Research from the Sidney Kimmel Cancer Center - Jefferson Health (SKCC) found significant decreases nationwide in the number of patients being seen for cancer-related care as the COVID-19 pandemic progressed during the few first months of 2020. The most significant decline was seen in encounters related to new cancer incidences, which included screening, initial diagnosis, second opinion, and treatment initiation appointments.
Anecdotal reports and physician surveys have suggested dramatic declines; however, this study, which was published in JCO Clinical Cancer Informatics, is the largest to date to measure the effects of the pandemic on normal cancer care activities.
"While it is not surprising that the pandemic has had a significant impact on patients seeking care, it was important to test and quantify these trends using a large, institutionally agnostic dataset, as the results have important implications for future cancer patients and the potential burden on hospitals moving forward," said Christopher McNair, PhD, Director of Cancer Informatics at SKCC and senior author of the study.
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McNair, along with Jack London, PhD, Research Professor Emeritus of Cancer Biology at Thomas Jefferson University, and colleagues leveraged the TriNetX platform to create a COVID and Cancer Research Network (CCRN). The CCRN is comprised of data from 20 healthcare organizations representing over 28 million patients throughout the United States and includes aggregate data from electronic medical records such as diagnoses, procedures, laboratory testing, and demographics. Using the CCRN, the study team compared the number of patients with cancer-related encounters in January through April of 2019 with those in January through April of 2020.
McNair and team identified a significant decline in patients with encounters associated with any neoplasm, including malignant, benign, and in situ diseases (-56.9%); new incidence neoplasms (-74%); malignant disease (-50%); and new incidence malignant disease (-65.2%). The researchers also looked at data from University Hospitals Plymouth NHS Trust in the United Kingdom, which showed similar trends. However, the researchers cautioned that more data are needed to compare trends outside the United States, as these findings are from a single hospital.
"While the decreases themselves were not unexpected, the magnitude of decline, while using a national cohort this large, was surprising," McNair said.