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
. 2022 Jan-Dec:29:10732748221114615.
doi: 10.1177/10732748221114615.

Healthcare Professional and Patient Perceptions of Changes in Colorectal Cancer Care Delivery During the COVID-19 Pandemic and Impact on Health Inequalities

Athena Ip  1 , Georgia Black  2 , Cecilia Vindrola-Padros  3 , Claire Taylor  4 , Sophie Otter  5 , Madeleine Hewish  5 , Afsana Bhuiya  6 , Julie Callin  7 , Angela Wong  8 , Michael Machesney  8 , James Green  8 , Raymond Oliphant  9 , Naomi J Fulop  2 , Cath Taylor  1 , Katriina L Whitaker  1
Affiliations

Healthcare Professional and Patient Perceptions of Changes in Colorectal Cancer Care Delivery During the COVID-19 Pandemic and Impact on Health Inequalities

Athena Ip et al. Cancer Control. 2022 Jan-Dec.

Abstract

Background: The COVID-19 pandemic changed the way in which people were diagnosed and treated for cancer. We explored healthcare professional and patient perceptions of the main changes to colorectal cancer delivery during the COVID-19 pandemic and how they impacted on socioeconomic inequalities in care.

Methods: In 2020, using a qualitative approach, we interviewed patients (n = 15) who accessed primary care with colorectal cancer symptoms and were referred for further investigations. In 2021, we interviewed a wide range of healthcare professionals (n = 30) across the cancer care pathway and gathered national and local documents/guidelines regarding changes in colorectal cancer care.

Results: Changes with the potential to exacerbate inequalities in care, included: the move to remote consultations; changes in symptomatic triage, new COVID testing procedures/ways to access healthcare, changes in visitor policies and treatment (e.g., shorter course radiotherapy). Changes that improved patient access/convenience or the diagnostic process have the potential to reduce inequalities in care.

Discussion: Changes in healthcare delivery during the COVID-19 pandemic have the ongoing potential to exacerbate existing health inequalities due to changes in how patients are triaged, changes to diagnostic and disease management processes, reduced social support available to patients and potential over-reliance on digital first approaches. We provide several recommendations to help mitigate these harms, whilst harnessing the gains.

Keywords: Covid-19; colorectal cancer; healthcare professional; inequalities; pathway; qualitative research.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

    1. World Health Organisation . Non-Communicable Diseases and COVID-19. Geneva, Switzerland: World Health Organisation ; 2020. https://www.who.int/teams/noncommunicable-diseases/covid-19. Accessed January 17, 2022.
    1. Balogun OD, Bea VJ, Phillips E. Disparities in cancer outcomes due to COVID-19—A tale of 2 cities. JAMA Oncol. 2020;6(10):1531-1532. - PubMed
    1. Harber I, Zeidan D, Aslam MN. Colorectal cancer screening: Impact of COVID-19 pandemic and possible consequences. Life (Basel). 2021;11(12):1297. - PMC - PubMed
    1. Gandhi TK, Singh H. Reducing the risk of diagnostic error in the COVID-19 era. J Hosp Med. 2020;15(6):363-366. - PMC - PubMed
    1. NHS England . East of England Guideline for the Referral and Prioritisation of Patients with Gastrointestinal Symptoms during COVID Recovery; 2021. https://www.canceralliance.co.uk/professionals/covid-19-national-guideli.... Acessed January 17, 2022.