• English
    • español
    • português (Brasil)
  • English 
    • English
    • español
    • português (Brasil)
  • Login
View Item 
  •   COVID-19
  • Resources in English
  • Technical documents and research evidence on COVID-19
  • View Item
  •   COVID-19
  • Resources in English
  • Technical documents and research evidence on COVID-19
  • View Item
JavaScript is disabled for your browser. Some features of this site may not work without it.

Collateral damage: the impact on cancer outcomes of the COVID-19 pandemic

 
Thumbnail
Date
2020-04-29
Author
Sud, Amit et al.
Metadata
Show full item record
Abstract
Background: Cancer diagnostics and surgery have been disrupted by the response of healthcare services to the COVID-19 pandemic. Progression of cancers during delay will impact on patient long-term survival. Methods: We generated per-day hazard ratios of cancer progression from observational studies and applied these to age-specific, stage-specific cancer survival for England 2013-2017. We modelled per-patient delay of three months and six months and periods of disruption of one year and two years. Using healthcare resource costing, we contextualise attributable lives saved and life years gained from cancer surgery to equivalent volumes of COVID-19 hospitalisations. Findings: Per year, 94,912 resections for major cancers result in 80,406 long-term survivors and 1,717,051 life years gained. Per-patient delay of six months would cause attributable death of 10,555 of these individuals with loss of 205,024 life years. For cancer surgery, average life years gained (LYGs) per patient are 18.1 under standard conditions and 15.9 with a delay of six months (a loss of 2.3 LYG per patient). Taking into account units of healthcare resource (HCRU), surgery results on average per patient in 2.25 resource-adjusted life years gained (RALYGs) under standard conditions and 1.98 RALYGs following delay of six months. For 94,912 hospital COVID-19 admissions, there are 474,505 LYGs requiring of 1,097,937 HCRUs. Hospitalisation of community-acquired COVID-19 patients yields on average per patient 5.0 LYG and 0.43 RALYGs. Interpretation: Delay of six months in surgery for incident cancers would mitigate 43% of life years gained by hospitalisation of an equivalent volume of admissions for community acquired COVID-19. This rises to 62% when considering resource-adjusted life-years gained. To avoid a downstream public health crisis of avoidable cancer deaths, cancer diagnostic and surgical pathways must be maintained at normal throughput, with rapid attention to any backlog already accrued. Funding: Breast Cancer Now, Cancer Research UK, Bobby Moore Fund for Cancer Research, National Institute for Health Research (NIHR)
URI
https://doi.org/10.1101/2020.04.21.20073833
Collections
  • Technical documents and research evidence on COVID-19

Browse

AllCommunities & CollectionsBy Issue DateAuthorsTitlesCategorySubjectsThis CollectionBy Issue DateAuthorsTitlesCategorySubjects

My Account

LoginRegister

Pan American Health Organization
World Health Organization. Regional Office for the Americas
525 Twenty-third Street, N.W., Washington, D.C. 20037, United States of America

Content Disclaimer (Important notes about the material)

Links

  • WHO International Clinical Trial Registry Platform (ICTRP)
  • WHO Coronavirus disease R&D Blueprint
  • WHO Database of Publications on Coronavirus Disease
  • PAHO Coronavirus Disease
  • PAHO/BIREME Windows of Knowledge COVID-19
  • Evidence aid Coronavirus (COVID-19) resources

  • PAHO Digital Library (IRIS PAHO)
  • Virtual Health Library (VHL)
  • Global Index Medicus (GIM)