Best of the Best Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2020

Impact of COVID-19 on Cancer Service Delivery; Results from an International Survey of Oncology Clinicians (#86)

Grace Chazan 1 , Fanny Franchini 2 3 4 , Marliese Alexander 1 5 , Susana Banerjee 6 7 , Linda Mileshkin 1 8 , Prunella Blinman 9 10 , Rob Zielinski 11 12 , Deme Karikios 13 14 , Nick Pavlakis 15 , Solange Peters 16 , Florian Lordick 17 , David Ball 1 18 , Gavin Wright 19 20 21 , Maarten IJzerman 2 4 22 , Ben Solomon 1 8
  1. Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
  2. Centre for Cancer Research and Centre for Health Policy, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
  3. Melbourne School of Public and Global Health, Faculty of Medicine, Dentistry and Health Sciences, Parkville, Victoria, Australia
  4. Department of Cancer Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  5. Pharmacy Department, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
  6. Gynaecology Unit, The Royal Marsden NHS Foundation Trust, London, United Kingdom
  7. Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
  8. Medical Oncology , Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
  9. Faculty of Medicine , University of Sydney, Sydney, New South Wales, Australia
  10. Medical Oncology , Concord Repatriation General Hospital , Concord, New South Wales, Australia
  11. Medical Oncology , Western Sydney University, Sydney, New South Wales, Australia
  12. Medical Oncology , Orange Hospital, Western New South Wales Local Health District , Orange, New South Wales, Australia
  13. Medical Oncology , Nepean Hospital, Sydney, Victoria, Australia
  14. Nepean Clinical School , University of Sydney, Sydney, New South Wales, Australia
  15. Medical Oncology , Royal North Shore Hospital, Sydney, New South Wales, Australia
  16. Medical Oncology , Lausanne University Hospital CHUV, Lausanne, Switzerland
  17. University Cancer Center Leipzig, University Medicine Leipzig, Leipzig, Germany
  18. Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
  19. St Vincent's Hospital, Victorian Comprehensive Cancer Centre, Fitzroy, Victoria , Australia
  20. Surgery , Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
  21. Department of Surgery , University of Melbourne, Parkville, Victoria, Australia
  22. University of Twente, Health Technology & Services Research, Enschede, Netherlands

OBJECTIVES To report clinician perceived changes to cancer service delivery in response to the Coronavirus Disease of 2019 (COVID-19).

DESIGN Multidisciplinary clinician survey in collaboration with (alphabetical) COSA, ESMO, MOGA, RACS and RANZCR.

SETTING Between May and June 2020 clinicians from 70 countries were surveyed; majority from Europe (39%) with 1877 confirmed COVID-19 cases per million people, Australia (AUS)/New Zealand(NZ) (38%) with 236/268 per million and Asia (15%) with 125 per million at survey distribution.  

PARTICIPANTS Medical oncologists (372/74%), radiation oncologists (91/18%) and surgical oncologists (38/8%).

RESULTS Eighty-nine percent of clinicians reported altering clinical practices; more commonly among those with versus without patients diagnosed with COVID-19 (142/93% vs 225/86%, p=0.027) but regardless of community transmission levels (p=0.260). More European clinicians (66%) had treated patients diagnosed with COVID-19 compared to Asia (28%) and AUS/NZ (5%), p<0.001. Many clinicians (71%) reported that reduced access to standard treatments during the pandemic would negatively impact cancer survival. Telehealth utilisation increased 3.8-fold in Asia, 7.2-fold in Europe and 11.8-fold in AUS/NZ and 25% of clinicians reported patient survival would be worse due to this. 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 53% of clinicians. 

CONCLUSION Clinicians reported wide-spread 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 changes of relevance for healthcare delivery at large.