Spanish Association Against Cancer (AECC), C. del Teniente Cnel. Noreña, Madrid, Spain.
Pathology Department, Bellvitge University Hospital, Barcelona, Spain.
ESMO Open. 2021 Jun;6(3):100157. doi: 10.1016/j.esmoop.2021.100157. Epub 2021 Apr 30.
Studies evaluating the effects of the COVID-19 pandemic on public healthcare systems are limited, particularly in cancer management. As no such studies have been carried out in Spain, our objective is to describe and quantify the impact of the COVID-19 pandemic on cancer patients in Spanish hospitals during the first wave of the pandemic.
This retrospective, multicenter, nationwide study collected information from hospital departments treating oncology patients. An electronic questionnaire comparing outcomes and management of oncohematological patients for the March-June 2019 and March-June 2020 periods was used.
Information from 78 departments (36 tertiary hospitals) was analyzed. Forty-four departments implemented adapted protocols during March 2020. Most of these (n = 38/44; 86.4%) carried out COVID-19 triage, while 26 of 44 (59.1%) carried out onsite polymerase chain reaction tests for clinically suspected cases. A shift from in-person to telephone visits was observed in 43 of 44 (97.7%) departments. Comparing the March-June 2019 and March-June 2020 periods, the number of new patients decreased by 20.8% (from 160.2 to 126.4). Decreases were also seen in the mean number of total (2858.2 versus 1686.1) and cancer (465.5 versus 367.2) biopsies, as well as the mean number of bone marrow biopsies (30.5 versus 18.6). Concerning the number of patients visiting specific cancer care departments, a decrease from 2019 to 2020 was seen for mean number of chemotherapy treatments (712.7 versus 643.8) and radiation therapy (2169.9 versus 2139.9). Finally, a reduction from 2019 to 2020 of 12.9% (from 8.6 to 7.4) in the mean number of patients included in clinical trials was noted.
This study provides the first comprehensive data concerning the impact of COVID-19 on cancer care in Spain. The pandemic caused a 20.8% decrease in newly diagnosed patients, which may impact future outcomes. Measures must be taken to ensure cancer management receives priority in times of healthcare emergencies.
评估 COVID-19 大流行对公共医疗体系影响的研究有限,尤其是在癌症管理方面。由于西班牙尚未开展此类研究,我们的目的是描述并量化 COVID-19 大流行对西班牙医院癌症患者的影响,研究对象为大流行第一波期间的癌症患者。
这是一项回顾性、多中心、全国性研究,收集了治疗肿瘤患者的医院科室的信息。我们使用了一份电子问卷,比较了 2019 年 3 月至 6 月和 2020 年 3 月至 6 月间肿瘤血液科患者的治疗结果和管理情况。
共分析了 78 个科室(36 家三级医院)的信息。2020 年 3 月期间,44 个科室实施了适应性方案。其中大部分(n=38/44;86.4%)开展了 COVID-19 分诊,26 个科室(44 个科室中的 26 个;59.1%)对疑似病例进行了现场聚合酶链反应检测。44 个科室中有 43 个(97.7%)将现场就诊转为电话问诊。与 2019 年 3 月至 6 月相比,2020 年 3 月至 6 月期间新诊断患者数量减少了 20.8%(从 160.2 例降至 126.4 例)。总活检量(2858.2 次与 1686.1 次)和癌症活检量(465.5 次与 367.2 次)以及骨髓活检量(30.5 次与 18.6 次)也有所减少。在特定癌症护理科室的就诊患者数量方面,2020 年与 2019 年相比,化疗治疗(712.7 次与 643.8 次)和放疗(2169.9 次与 2139.9 次)的就诊患者数量也有所减少。最后,临床试验中纳入患者的数量从 2019 年到 2020 年减少了 12.9%(从 8.6 例降至 7.4 例)。
本研究首次提供了有关 COVID-19 对西班牙癌症护理影响的全面数据。大流行导致新诊断患者数量减少了 20.8%,这可能会影响未来的结果。在医疗紧急情况下,必须采取措施确保癌症管理得到优先考虑。