The long-term consequences of the impact of the pandemic on cancer care are already becoming evident: the backlogs of cancer surgeries continue, and new patients are being diagnosed with more advanced cancers. Now researchers can begin to quantify these consequences. Two new papers have been published that use cancer data from Ontario to estimate how many cancer cases went undiagnosed, and what the consequences could be of delayed cancer surgeries.
Although these analyses are both limited in scope to the first six months of the pandemic, they are important. The impact of the pandemic on cancer care has already been well documented on the scale of individual cancer patients, caregivers, and survivors. Now this impact is also being quantified on a larger scale.
Estimate of delayed diagnoses
Researchers analyzed the data from the Ontario Cancer Registry to determine the change in how many cancers were diagnosed in the first six months of the pandemic. They found a dramatic decline: new cancer diagnoses dropped by 34 per cent in March 2020, and gradually increased from there by about one per cent each week.
This drop in diagnoses corresponds to a large number of people who will be diagnosed with cancer later than they should have been, at a point when their disease is more advanced. The exact impact of these undiagnosed cancer cases is unknown, precisely because they are undiagnosed. However, there is no question that a cancer diagnosed late is worse for the patient and a greater burden on the healthcare system.
Simulation estimates impact of delayed surgeries
In a paper published in the Canadian Medical Association Journal, researchers used data from Ontario from 2019 and 2020 to simulate the effect of an increase in wait times for cancer surgery over six months. The simulation predicted that, if surgery resources for cancer were reduced to 60 per cent of their pre-pandemic state for the first two months of the pandemic and 75 per cent for the next four months, this would result in 1306 years of life lost among cancer patients in Ontario over the following ten years.
This is a conservative estimate of the impact of delays in cancer surgery – both because of intrinsic limitations of the simulation, and because the estimate does not take into account the potential number of additional undiagnosed cancer cases during the pandemic.
Cancer can’t be postponed
These studies reinforce the importance of prioritizing cancer care in public health decision-making during a pandemic. They show how critical it is that screening programs continue even during a public health crisis, and that people should never hesitate to get screened. They show that cancer surgeries, though ‘elective’, cannot be delayed for arbitrary lengths of time. In short, they remind us that cancer can’t wait!