A significant number of cancer patients around the world had vital surgery delayed due to the coronavirus pandemic, new research shows.
One in seven cancer patients globally had potentially life-saving operations postponed during Covid-19 lockdowns, according to researchers from the University of Birmingham.
Experts said the findings showed that cancer surgery systems were “fragile” to lockdowns as they called for plans to be put in place so that, even in the event of another public health emergency, urgent surgeries can continue safely.
Researchers analysed data from 61 countries concerning surgery for 15 common cancers across 466 hospitals.
Cancer surgery systems worldwide were fragile to lockdownsThe Lancet Oncology
Data on more than 20,000 patients was analysed, including more than 6,000 patients from the UK.
The research team compared surgery cancellations and delays during lockdowns to times where there were “light restrictions only”.
The findings, published in the journal Lancet Oncology, show that during full lockdowns 15% of patients did not receive their planned operation due to a Covid-related reason.
This compared to 0.6% during periods of “light restrictions”.
Patients awaiting surgery for more than six weeks during full lockdown were significantly less likely to have their planned cancer surgery, the authors said.
Frail patients, those with advanced cancer, and those waiting surgery in lower-middle income countries were all less likely have the cancer operation as scheduled, they added.
The authors wrote: “Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays.
“During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening.”
Co-lead author Mr James Glasbey, from the University of Birmingham, said: “Our research reveals the collateral impact of lockdowns on patients awaiting cancer surgery during the pandemic.
“Whilst lockdowns are critical to saving lives and reducing the spread of the virus, ensuring capacity for safe elective cancer surgery should be part of every country’s plan to ensure continued health across the whole population.
“In order to prevent further harm during future lockdowns, we must make the systems around elective surgery more resilient – protecting elective surgery beds and operating theatre space, and properly resourcing surge capacity for periods of high demand on the hospital, whether that is Covid, the flu or other public health emergencies.”
The most vulnerable patients to lockdown effects were those in lower income countries, where capacity issues that were present before the pandemic were worsened during lockdown restrictionsAneel Bhangu, study co-author
Co-lead author Mr Aneel Bhangu, from the University of Birmingham, added: “The most vulnerable patients to lockdown effects were those in lower income countries, where capacity issues that were present before the pandemic were worsened during lockdown restrictions. Patients in these environment were at highest risk of cancellation, despite being younger and having fewer co-morbidities.
“Whilst we only followed patients that underwent a delay for a short period of time, evidence from other research suggests that these patients may be at higher risk of recurrence. To help mitigate against this, surgeons and cancer doctors should consider closer follow-up for patients that were subject to delays before surgery.”
In September, a damning report concluded that it could take more than a decade to clear the cancer backlog in England.
While the number of people who need cancer treatment has not changed, the research from the Institute for Public Policy Research think tank and the CF health consultancy shows that during the height of the pandemic (March 2020 to February 2021):
– 369,000 fewer people than expected were referred to a specialist with suspected cancer (15% lower than expected);
– 187,000 fewer chemotherapy treatments (7% lower than expected);
– 15,000 fewer radiotherapy treatments (13% lower than expected).
The report said: “Behind these statistics are thousands of people for whom it will now be too late to cure their cancer.”