Cancer Care Trend during two years of COVID-19 Pandemic at a Tertiary Care Super-Specialty Hospital: An Observational Study

Abstract

Summary and Background

COVID-19 pandemic affected all facets of life,^1,2 including non-COVID health care delivery.^3,4 While many elective healthcare aspects got deferred,⁵ studies revealed that even emergent^6,7 and essential health care delivery including cancer care was affected in most parts of the world, irrespective of the developmental status of countries.⁸ While cancer continues to be on the rise throughout the world, efforts have led to many gains in cancer management in terms of screening, early diagnosis, different modalities, or multi- modalities with improved outcomes.⁹ However, COVID-19 has adversely affected cancer care-seeking, utilization, and delivery in almost all parts of the globe.³ While many studies have objectively demonstrated the decline in cancer care around the start¹⁰ or first year of pandemic,¹¹ we wanted to follow the trend over approximately two years of the start of COVID-19 Pandemic. Whether there has been a significant decline in cancer care in our hospital and if so, has there been any trend of a return to normal or an overshoot of the pre-pandemic numbers. The primary objective of our study was to understand the trend in cancer care at our hospital during the twenty-two months of the ongoing COVID-19 pandemic. We aim to provide feedback for policy matters on maintaining the continuity of cancer care in case more waves of COVID-19 occur or any other pandemic strikes in the future.

Methodology consisted of a review of the records maintained in the Medical Records Department, for the years 2019 (comparison year), 2020, and 2021. Missing information was obtained from main cancer management specialty departments like medical oncology, radiation oncology, and surgical oncology. Data was collected for registrations. outpatient visits, admissions, day-care sessions, radiation therapy including pain and palliation, and surgeries. Data were analyzed on excel using descriptive statistics like counts, percentages, and arithmetic means.  

Results revealed a drop in the number of patients availing services of registration, outpatient visits, admissions, day-care sessions, and surgeries, The highest decline being during the strict lockdown periods and pandemic waves. However, there was a trend of returning to normal pre-pandemic figures in most of the remaining months. For all but radiation oncology services.

Conclusion: After the initial decline in the first year of the COVID-19 pandemic in the first year, there has been a catch-up of cancer care-seeking and delivery in the year 2021 of the COVID-19 pandemic era. 

Limitation: The study did not find the impact of delays in diagnosis and treatment on individual patients and subsequent consequences on their short-term or long-term survival. The study is unicentric.

Keywords: Cancer care, COVID-19, Impact, Day-care, trend a, radiation therapy, admissions, outpatient visits