Multicenter Study
. 2021 Jul;22(7):970-976. doi: 10.1016/S1470-2045(21)00240-0. Epub 2021 May 27. Impact of COVID-19 on cancer care in India: a cohort study Manju Sengar 1 , Girish Chinnaswamy 1 , Gaurav Agrawal 2 , Rajkumar Arumugham 3 , Rajiv Bhatt 4 , Ramesh Bilimagga 5 , Jayanta Chakrabarti 6 , Arun Chandrasekharan 7 , Harit Kumar Chaturvedi 8 , Rajiv Choudhrie 9 , Mitali Dandekar 10 , Ashok Das 11 , Vineeta Goel 12 , Caleb Harris 13 , Sujai Kolnadguthu Hegde 14 , Narendra Hulikal 15 , Deepa Joseph 16 , Rajesh Kantharia 17 , Azizullah Khan 18 , Rohan Kharde 19 , Navin Khattry 1 , Maqbool M Lone 20 , Umesh Mahantshetty 21 , Hemant Malhotra 22 , Hari Menon 23 , Deepti Mishra 24 , Rekha A Nair 25 , Shashank J Pandya 26 , Nidhi Patni 27 , Jeremy Pautu 28 , Simon Pavamani 29 , Satyajit Pradhan 30 , Subramanyeshwar Rao Thammineedi 31 , G Selvaluxmy 32 , Krishna Sharan 33 , B K Sharma 34 , Jayesh Sharma 35 , Suresh Singh 36 , Gowtham Chandra Srungavarapu 37 , R Subramaniam 38 , Rajendra Toprani 39 , Ramanan Venkat Raman 40 , Rajendra Achyut Badwe 1 , C S Pramesh 41 ; National Cancer Grid of IndiaAffiliations
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Multicenter Study
Impact of COVID-19 on cancer care in India: a cohort studyPriya Ranganathan et al. Lancet Oncol. 2021 Jul.
. 2021 Jul;22(7):970-976. doi: 10.1016/S1470-2045(21)00240-0. Epub 2021 May 27. Authors Priya Ranganathan 1 , Manju Sengar 1 , Girish Chinnaswamy 1 , Gaurav Agrawal 2 , Rajkumar Arumugham 3 , Rajiv Bhatt 4 , Ramesh Bilimagga 5 , Jayanta Chakrabarti 6 , Arun Chandrasekharan 7 , Harit Kumar Chaturvedi 8 , Rajiv Choudhrie 9 , Mitali Dandekar 10 , Ashok Das 11 , Vineeta Goel 12 , Caleb Harris 13 , Sujai Kolnadguthu Hegde 14 , Narendra Hulikal 15 , Deepa Joseph 16 , Rajesh Kantharia 17 , Azizullah Khan 18 , Rohan Kharde 19 , Navin Khattry 1 , Maqbool M Lone 20 , Umesh Mahantshetty 21 , Hemant Malhotra 22 , Hari Menon 23 , Deepti Mishra 24 , Rekha A Nair 25 , Shashank J Pandya 26 , Nidhi Patni 27 , Jeremy Pautu 28 , Simon Pavamani 29 , Satyajit Pradhan 30 , Subramanyeshwar Rao Thammineedi 31 , G Selvaluxmy 32 , Krishna Sharan 33 , B K Sharma 34 , Jayesh Sharma 35 , Suresh Singh 36 , Gowtham Chandra Srungavarapu 37 , R Subramaniam 38 , Rajendra Toprani 39 , Ramanan Venkat Raman 40 , Rajendra Achyut Badwe 1 , C S Pramesh 41 ; National Cancer Grid of India AffiliationsItem in Clipboard
AbstractBackground: The COVID-19 pandemic has disrupted health-care systems, leading to concerns about its subsequent impact on non-COVID disease conditions. The diagnosis and management of cancer is time sensitive and is likely to be substantially affected by these disruptions. We aimed to assess the impact of the COVID-19 pandemic on cancer care in India.
Methods: We did an ambidirectional cohort study at 41 cancer centres across India that were members of the National Cancer Grid of India to compare provision of oncology services between March 1 and May 31, 2020, with the same time period in 2019. We collected data on new patient registrations, number of patients visiting outpatient clinics, hospital admissions, day care admissions for chemotherapy, minor and major surgeries, patients accessing radiotherapy, diagnostic tests done (pathology reports, CT scans, MRI scans), and palliative care referrals. We also obtained estimates from participating centres on cancer screening, research, and educational activities (teaching of postgraduate students and trainees). We calculated proportional reductions in the provision of oncology services in 2020, compared with 2019.
Findings: Between March 1 and May 31, 2020, the number of new patients registered decreased from 112 270 to 51 760 (54% reduction), patients who had follow-up visits decreased from 634 745 to 340 984 (46% reduction), hospital admissions decreased from 88 801 to 56 885 (36% reduction), outpatient chemotherapy decreased from 173634 to 109 107 (37% reduction), the number of major surgeries decreased from 17 120 to 8677 (49% reduction), minor surgeries from 18 004 to 8630 (52% reduction), patients accessing radiotherapy from 51 142 to 39 365 (23% reduction), pathological diagnostic tests from 398 373 to 246 616 (38% reduction), number of radiological diagnostic tests from 93 449 to 53 560 (43% reduction), and palliative care referrals from 19 474 to 13 890 (29% reduction). These reductions were even more marked between April and May, 2020. Cancer screening was stopped completely or was functioning at less than 25% of usual capacity at more than 70% of centres during these months. Reductions in the provision of oncology services were higher for centres in tier 1 cities (larger cities) than tier 2 and 3 cities (smaller cities).
Interpretation: The COVID-19 pandemic has had considerable impact on the delivery of oncology services in India. The long-term impact of cessation of cancer screening and delayed hospital visits on cancer stage migration and outcomes are likely to be substantial.
Funding: None.
Translation: For the Hindi translation of the abstract see Supplementary Materials section.
Copyright © 2021 Elsevier Ltd. All rights reserved.
Conflict of interest statementDeclaration of interests AC reports personal fees from AstraZeneca, Novartis, Merck, Eli Lilly, Pfizer, Dr Reddy's, and Intas, outside the submitted work. All other authors declare no competing interests.
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