Division of Surgical Oncology - Department of Surgery, Dr Sardjito Hospital / Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia.
Division of Surgical Oncology - Department of Surgery, Dr M. Djamil Hospital / Faculty of Medicine, Universitas Andalas, Padang, 25217, Indonesia.
Int J Surg. 2020 Jul;79:206-212. doi: 10.1016/j.ijsu.2020.05.072. Epub 2020 Jun 1.
The rapidly spreading coronavirus infection (COVID-19) worldwide has contracted all aspects of health systems. Developing countries that mostly have a weaker healthcare system and insufficient resources are likely to be the most hardly affected by the pandemic. Cancers are frequently diagnosed in late stages with higher case-fatality rates compared to those in high-income countries. Delayed diagnosis, lack of cancer awareness, low adherence to treatment, and unequal or limited access to treatment are among the challenging factors of cancer management in developing countries. Elective cancer surgeries are often considered to be postponed during COVID-19 pandemic to preserve valuable hospital resources such as personal protection equipment, hospital bed, intensive care unit capacity, and manpower to screen and treat the affected individuals. However, specific considerations to defer cancer surgery in developing countries might need to be carefully adjusted to counterbalance between preventing COVID-19 transmission and preserving patients 'long-term life expectancy and quality of life.
全球迅速蔓延的冠状病毒感染(COVID-19)已波及卫生系统的各个方面。大多数医疗体系较弱且资源不足的发展中国家可能受到疫情的影响最大。与高收入国家相比,癌症的诊断往往较晚,病死率更高。在发展中国家,癌症管理的挑战因素包括诊断延误、癌症意识不足、治疗依从性低以及获得治疗的机会不平等或有限。在 COVID-19 大流行期间,通常认为择期癌症手术可以推迟,以节省有价值的医院资源,如个人防护设备、病床、重症监护室容量和人力,以筛查和治疗受影响的个体。然而,在发展中国家推迟癌症手术可能需要进行具体考虑,以在预防 COVID-19 传播和保护患者的长期预期寿命和生活质量之间取得平衡。