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

• Published in: ESMO open Vol. 5; no. 6; p. e001090
• Main Authors: Chazan, Grace, Franchini, Fanny, Alexander, Marliese, Banerjee, Susana, Mileshkin, Linda, Blinman, Prunella, Zielinski, Rob, Karikios, Deme, Pavlakis, Nick, Peters, Solange, Lordick, Florian, Ball, David, Wright, Gavin, I. Jzerman, Maarten, Solomon, Benjamin
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.12.2020; THE AUTHORS. Published by Elsevier Limited on behalf of European Society for Medical Oncology; Originally published by BMJ; Elsevier
• Subjects: Adult; Asia - epidemiology; Australia - epidemiology; COVID-19; COVID-19 - epidemiology; COVID-19 - virology; Europe - epidemiology; Female; Humans; Male; Medical Oncology - methods; Medical Oncology - statistics & numerical data; Neoplasms - epidemiology; Neoplasms - therapy; Oncologists - statistics & numerical data; oncology; Original Research; Pandemics; SARS-CoV-2 - isolation & purification; service delivery; Surveys and Questionnaires; Australia; Asia; Europe; COVID-19; service delivery; oncology
• ISSN: 2059-7029; 2059-7029
• DOI: 10.1136/esmoopen-2020-001090

To report clinician-perceived changes to cancer service delivery in response to COVID-19. Multidisciplinary Australasian cancer clinician survey in collaboration with the European Society of Medical Oncology. 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. Medical oncologists (n=372; 74%), radiation oncologists (n=91; 18%) and surgical oncologists (n=38; 8%). 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. 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.