serval:BIB_EBC36A1764E1
Impact of COVID-19 on cancer service delivery: results from an international survey of oncology clinicians.
10.1136/esmoopen-2020-001090
000597167800004
33262203
Chazan
G.
author
Franchini
F.
author
Alexander
M.
author
Banerjee
S.
author
Mileshkin
L.
author
Blinman
P.
author
Zielinski
R.
author
Karikios
D.
author
Pavlakis
N.
author
Peters
S.
author
Lordick
F.
author
Ball
D.
author
Wright
G.
author
IJzerman
M.
author
Solomon
B.
author
article
2020-12
ESMO open
2059-7029
2059-7029
journal
5
6
e001090
To report clinician-perceived changes to cancer service delivery in response to COVID-19.
Multidisciplinary Australasian cancer clinician survey in collaboration with the European Society of Medical Oncology.
Between May and June 2020 clinicians from 70 countries were surveyed; majority from Europe (n=196; 39%) with 1846 COVID-19 cases per million people, Australia (AUS)/New Zealand (NZ) (n=188; 38%) with 267/236 per million and Asia (n=75; 15%) with 121 per million at time of survey distribution.
Medical oncologists (n=372; 74%), radiation oncologists (n=91; 18%) and surgical oncologists (n=38; 8%).
Eighty-nine per cent of clinicians reported altering clinical practices; more commonly among those with versus without patients diagnosed with COVID-19 (n=142; 93% vs n=225; 86%, p=0.03) but regardless of community transmission levels (p=0.26). More European clinicians (n=111; 66.1%) had treated patients diagnosed with COVID-19 compared with Asia (n=20; 27.8%) and AUS/NZ (n=8; 4.8%), p<0.001. Many clinicians (n=307; 71.4%) reported concerns that reduced access to standard treatments during the pandemic would negatively impact patient survival. The reported proportion of consultations using telehealth increased by 7.7-fold, with 25.1% (n=108) of clinicians concerned that patient survival would be worse due to this increase. Clinicians reviewed a median of 10 fewer outpatients/week (including non-face to face) compared with prior to the pandemic, translating to 5010 fewer specialist oncology visits per week among the surveyed group. Mental health was negatively impacted for 52.6% (n=190) of clinicians.
Clinicians reported widespread changes to oncology services, in regions of both high and low COVID-19 case numbers. Clinician concerns of potential negative impacts on patient outcomes warrant objective assessment, with system and policy implications for healthcare delivery at large.
Adult
Asia/epidemiology
Australia/epidemiology
COVID-19/epidemiology
COVID-19/virology
Europe/epidemiology
Female
Humans
Male
Medical Oncology/methods
Medical Oncology/statistics & numerical data
Neoplasms/epidemiology
Neoplasms/therapy
Oncologists/statistics & numerical data
Pandemics
SARS-CoV-2/isolation & purification
Surveys and Questionnaires
COVID-19
oncology
service delivery
eng
60_published
true
peer-reviewed
Publication types: Journal Article ; Multicenter Study
Publication Status: ppublish
University of Lausanne
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