The COVID-19 pandemic has prompted unprecedented changes to cancer care across the care pathway. Social distancing and quarantine measures employed in response to the pandemic have challenged the delivery of cancer care and have led to potential delays in cancer diagnosis and treatment, which are likely to impact cancer outcomes. However, the pandemic has also provided opportunities for improvement in quality cancer care, as some modifications to care will be of permanent value.
As the initial acute phase of the pandemic passes and the recovery phase begins, Cancer Australia has investigated high-value changes to cancer care that should be retained and enhanced to improve quality and resilience in the delivery of cancer care.
A desktop review of published peer-reviewed and grey literature identified evidence of changes to cancer care resulting from the pandemic. A virtual roundtable comprising 31 cancer control experts and consumer representatives was held to discuss strategies to retain, embed and enhance changes which improve the quality of patient care.
Twelve core elements of cancer care which changed during the COVID-19 pandemic were identified, including: telehealth; modifications to treatment schedules (including hypofractionated radiotherapy); patient support information; shared follow-up and survivorship care; virtual multidisciplinary teams; home-based chemotherapy; virtual supportive and palliative care; innovative hospital and infrastructure models; tele-trials; and increased oncology sector collaboration. Strategies to retain or embed changes to care deemed of long-term value were identified.
During the COVID-19 pandemic, some new or modified approaches to cancer care were adopted to maximise patient outcomes, while balancing the risk of exposure to, and harm from, SARS-Cov-2 infection against the benefits of treatment. The pandemic presents an opportunity to revise some healthcare practices to focus on delivering quality outcomes for patients, delivering new models of care and driving high-value care.