Abstract
BACKGROUND: Coronavirus disease 2019 (COVID-19) pandemic has caused disruption of oncology services, but data on actual delays are lacking. We sought to study the delays faced by the cancer patients during the COVID-19 pandemic and the impact of measures carried out to reduce the delays. METHODS: We carried out a review of inpatient and outpatient oncology services from March 15 to June 15, 2020, at our institution. We obtained data on delays in referrals, diagnosis, chemotherapy, and treatment delivery for cancer patients. To examine the delays, patients were assessed in the inpatient and outpatient settings and according to cancer types. RESULTS: A total of 505 patients' events were included in the study, with 136 referral delays, 167 diagnostic delays, 121 chemotherapy delays, and 81 treatment delays. In the outpatient settings, maximum referral delays were faced by breast cancer patients (9.5 ± 3.3 days, range 7–14), followed by hematologic malignancy (hematology) patients (8.4 ± 4.5 days, range 0–14). Maximum diagnosis delay was faced by hematology patients (11.75 ± 5 days, range 0–14), followed by breast cancer patients (11.2 ± 3.4 days, range 7–14). Breast and colorectal cancer patients faced maximum chemotherapy delays (9.5 ± 6.6 days, range 0–14), followed by hematology patients (7.3 ± 6.6 days, range 0–14). In the inpatient setting, maximum diagnosis delays were faced by hematology patients (11 ± 2 days, range 10–14), followed by gastrointestinal cancers (8 ± 2.4 days, range 5–10). Maximum chemotherapy delays were faced by hematology patients (8.5 ± 5.9 days, range 0–14) and breast cancer patients (8 ± 2.4 days, range 5–10). Hematology patients were most affected by treatment-delays (6.75 ± 4.7 days, range 0–10). Comparison of delays during the earlier part of the study with the later part showed that referral delays improved by 3.5 days (P = 0.02), diagnosis delays improved by 6.1 days (P < 0.001), chemotherapy delays improved by 7.7 days (P < 0.001), and treatment delays improved by 8 days (P < 0.001). CONCLUSIONS: COVID-19 pandemic caused delays in the diagnosis and management of most cancer patients. Measures adopted to overcome delays resulted in a significant reduction in delays.
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