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. 2022 Mar:31:100316.
doi: 10.1016/j.jcpo.2021.100316. Epub 2021 Dec 8.

Association between COVID-19 burden and delays to diagnosis and treatment of cancer patients in England

Louis Fox  1 , Maria J Monroy-Iglesias  2 , Ajay Aggarwal  3 , Kate Haire  4 , Arnie Purushotham  5 , James Spicer  3 , Sophie Papa  3 , Anne Rigg  5 , Saoirse Dolly  5 , Richard Sullivan  6 , Mieke Van Hemelrijck  1
Affiliations

Association between COVID-19 burden and delays to diagnosis and treatment of cancer patients in England

Louis Fox et al. J Cancer Policy. 2022 Mar.

Abstract

Background: The COVID-19 pandemic has been highly disruptive for cancer care. Here, we examined the effect COVID-19 had on performance of the 62-day Cancer Waiting Time (CWT) target set by the National Health Service (NHS) in England.

Methods: Data were retrospectively obtained on COVID-19 hospitalisations and CWT for NHS hospitals in England (n = 121). We produced a 'COVID-19 burden' to describe the proportion of each provider's beds occupied with COVID-19 patients. COVID-19 burden was examined against CWT performance for 1st April - 30th May 2020 (Wave 1), and 1st October - 30th November 2020 (Wave 2). Two-tailed Spearman correlations were used to identify relationships between COVID-19 burden and CWT performance amongst different referral (i.e., 2-week-wait (2 W W) and internal specialist) and tumour types. Significantly correlated variables were further examined using linear regression models.

Results: COVID-19 burden was negatively associated with the percentage of 2 W W pathway referrals that met the CWT target in Wave 1 (r= -0.30, p = 0.001) and Wave 2 (r= -0.21, p = 0.02). These associations were supported by the results from our linear regression models (B for wave 1: -0.71; 95 %CI: -1.03 to -0.40; B for wave 2: -0.38; 95 %CI: -0.68 to -0.07). No associations were found between COVID-19 burden and internal specialist referrals or tumour type.

Conclusion: Increased COVID-19 burden was associated with lower compliance with CWT targets amongst urgent referrals from primary care in England. This will likely be an ongoing issue due to the backlog of patients awaiting investigations and treatment.

Policy summary: As the number of cancer referrals improve, we highlight the need for changes to primary and secondary care to manage the backlog within cancer diagnostic services to alleviate the impact of COVID-19.

Keywords: COVID-19; Cancer care; Cancer waiting time; NHS.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Flowchart explaining the NHS two week wait (2 W W) pathway, the 31-day target, and the 62-day Cancer Waiting Time (CWT). GP, general practitioner; MDT, multidisciplinary team.
See this image and copyright information in PMC

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References

    1. Raymond E., Thieblemont C., Alran S., Faivre S. Impact of the COVID-19 outbreak on the management of patients with cancer. Target. Oncol. 2020;15(3):249–259. - PMC - PubMed
    1. Monroy-Iglesias M.J., Tagliabue M., Dickinson H., Roberts G., De Berardinis R., Russell B., et al. Continuity of Cancer care: the surgical experience of two large cancer hubs in London and Milan. Cancers (Basel) 2021;13(7) - PMC - PubMed
    1. Government U. 2021. Staying at Home and Away From Others (Social Distancing)https://www.gov.uk/government/publications/full-guidance-on-staying-at-h... [Available from:
    1. Maringe C., Spicer J., Morris M., Purushotham A., Nolte E., Sullivan R., et al. The impact of the COVID-19 pandemic on cancer deaths due to delays in diagnosis in England, UK: a national, population-based, modelling study. Lancet Oncol. 2020;21(8):1023–1034. - PMC - PubMed
    1. Sud A., Torr B., Jones M.E., Broggio J., Scott S., Loveday C., et al. Effect of delays in the 2-week-wait cancer referral pathway during the COVID-19 pandemic on cancer survival in the UK: a modelling study. Lancet Oncol. 2020;21(8):1035–1044. - PMC - PubMed