Aims
Significant reductions in services relating to cancer investigations or treatment procedures due to the impact of COVID-19 in Australia have been reported. To provide an evidence base to understand where reductions have occurred and types of services affected, an examination of total monthly cancer-related services in 2020 has been undertaken utilising Medicare Benefits Schedule (MBS) claims data.1
Methods
Over 500 MBS item codes for cancer-related (or potentially cancer-related) diagnostic and treatment services, including surgical procedures and procedures for delivery of radiotherapy and systemic anti-cancer therapies, were identified and grouped for analysis where similarities existed either by type of service and/ or cancer type.
Total monthly services for these ‘analysis groups’ reimbursed through the MBS during the months January to June 2020 were examined to determine if reductions were apparent during the initial COVID-19 period. To allow for seasonal changes and normal monthly variation, corresponding historical data were also examined. The scope and scale of changes in services was determined, including any subsequent recovery to pre-COVID-19 monthly totals.
Results
Analyses showed notable reductions in total monthly services for a range of both diagnostic and therapeutic procedures during the COVID-19 period across a number of cancer types including breast, colorectal, prostate and skin cancers.
Key trends observed were reductions in numbers of monthly services between March and April for diagnostic procedures. This compared with surgical treatment procedures where the largest decreases were more frequently observed between April and May. Monthly services showed an initial recovery, with many groups showing full recovery in service numbers by June 2020.
Conclusion
During the initial phase of the COVID-19 pandemic, impacts on cancer-related services have been significant. Reductions in diagnostic and treatment procedures may ultimately lead to later presentation at diagnosis, increased requirements for interventions and overall changes in outcomes such as recurrence and survival.