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. 2022 Jan-Dec:29:10732748221131000.
doi: 10.1177/10732748221131000.

Impact of the COVID-19 Pandemic on a Cancer Fast-Track Programme

M T Martínez  1 , S Moragon  1 , B Ortega-Morillo  1 , J Montón-Bueno  1 , S Simon  1 , S Roselló  1   2   3 , A Insa  1 , A Viala  1 , J Navarro  4   5 , A Sanmartín  4 , C Fluixá  6 , A Julve  7 , D Soriano  7 , E Buch  8 , A Peña  9 , J Franco  10 , J Martínez-Jabaloyas  11 , J Marco  12 , M J Forner  13 , A Cano  14 , A Silvestre  15 , A Teruel  16 , B Bermejo  1   2   3 , A Cervantes  1   2   3 , I Chirivella Gonzalez  1
Affiliations

Impact of the COVID-19 Pandemic on a Cancer Fast-Track Programme

M T Martínez et al. Cancer Control. 2022 Jan-Dec.

Abstract

Introduction: The COVID-19 pandemic has disrupted many aspects of clinical practice in oncology, particularly regarding early cancer diagnosis, sparking public health concerns that possible delays could increase the proportion of patients diagnosed at advanced stages. In 2009, a cancer fast-track program (CFP) was implemented at the Clinico-Malvarrosa Health Department in Valencia, Spain with the aim of shortening waiting times between suspected cancer symptoms, diagnosis and therapy initiation.

Objectives: The study aimed to explore the effects of the COVID-19 pandemic on our cancer diagnosis fast-track program.

Methods: The program workflow (patients included and time periods) was analysed from the beginning of the state of alarm on March 16th, 2020 until March 15th, 2021. Data was compared with data from the same period of time from the year before (2019).

Results: During the pandemic year, 975 suspected cancer cases were submitted to the CFP. The number of submissions only decreased during times of highest COVID-19 incidence and stricter lockdown, and overall, referrals were slightly higher than in the previous 2 years. Cancer diagnosis was confirmed in 197 (24.1%) cases, among which 33% were urological, 23% breast, 16% gastrointestinal and 9% lung cancer. The median time from referral to specialist appointment was 13 days and diagnosis was reached at a median of 18 days. In confirmed cancer cases, treatment was started at around 30 days from time of diagnosis. In total, 61% of cancer disease was detected at early stage, 20% at locally advanced stage, and 19% at advanced stage, displaying time frames and case proportions similar to pre-pandemic years.

Conclusions: Our program has been able to maintain normal flow and efficacy despite the challenges of the current pandemic, and has proven a reliable tool to help primary care physicians referring suspected cancer patients.

Keywords: COVID-19 pandemic; cancer; cancer fast track program; early diagnostic; primary care.

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Conflict of interest statement

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

Figures

Figure 1.
Figure 1.
Consort diagram showing all referrals to different specialist units during year 1 and 2. Year 1: From March 16th, 2019 to March 15th, 2020. Year 2: From March 16th, 2020 to March 15th, 2021.
Figure 2.
Figure 2.
Diagnoses by speciality among all studied patients during years 1 and 2. Year 1: From March 16th, 2019 to March 15th, 2020. Year 2: From March 16th, 2020 to March 15th, 2021. The others group includes haematology, dermatology, traumatology and other diagnoses from the above pathologies. CIS: carcinoma in situ; H&N SCC: head and neck squamous cell carcinoma.
Figure 3.
Figure 3.
Referrals by month between year 1 and 2; COVID-19 admissions in our institution between every month during year 2. *: Indicates significant differences between years 1 and 2. Year 1: From March 16th, 2019 to March 15th, 2020. Year 2: From March 16th, 2020 to March 15th, 2021.
Figure 4.
Figure 4.
Referrals by age range across year 1 and 2. There are no statistically significant changes between groups of age. Year 1: From March 16th, 2019 to March 15th, 2020. Year 2: From March 16th, 2020 to March 15th, 2021.
See this image and copyright information in PMC

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