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Delays and Disruptions in Cancer Health Care Due to COVID-19 Pandemic: Systematic ReviewRachel Riera et al. JCO Glob Oncol. 2021 Feb.
doi: 10.1200/GO.20.00639. AffiliationsItem in Clipboard
AbstractPurpose: There has been noteworthy concern about the impact of COVID-19 pandemic on health services including the management of cancer. In addition to being considered at higher risk for worse outcomes from COVID-19, people with cancer may also experience disruptions or delays in health services. This systematic review aimed to identify the delays and disruptions to cancer services globally.
Methods: This is a systematic review with a comprehensive search including specific and general databases. We considered any observational longitudinal and cross-sectional study design. The selection, data extraction, and methodological assessment were performed by two independent reviewers. The methodological quality of the studies was assessed by specific tools. The delays and disruptions identified were categorized, and their frequency was presented.
Results: Among the 62 studies identified, none exhibited high methodological quality. The most frequent determinants for disruptions were provider- or system-related, mainly because of the reduction in service availability. The studies identified 38 different categories of delays and disruptions with impact on treatment, diagnosis, or general health service. Delays or disruptions most investigated included reduction in routine activity of cancer services and number of cancer surgeries; delay in radiotherapy; and delay, reschedule, or cancellation of outpatient visits. Interruptions and disruptions largely affected facilities (up to 77.5%), supply chain (up to 79%), and personnel availability (up to 60%).
Conclusion: The remarkable frequency of delays and disruptions in health care mostly related to the reduction of the COVID-19 burden unintentionally posed a major risk on cancer care worldwide. Strategies can be proposed not only to mitigate the main delays and disruptions but also to standardize their measurement and reporting. As a high number of publications continuously are being published, it is critical to harmonize the upcoming reports and constantly update this review.
Conflict of interest statement Daniela Vianna PachitoEmployment: Hospital Sírio-Libanês
Consulting or Advisory Role: ResMed Brazil
Felipe RoitbergHonoraria: Boehringer Ingelheim, Sanofi, Roche, MSD Oncology, AstraZeneca, Nestle Health Science, Dr Reddy's, Oncologia Brazil
Consulting or Advisory Role: MSD Oncology
Research Funding: Roche, Boehringer Ingelheim, MSD, Bayer, AstraZeneca, Takeda
No other potential conflicts of interest were reported.
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Flowchart of the process of study identification and selection.
FIG 1Flowchart of the process of study identification and selection.
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Design of included studies.
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Design of included studies.
FIG 2Design of included studies.
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Countries considered by included studies.
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Countries considered by included studies.
FIG 3Countries considered by included studies.
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Types of cancer considered by…
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Types of cancer considered by included studies.
FIG 4Types of cancer considered by included studies.
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Declaration of funding source by…
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Declaration of funding source by included studies.
FIG 5Declaration of funding source by included studies.
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