Abstract
Objective: This study aimed to evaluate the impact of the coronavirus disease-2019 (COVID-19) pandemic on the follow-up
and management of cancer patients. Material and Methods: A survey consisting of 15 questions asking whether there was a delay in followup
or treatment of cancer during the COVID-19 pandemic was applied to the cancer patients who were admitted to our medical oncology outpatient
clinic for follow-up or treatment. Results: A total of 209 cancer patients were included in this study. In 56 (26.8%) patients, there was
a delay in the follow-up or treatment of cancer. The delay in cancer treatment occurred in 37 (66%) patients, and the delay in the follow-up
of cancer occurred in 19 (34%) patients. The median delay in the follow-up and treatment of cancer was both 30 days (range 1-120) and
(range 2-120), respectively. 12.5% of all patients who encountered delays in cancer follow-up or treatment had subsequent cancer-related
complications. Also, the delay was significantly higher in quarantined patients and patients diagnosed with severe acute respiratory syndromecoronavirus-
2. In binary logistic regression analysis, living in rural areas and being quarantined due to the COVID-19 pandemic were determined
as independent predictors of the delay. Conclusion: The COVID-19 outbreak caused delays in the follow-up and treatment of cancer
patients, and acute complications arose due to unavoidable disruptions. To prevent long-term negative consequences of delays in cancer follow-
up and treatment, it is necessary to adapt the treatments judiciously without sacrificing patient safety and care.
Keywords:
Cancer patients, COVID-19, follow-up
References
1Lai CC, Wang CY, Wang YH, Hsueh SC, Ko WC, Hsueh PR. Global epidemiology of coronavirus disease 2019 (COVID-19): disease incidence, daily cumulative index, mortality, and their association with country healthcare resources and economic status. Int J Antimicrob Agents. 2020;55(4):105946.
2Shi Y, Wang G, Cai XP, et al. An overview of COVID-19. J Zhejiang Univ Sci B. 2020;21(5): 343-360.
3Hu Y, Sun J, Dai Z, et al. Prevalence and severity of corona virus disease 2019 (COVID-19): A systematic review and meta-analysis. J Clin Virol. 2020;127:104371.
4Demirbilek Y, Pehlivantürk G, Özgüler ZÖ, Alp Meşe E. COVID-19 outbreak control, example of ministry of health of Turkey. Turk J Med Sci. 2020;50(SI-1):489-494.
5Ministry of Health [Internet]. ©2021 Ministry of Health. COVID-19 Information Platform. 7 December 2020. Available from:
6Maringe C, Spicer J, Morris M, et al. The impact of the COVID-19 pandemic on cancer deaths due to delays in diagnosis in England, UK: a national, population-based, modelling study. Lancet Oncol. 2020;21(8):1023-1034. Erratum in: Lancet Oncol. 2021;22(1):e5.
7Parohan M, Yaghoubi S, Seraji A, Javanbakht MH, Sarraf P, Djalali M. Risk factors for mortality in patients with Coronavirus disease 2019 (COVID-19) infection: a systematic review and meta-analysis of observational studies. Aging Male. 2020;23(5):1416-1424.
8Liang W, Guan W, Chen R, et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol. 2020;21(3): 335-337.
9Tian J, Yuan X, Xiao J, et al. Clinical characteristics and risk factors associated with COVID-19 disease severity in patients with cancer in Wuhan, China: a multicentre, retrospective, cohort study. Lancet Oncol. 2020; 21(7):893-903.
10Robilotti EV, Babady NE, Mead PA, et al. Determinants of COVID-19 disease severity in patients with cancer. Nat Med. 2020;26(8): 1218-1223.
11Lee LY, Cazier JB, Angelis V, et al; UK Coronavirus Monitoring Project Team, Kerr R, Middleton G. COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study. Lancet. 2020;395(10241):1919-1926. Erratum in: Lancet. 2020;396(10250):534.
12Barlesi F, Foulon S, Bayle A, et al. Outcome of cancer patients infected with COVID-19, including toxicity of cancer treatments. Cancer Research. AACR Annual Meeting. 2020; 80(16).
13Al-Quteimat OM, Amer AM. The impact of the COVID-19 pandemic on cancer patients. Am J Clin Oncol. 2020;43(6):452-455.
14Passaro A, Addeo A, Von Garnier C, et al. ESMO Management and treatment adapted recommendations in the COVID-19 era: Lung cancer. ESMO Open. 2020;5(Suppl 3):e00 0820.
15Colombo I, Zaccarelli E, Del Grande M, et al. ESMO management and treatment adapted recommendations in the COVID-19 era: gynaecological malignancies. ESMO Open. 2020;5(Suppl 3):e000827.
16Tachibana I, Ferguson EL, Mahenthiran A, et al. Delaying cancer cases in urology during COVID-19: review of the literature. J Urol. 2020;204(5):926-933.
17Maio M, Hamid O, Larkin J, et al. Immune checkpoint inhibitors for cancer therapy in the COVID-19 Era. Clin Cancer Res. 2020;26(16): 4201-4205.
18Guven DC, Aktas BY, Aksun MS, et al. COVID-19 pandemic: changes in cancer admissions. BMJ Support Palliat Care. 2020 Jul 14:bmjspcare-2020-002468.
19Akagunduz B, Ozer M, Karacin C, Atcı MM, Yıldırım HC, Unver E. Impact of coronaphobia on treatment and follow-up compliance of cancer patients. Future Oncol. 2021;17(20):2621-2629.
20Erdem D, Karaman I. Awareness and perceptions related to COVID-19 among cancer patients: A survey in oncology department. Eur J Cancer Care (Engl). 2020;29(6):e13309.
21Sud A, Jones ME, Broggio J, et al. Collateral damage: the impact on outcomes from cancer surgery of the COVID-19 pandemic. Ann Oncol. 2020;31(8):1065-1074.
22Sud A, Torr B, Jones ME, et al. Effect of delays in the 2-week-wait cancer referral pathway during the COVID-19 pandemic on cancer survival in the UK: a modelling study. Lancet Oncol. 2020;21(8):1035-1044.
23Alimoglu O, Erol CI, Kilic F, Baysal H. Cancer surgery during the Covid-19 pandemic in Turkey. Int J Surg. 2020;79:54-55.
24Finley C, Prashad A, Camuso N, et al. Guidance for management of cancer surgery during the COVID-19 pandemic. Can J Surg. 2020;63(22):S2-S4.
25Vecchione L, Stintzing S, Pentheroudakis G, Douillard JY, Lordick F. ESMO management and treatment adapted recommendations in the COVID-19 era: colorectal cancer. ESMO Open. 2020;5(Suppl 3):e000826.
26Bernhardt D, Wick W, Weiss SE, et al. Neuro-oncology management during the COVID-19 pandemic with a focus on WHO Grade III and IV Gliomas. Neuro Oncol. 2020;22(7):928-35.
