ecancermedicalscience

Research

The impact of national non-pharmaceutical interventions (‘lockdowns’) on the presentation of cancer patients

3 Feb 2021
Arnie Purushotham, Graham Roberts, Kate Haire, Joanna Dodkins, Elizabeth Harvey-Jones, Lu Han, Anne Rigg, Claire Twinn, Conjeevaram Pramesh, Priya Ranganathan, Richard Sullivan, Ajay Aggarwal

One of the most ignored aspects of the COVID-19 pandemic has been the impact of public health measures by governments on wider health and welfare. From March 2020, hospitals in the UK saw a dramatic reduction in patients with cancer presenting due to multifactorial reasons. The impact of the pandemic on patients with cancer in the South East London Cancer Alliance was studied. The specific aims were (1) to examine the reduction in cancer diagnoses during the first wave of the pandemic and (2) to examine the stage of diagnosis of patients with cancer presenting during the pandemic compared with that of patients presenting before the pandemic.

There was an 18.2% reduction in new cancer diagnoses (an estimate of 987 cancers), when compared with 2019. This fall in cancer diagnoses was most marked in patients with prostate (51.4%), gynaecological (29.7%), breast (29.5%) and lung (23.4%) cancers. There was an overall 3.9% increase in advanced stage presentation (Stages 3 and 4), with an overall 6.8% increase in Stage 4 cancers during this period. The greatest shifts were seen in lung (increase of 6.3%, with an 11.2% increase in Stage 4 cancer alone) and colorectal (5.4%) cancers. For prostate cancer, there was an increase in 3.8% in those presenting with Stage 4 disease. For breast cancer, there was an 8% reduction in patients diagnosed with Stage 1 cancer with commensurate increases in the proportion of those with Stage 2 disease.

The experiences in cancer are a salient warning that pandemic control measures and policy need to balance all health and welfare. Alternative strategies need to be adopted during further waves of the current and any future pandemic to ensure that patients with cancer are prioritised for diagnosis and treatment to prevent late-stage presentation and an increase in avoidable deaths.

Related Articles

Ronald Limón, Lucia Reynolds, Erick Rocha, Lucia Richter, Mario Gianella, Oscar Niño de Guzman, Gerson Mejía, José Nina, Wendy Rojas, Lijia Avilés, Iván Maldonado, Cristian Pacheco, Claudio Martín, Maria G Cervantes, Federico Bakal, Eduardo Cazap
Frederic Ivan Ting, Crizel Denise Uy, Katrina Gaelic Bebero, Danielle Benedict Sacdalan, Honey Sarita Abarquez, Grace Nilo, Buenaventura Ramos Jr, Dennis L Sacdalan, Arnold John Uson
Sharif Adeniyi Folorunso, Atara Ntekim, Abbas Adesina Abdus-salam, Adeniyi Olabumuyi, Aminat Omolara Folorunso, Festus Igbinoba, Adeniyi Abidemi Adenipekun
Suvraraj Das, Rajeev Sharan, Anoop Attakkil, Saugata Sen, Kapila Manikantan, Prateek V Jain, Pattatheyil Arun