The impact of COVID‐19 pandemic on access to treatment for children with cancer in India and treating center practices
Open accessAbstract
Background: The coronavirus disease 2019 (COVID‐19) pandemic led the Indian government to announce a nationwide lockdown on March 23, 2020. This study aimed to explore the impact of the pandemic on the accessibility of care for children with cancer and to view strategies adopted by hospitals for service delivery. Methods: Weekly average of childhood cancer (≤18 years) patient registrations during pre‐lockdown period (January 1 to March 23, 2020) were compared with post‐lockdown period (March 24 to May 31, 2020). The effect on the scheduled treatment was investigated for post‐lockdown period. A survey of health care providers was conducted to determine centers' adopted strategies. Results: In 30 participating centers, 1146 patients with childhood cancer (797 pre‐lockdown period and 349 post‐lockdown period) were registered. The weekly average registration was 67.3 and 35.5 patients during pre‐lockdown and post‐lockdown respectively (decline of 47.9%). Although most centers experienced this decline, there were 4 that saw an increase in patient registrations. The distribution of patients registered post‐lockdown was found significantly different by age (lesser older age, P = .010) and distance (lesser travel distance, P = .001). 36.1% of patients, who were scheduled for any of the treatment modalities (chemotherapy, surgery, radiotherapy, and hematopoietic stem cell transplantation) during the post‐lockdown period, experienced delays. Centers adopted several strategies including modifications to treatment protocols, increased use of growth factors, and increased support from social organizations. Conclusions: This multicenter study from India suggests that the COVID‐19 pandemic and the lockdown impacted 2 out of 3 children with cancer. The effect of this on survival is yet to be established.
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Prior studies have reported reductions in care quality for cancer patients (e.g., fewer follow-up visits, fewer chemotherapy courses administered, and fewer surgeries performed) as well as reduced cancer screening and diagnosis of new cases within India during the pandemic.
“Prior studies have reported reductions in care quality for cancer patients (e.g., fewer follow-up visits, fewer chemotherapy courses administered, and fewer surgeries performed) as well as reduced cancer screening and diagnosis of new cases within India during the pandemic52–54.”
From Attributed causes of excess mortality during the COVID-19 pandemic in a south Indian city (2023) · cites this paper as [53]
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- Authors
- Sharma, J., Mahajan, A., Bakhshi, S., Patil, V., Verma, N., Radhakrishnan, V., Singh, A., Kayal, S., Seth, R., Pushpam, D., & Arora, R. S.
- Affiliations
- CanKids KidsCan (IN)
- Indraprastha Apollo Hospitals (IN)
- All India Institute of Medical Sciences (IN)
- Basavatarakam Indo American Cancer Hospital and Research Institute (IN)
- King George's Medical University (IN)
- Cancer Institute (WIA) (IN)
- Safdarjang Hospital (IN)
- Jawaharlal Institute of Post Graduate Medical Education and Research (IN)
- Max Super Speciality Hospital (IN)
- Corresponding author
- Arora, Ramandeep Singh
- ORCID
- Venue
- Cancer
- Publisher
- Wiley
- Published
- 2021-10-07
- Volume
- 128
- Issue
- 3
- Pages
- 579-586
- ISSN
- 0008-543X (ISSN-L)
- 1097-0142
- PMC
- PMC8653392
- OpenAlex
- W3204132436
- Cited by
- 30
- References
- 20
- Citations by year
- 2025: 2 · 2024: 9 · 2023: 7 · 2022: 10 · 2021: 2
- FWCI
- 2.55
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Cancer (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Oncology › COVID-19 and healthcare impacts
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Acute Lymphoblastic Leukemia research
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advances in Oncology and Radiotherapy
- Keywords
- COVID-19 pandemic, childhood cancer, access to cancer treatment, lockdown, treatment delay, patient registration, growth factors, hematopoietic stem cell transplantation, India
- MeSH terms
- COVID-19, SARS-CoV-2, Aged, Communicable Disease Control, Health Services Accessibility, Humans, India, Neoplasms, Pandemics
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