The COVID-19 pandemic is one of the most devastating events in recent history. It killed more than 5 million people worldwide and upended the lives of hundreds of millions more. It has been nearly two years since the pandemic started in 2019, but there are still way too many people who have to deal with its effects every day.
The COVID-19 disease also had a significant impact on cancer rates and survivors.
In the first half of 2020, in order to slow down the spread of the novel coronavirus, health institutions severely delayed or outright canceled certain types of cancer screenings and treatments. These restrictions lasted for weeks or even months in some cases, which resulted in the year 2020 seeing considerably fewer new cancer cases than 2019 had during the same time period.
This blog post will explore the full effect of COVID-19 on cancer incidence and survivorship in the past two years.
COVID-19 And Cancer Incidence
Since the start of 2020, numerous studies have documented a lower number of new cancer cases in different corners of the world.
From March 1 to April 18, 2020, in the United States, there was a 46% decline in the diagnosis of the six most common cancers (colorectal, breast, lung, pancreas, esophagus, and stomach) compared to the previous year.
Similar findings were reported in other countries: the United Kingdom, the Netherlands, Poland, Brazil, Chile, Australia, and more.
The main reasons for this decline in the number of new cancer diagnoses include:
- COVID-19 restrictions imposed by governments and health ministries, such as canceling or delaying cancer screenings and referrals for suspected cancer. In response to the pandemic, the official recommendation of the American Society of Clinical Oncology was “that cancer screening procedures that require clinic/center visits, such as screening mammograms and colonoscopy, be postponed for the time being.”
- Shifting of attention to the COVID-19 pandemic. Reallocating human resources, equipment, and medical supplies to fight the pandemic has meant that health institutions can’t focus their efforts on diagnosing and treating cancer.
- Many cancer patients (and potential cancer patients) are also people with compromised immune systems who are at high risk for contracting the novel coronavirus. This contributed to the rising feelings of fear and anxiety among people with cancer symptoms, which in turn led them to avoid visiting doctors and clinics.
Interestingly enough, these severe adverse effects of COVID-19 on cancer diagnoses were not observed in the case of pediatric cancer patients in Germany. Exactly why the number of children diagnosed with cancer remained the same or even slightly higher during the start of the pandemic in this part of the world is still unclear.
COVID-19 And Cancer Survivorship
Survivorship is defined as the period from the moment of cancer diagnosis to the end of the cancer patient’s life. It is an important indicator of how effective and successful treatment was in prolonging life expectancy, but it’s also one that has been deeply affected by COVID-19 pandemic restrictions on cancer screening and cancer care.
Consequences of Delayed Diagnoses
Discovering cancer as early as possible is extremely important for prognosis and treatment. In some types of cancers, early diagnosis is a matter of life and death.
Because the COVID-19 pandemic has caused delays in cancer diagnosis for countless individuals, it could lead to an increased number of cancer deaths that could have been prevented.
Delayed cancer diagnosis causes the following consequences:
- Increased risk of metastasis or cancer spreading to other parts of the body.
- Higher chances of dying from cancer or complications resulting from treatment (e.g., infection). Delay in diagnosis also means that patients may receive less effective treatments with more severe side effects when they do finally get around to cancer treatment.
- Increased risk of cancer recurrence and secondary cancers (e.g., liver, brain).
Overall, cancer that is not detected on time (regardless of the cancer type) has a poorer prognosis than cancer that has been diagnosed early.
Delayed Treatment
At the height of the pandemic, it wasn’t only cancer screenings and tests that were delayed. Cancer treatment was typically postponed (surgeries, chemotherapy, radiation therapy, and other treatment types), usually for the period when COVID-19 pandemic restrictions were in place.
Cancer patients who were diagnosed during the peak of the pandemic often had to wait weeks or even months before their treatments could start. Those who were already in the middle of active treatment programs were forced to stop.
This, too, had a negative impact on the prognosis and survival rates of these patients.
Survivorship Care
Unfortunately, the COVID pandemic had an impact on cancer survivorship care as well. It has caused many health institutions to shift their attention away from cancer survivors who were finished with active treatment since they were not critical patients in many ways.
However, that does not mean that cancer survivors who have finished their first round of treatment – even if they did so successfully – can be forgotten. They still need survivorship care, the same as active cancer patients and those who are only in the early stages of diagnosis and treatment.
Cancer survivors require support with social and psychological issues, such as returning to work, coping with the cancer diagnosis when they are alone or back in their social environment (e.g., at school), and potentially understanding what it means for them that cancer is no longer just a disease but also a part of who they are now.
Cancer survivors often need medical follow-ups, too, to ensure that they are healthy and cancer-free. Some may also face debilitating and long-lasting adverse effects resulting from cancer treatment (e.g., infertility).
Although intensive follow-up programs for survivors were limited during COVID-19 pandemic restrictions on health services, their importance cannot be ignored or taken for granted.
Telehealth
Because of the pandemic’s unique challenges for healthcare providers and patients alike, the rise of innovative technologies and solutions was inevitable.
One such solution is telehealth – using phone or video calls for medical follow-ups. Most health institutions have been using telehealth tools throughout the COVID pandemic to continue providing a certain level of care and monitoring for patients, even when they were not allowed in-person visits.
It is an imperfect system since it does not have the same level of hands-on care as face-to-face medical appointments, but it has allowed cancer survivors to receive at least some of the care they need when in-person visits are restricted or not possible.
Telehealth, in general, represents a novel approach to healthcare that could be a beneficial solution for many different types of patients and medical issues in the future.
Conclusion
The COVID-19 pandemic has taken millions of lives and is still not over yet. Its impact on healthcare systems worldwide has been profound. It was not easy for hospitals and clinics to function properly, especially when it came to cancer patients.
In the first semester of 2020, the number of new cancer cases was lower than during the same period in 2019. Many cancer screenings, tests, and treatments were postponed and delayed due to pandemic restrictions, which impacted the prognosis and survival rate of patients.
Survivorship care has suffered too: health institutions had to shift their attention away from cancer survivors who finished treatment and towards more critical cases.
However, the pandemic has also prompted some interesting changes in healthcare systems that could improve medical care for future generations. Even though they are far from ideal, telehealth options have helped provide cancer survivors with some of the care they have needed during this difficult time.
Our fight against COVID-19 and cancer is not over yet. Do your part in saving lives and donate now to support more research and improved healthcare systems.