Cancer has not gone away: a primary care perspective to support a balanced approach for timely cancer diagnosis during COVID-19
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The COVID‐19 pandemic has had a profound and direct impact on the health and lives of the global population and has placed a huge burden on healthcare systems (Mayor, 2020; CDC, 2020a,b; WHO, 2020a). As the pandemic spread, many countries took drastic actions aiming to curtail the spread of the disease and to avoid overwhelming local, regional and national health care services. Much of routine health care diverted to COVID‐19; non‐COVID primary care and specialty care services were downscaled or completely halted. (Jones et al., 2020; The Lancet Oncology, 2020a; WHO, 2020a). Fear of contracting COVID‐19 also led to patient reluctance towards attending in‐person visits (CRUK, 2020; Jones et al., 2020). Consequently, timely cancer diagnosis may have been affected, with early reports suggesting that the decreased number of general practitioner (GP) consultations, combined with the minimalised capacity for non‐COVID care, may have had a serious impact on the diagnostic pathway (CRUK, 2020; Richards et al., 2020; Dinmohamed et al., 2020; EHRN, 2020; WHO, 2020a). For example, in the Netherlands, the number of new weekly diagnoses of all cancers (except skin) dropped to 73% of normal and to 39% of normal for skin cancers (Dinmohamed et al., 2020). In the United States, a data set that included 2.7 million patients from 39 health systems, showed that appointments for cervical, colon and breast cancer screening decreased by 86%–95% in March 2020 (EHRN, 2020). In Australia, despite relatively few COVID‐19 cases, anecdotal accounts suggest while overall GP consultations have not fallen dramatically, the switch to telemedicine has been associated with reduced pathology and radiology requests, reduced referrals for suspected cancer, and early evidence of reduced cancer incidence (Cunningham, 2020). In countries with organised cancer screening programmes, services were suspended or reduced in capacity, and in some cases, staff and laboratory resources pivoted to support COVID‐19 efforts (CRUK, 2020; Dinmohamed et al., 2020).
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Other studies have described problems of increased antimicrobial prescribing, reduced ordering of diagnostic investigations and delayed diagnosis of cancer attributed to the pandemic-related shift to remote consultations.
“Other studies have described problems of increased antimicrobial prescribing (120), reduced ordering of diagnostic investigations (121) and delayed diagnosis of cancer (122, 123) attributed to the pandemic-related shift to remote consultations”
From Planning and Evaluating Remote Consultation Services: A New Conceptual Framework Incorporating Complexity and Practical Ethics (2021) · cites this paper as [123]
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- Authors
- Helsper, C. W., Campbell, C., Emery, J., Neal, R. D., Li, L., Rubin, G., Weert, H., Vedsted, P., Walter, F. M., Weller, D., & Nekhlyudov, L.
- Affiliations
- Utrecht University (NL)
- University of Edinburgh (GB)
- The University of Melbourne (AU)
- University of Leeds (GB)
- University of Virginia (US)
- Newcastle University (GB)
- Amsterdam Public Health (NL)
- Aarhus University (DK)
- University of Cambridge (GB)
- Brigham and Women's Hospital (US)
- Corresponding author
- Helsper, Charles W.
- ORCID
- Venue
- European Journal of Cancer Care
- Publisher
- Wiley
- Published
- 2020-07-07
- Volume
- 29
- Issue
- 5
- Pages
- e13290-e13290
- ISSN
- 0961-5423 (ISSN-L)
- 1365-2354
- PMC
- PMC7361158
- OpenAlex
- W3038899650
- Cited by
- 65
- References
- 31
- Citations by year
- 2025: 1 · 2024: 4 · 2023: 7 · 2022: 20 · 2021: 26 · 2020: 7
- FWCI
- 5.42
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- European Journal of Cancer Care (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Edinburgh Research Explorer (University of Edinburgh) (publishedVersion, other-oa)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- Pure Amsterdam UMC (submittedVersion, cc-by)
- Apollo (University of Cambridge) (submittedVersion, cc-by-nc)
- Apollo
- Funders
- Cancer Research UK (23385)
- Topics
- Health Sciences › Medicine › Oncology › COVID-19 and healthcare impacts
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Health Sciences › Health Professions › General Health Professions › Healthcare Systems and Challenges
- Keywords
- COVID-19 pandemic, cancer diagnosis, delayed diagnosis, primary care, general practitioner visits, cancer screening, telemedicine, diagnostic pathway, healthcare disruption, cancer incidence, access to cancer care
- MeSH terms
- Betacoronavirus, Internet Access, COVID-19, SARS-CoV-2, Health Services Accessibility, Humans, Neoplasms, Patient Education as Topic, Pneumonia, Viral, Primary Health Care, Referral and Consultation, Telemedicine, Coronavirus Infections, Healthcare Disparities, Workflow, Delayed Diagnosis, Pandemics
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