Impact of COVID-19 on cancer service delivery: results from an international survey of oncology clinicians

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Chazan, G; Franchini, F; Alexander, M; Banerjee, S; Mileshkin, L; Blinman, P; Zielinski, R; Karikios, D; Pavlakis, N; Peters, S; ...Date
2020-01-01Source Title
ESMO OpenPublisher
BMJ PUBLISHING GROUPUniversity of Melbourne Author/s
Franchini, Fanny; Mileshkin, Linda; Solomon, Benjamin; Ball, David; IJzerman, Maarten; Alexander, MarlieseAffiliation
Melbourne School of Population and Global HealthMedical Education
Sir Peter MacCallum Department of Oncology
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Journal ArticleCitations
Chazan, G., Franchini, F., Alexander, M., Banerjee, S., Mileshkin, L., Blinman, P., Zielinski, R., Karikios, D., Pavlakis, N., Peters, S., Lordick, F., Ball, D., Wright, G., IJzerman, M. & Solomon, B. (2020). Impact of COVID-19 on cancer service delivery: results from an international survey of oncology clinicians. ESMO OPEN, 5 (6), https://doi.org/10.1136/esmoopen-2020-001090.Access Status
Open AccessAbstract
OBJECTIVES: To report clinician-perceived changes to cancer service delivery in response to COVID-19. DESIGN: Multidisciplinary Australasian cancer clinician survey in collaboration with the European Society of Medical Oncology. SETTING: 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. PARTICIPANTS: Medical oncologists (n=372; 74%), radiation oncologists (n=91; 18%) and surgical oncologists (n=38; 8%). RESULTS: 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. CONCLUSION: 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.
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