Cancer still waiting…

If you think that COVID-19 disruption of cancer care is nearly over, think again!

CCSN’s recent Leger survey of 1,243 Canadians revealed that the response to the COVID-19 pandemic has led to a crisis in essential cancer care across the country. Cancer patients, their caregivers and those awaiting confirmation of a cancer diagnosis faced and still face postponed and cancelled appointments, tests and treatment, causing heightened fears and anxiety even as pandemic restrictions are lifted.

Safe and timely access to cancer care, including diagnostics, screening, testing and treatment must remain a top priority during any public health crisis. Unfortunately, this has not happened, and the results are starting to show.

Nova Scotia’s Health Authority has stated that they have a backlog of 700 colon cancer cases[i] and that they have temporarily suspended mailing out home screening kits. However, the Health Authority stopped mailing out colon cancer home screening kits in March due to the pandemic, and even now it is only conducting about 50% capacity for colonoscopies. How is temporarily suspending the home screening kits going to help ensure that colon cancer is diagnosed early in Nova Scotians? Clearly, it’s not. When the kits finally reach people, some of them are going to be diagnosed at a later rather than early stage of cancer, which defeats the purpose of the kits. With “colorectal cancer being the third most commonly diagnosed cancer in 2020…the second leading cause of death from cancer in men and the third leading cause of death from cancer in women,”[ii] Nova Scotia should do better.

And in British Columbia, a CBC article published on July 21, 2020 states that “more than 32,400 people either had their surgeries postponed or not scheduled at all after non-essential procedures were cancelled on March 16, in order to free up hospital beds in case there was a rush of COVID-19 patients…Those patients left waiting either joined or remained on a pre-existing wait-list, bringing the total number of people waiting for surgery in B.C. to 93,000.”[iii]

B.C. Health Minister Adrian Dix did not say how many of these 93,000 people waiting for surgery were cancer patients, but clearly that not all cancer surgeries are deemed urgent. Minister Dix did say that “fifty-two per cent of the patients who missed their surgeries in the spring had the procedures completed between May 18 and June 25.”[iv] One can only imagine the anxiety among cancer patients who are still waiting for surgery and wondering whether their cancer will have progressed during that wait.

Ontario is no better. An early-released Canadian Medical Association Journal (CMAJ) report entitled Clearing the surgical backlog caused by COVID-19 in Ontario: a time series modelling study found that “Between Mar. 15 and June 13, 2020, the estimated backlog in Ontario was 148,364 surgeries… [the] estimated backlog clearance time is 84 weeks…”[v] The authors of this study go on to say that “The magnitude of the surgical backlog from COVID-19 raises serious implications for the recovery phase in Ontario.”[vi] 84 weeks is approximately one year and six months.

BUT CANCER CAN’T BE CANCELLED OR POSTPONED, AND NEITHER CAN CANCER DIAGNOSIS AND TREATMENT!

Governments must do better. They must explicitly include essential cancer care in pandemic planning and stop cancelling or postponing cancer care during a second or third wave of the current pandemic.

…Cancer can’t wait!

 

References:

[i] Halifax Today: Health authority handling backlog of 700 colon cancer cases, August 30, 2020, by Chris Stoodley. https://bit.ly/3bhFV2w

[ii] Ibid.

[iii] CBC: B.C. now aiming to clear surgery backlog in 15 months, rather than 2 years. https://bit.ly/35aMt23

[iv] Ibid.

[v] Clearing the surgical backlog caused by COVID-19 in Ontario: a time series modelling study. CMAJ 2020. doi. 10.1503/cmaj.201521; early-released September 1, 2020. https://www.cmaj.ca/content/cmaj/early/2020/09/01/cmaj.201521.full.pdf

[vi] Ibid.