Post COVID-19 cancer care in Latin America

4 Nov 2020
Post COVID-19 cancer care in Latin America

by ecancer reporter Saira Ahmed

Since December 2019, global public health has been seriously affected by this century's most severe infectious pandemic.

Cancer control, especially in its preventive and treatment aspects is compromised mainly due to a scenario dominated by the emergencies of the COVID-19 pandemic.

Published studies on COVID-19 and cancer show that cancer patients with active disease have a higher risk of serious complications and mortality from COVID-19 than the general population, particularly those with lung neoplastic involvement, myeloid suppressive treatments, advanced age, compromise of their functional status and/or comorbidities.

Globally, cancer is one of the leading health challenges.

Latin America and the Caribbean, cancer ranks second as a cause of death, with 672,758 deaths from cancer recorded in 2018. During 2018, the incidence of new cases rose to 1,412,732. Looking forward, because of the region’s aging population and changes in lifestyle, the incidence will increase significantly in coming years.

Latin America's pre-pandemic situation already presents a picture of fragmented health systems and weak social protection systems.

Concerned about this urgent crisis, a group of Latin American experts on cancer from Argentina, Brazil, Chile, Colombia, Honduras, Mexico, Nicaragua, Peru, and Uruguay and under the leadership of Dr. Tabaré Vázquez, President of Uruguay from 2005 to 2010 and from 2015 to 2020, produced a Position Paper and a Report Summary.

It serves as an urgent call to governments and civil society as a whole to propose, approve, and implement cost-effective measures based on a scientific-technical proposal to face the challenges that the post-pandemic scenario imposes regarding Cancer.

The position paper on this topic first assessed the characteristics of the health care and cancer control prior to the pandemic, in the countries mentioned above.

They then assessed the effect of the pandemic on cancer control and care and concluded that there was significant deduction in the number of early cancer detection cases from March 2020 to June 2020.

Moreover, it was deduced that this reduction in early screening could increase the cases of late stage cancers amongst the population which could have a detrimental impact on the health and economy of these countries.

Not only this, but due to the pandemic there will be an overload of demand on health services to ensure diagnostic tests and consequent treatments.

This will, in turn, negatively impact the level of resources available for cancer control. Cancer mortality and direct expenses linked with cancer care will increase furthermore.

To reduce the impact of cancer on populations at the regional level and prevent an uncontrollable situation from being generated in the coming years in public health, the position paper proposed the following solutions:

• Strengthening the planning of actions against cancer through Primary Health Care.

• Building and development of health policies based on the prevention and care of cancer in its different stages.

• Design and implementation of a clear, agile, and precise information and statistical instrument for the Americas to develop better cancer prevention and control policies in the region.

• Linking the region's health systems and seeking intersectoral and inter-institutional collaboration in reducing the impact of cancer in the community.

They further came up with detailed short term and long-term recommendations.

The short-term recommendations comprised of individual, medical, health systems and government policies dimensions.

Whereas, the medium and long-term recommendations comprised of ensuring the necessary infrastructure for the prevention, early detection, and treatment of cancer, guaranteeing access to and coverage of essential cancer-related services and empowering patients, their families, and civil society groups to advance cancer prevention, diagnosis, treatment, and rehabilitation.

It also talked about developing, promoting and implementing National Cancer Control Programs in the face of the new public health realities and developing strategic operational plans for phased reintroduction of activities for early detection of cancer with the aim of reducing the risk of late diagnoses without overwhelming the capacity of oncology services etc.

Overall, the main solutions urge the health care professionals and patients to maintain prevention and monitoring and avoid stopping cancer treatment.

The doctors should talk to their patients about the medical response to their disease and what can be delayed, what decision they have options, and what to do, even during the crisis.

The health systems should maintain functional and operational health systems for cancer patients and develop strategic operational plans for phased reintroduction of activities for early detection of cancer.

They should avoid excessive focus only on the COVID epidemic.

Resilient health systems are required. Lastly, public policies should preserve operational and funded national cancer plans.

The full report on this topic will be coming soon.

To see the full position paper, go here.

To see the summary of the report, go here.