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.