan et al. ESMO Open. 2020 Dec.

Abstract

Objectives: To report clinician-perceived changes to cancer service delivery in response to COVID-19.

Design: Multidisciplinary Australasian cancer clinician survey in collaboration with the European Society of Medical Oncology.

Setting: Between May and June 2020 clinicians from 70 countries were surveyed; majority from Europe (n=196; 39%) with 1846 COVID-19 cases per million people, Australia (AUS)/New Zealand (NZ) (n=188; 38%) with 267/236 per million and Asia (n=75; 15%) with 121 per million at time of survey distribution.

Participants: Medical oncologists (n=372; 74%), radiation oncologists (n=91; 18%) and surgical oncologists (n=38; 8%).

Results: Eighty-nine per cent of clinicians reported altering clinical practices; more commonly among those with versus without patients diagnosed with COVID-19 (n=142; 93% vs n=225; 86%, p=0.03) but regardless of community transmission levels (p=0.26). More European clinicians (n=111; 66.1%) had treated patients diagnosed with COVID-19 compared with Asia (n=20; 27.8%) and AUS/NZ (n=8; 4.8%), p<0.001. Many clinicians (n=307; 71.4%) reported concerns that reduced access to standard treatments during the pandemic would negatively impact patient survival. The reported proportion of consultations using telehealth increased by 7.7-fold, with 25.1% (n=108) of clinicians concerned that patient survival would be worse due to this increase. Clinicians reviewed a median of 10 fewer outpatients/week (including non-face to face) compared with prior to the pandemic, translating to 5010 fewer specialist oncology visits per week among the surveyed group. Mental health was negatively impacted for 52.6% (n=190) of clinicians.

Conclusion: Clinicians reported widespread changes to oncology services, in regions of both high and low COVID-19 case numbers. Clinician concerns of potential negative impacts on patient outcomes warrant objective assessment, with system and policy implications for healthcare delivery at large.

Keywords: COVID-19; oncology; service delivery.

PubMed Disclaimer

Conflict of interest statement

Competing interests: Some authors of this manuscript hold leadership positions on the ESMO board.

Figures

Figure 1
Figure 1
Outpatient consultants conducted via telehealth (broadly defined) before and during COVID-19.
Figure 2
Figure 2
Changes to patient management by medical oncologists due to COVID-19. Panel A demonstrates the ways in which medical oncologists report altering management in the curative setting and Panel B in the palliative setting.
Figure 3
Figure 3
Changes to patient management by radiation oncologists due to COVID-19. Panel A demonstrates the ways in which radiation oncologists report altering management in the curative setting and Panel B in the palliative setting.
Figure 4
Figure 4
Predicted impact of changes to patient management and oncology service delivery.
See this image and copyright information in PMC

References

    1. Miyashita H., Mikami T., Chopra N., et al. Do patients with cancer have a poorer prognosis of COVID-19? An experience in New York City. Ann Oncol. 2020;31:1088–1089. http://www.ncbi.nlm.nih.gov/pubmed/32330541 - DOI - PMC - PubMed
    1. Garassino M.C., Whisenant J.G., Huang L.-C., et al. COVID-19 in patients with thoracic malignancies (TERAVOLT): first results of an international, registry-based, cohort study. Lancet Oncol. 2020;21:914–922. http://www.ncbi.nlm.nih.gov/pubmed/32539942 - DOI - PMC - PubMed
    1. Robilotti E.V., Babady N.E., Mead P.A., et al. Determinants of COVID-19 disease severity in patients with cancer. Nat Med. 2020;26:1218–1223. http://www.ncbi.nlm.nih.gov/pubmed/32581323 - DOI - PMC - PubMed
    1. Saini K.S., Tagliamento M., Lambertini M., et al. Mortality in patients with cancer and coronavirus disease 2019: a systematic review and pooled analysis of 52 studies. Eur J Cancer. 2020;139:43–50. http://www.ncbi.nlm.nih.gov/pubmed/32971510 - DOI - PMC - PubMed
    1. de Azambuja E., Brandão M., Wildiers H., et al. Impact of solid cancer on in-hospital mortality overall and among different subgroups of patients with COVID-19: a nationwide, population-based analysis. ESMO Open. 2020;5 http://www.ncbi.nlm.nih.gov/pubmed/32978251 e000947. - DOI - PMC - PubMed

Publication types