Oncological surgeries in Brazil during the COVID-19 pandemic: an epidemiological, cross-sectional, descriptive study

Abstract

BackgroundThe COVID-19 pandemic has affected health-care systems worldwide. Elective procedures, including cancer surgeries, were suspended in most hospitals in consequence of the need to prioritise emergencies and to reduce the risk of transmission of the SARS-CoV-2 virus. The objective of this work was to understand the variation in the number of cancer surgeries after the partial suspension of these services in Brazil during the pandemic.MethodsFor this epidemiological, cross-sectional, descriptive study, data on the number of patients admitted to hospital were collected from the oncology panel of the Department of Informatics of the Brazilian Unified Health System, known as Datasus, in December, 2021. The following criteria were used: records dated Jan 1, 2016, to July 31, 2021; location of the treatment federative unit (all Brazilian states); total number of procedures (surgeries) done; and number of procedures done at each centre. Data were tabulated on Microsoft Excel 2019.Findings1 255 451 oncological surgical procedures were done in the public health facilities in Brazil between Jan 1, 2016, and July 31, 2021, corresponding to an annual average of 50 218 surgeries. An increase of 22% was observed from 2016 (124 807 oncological surgeries) to 2021 (152 470 surgeries). The mean ratio of oncological surgeries was 9·98 procedures per 10 000 inhabitants per year. The southern region of Brazil, which includes the states of Rio Grande do Sul, Paraná, and Santa Catarina, had the highest rate of oncological surgeries (11·71 surgeries per 10 000 inhabitants in 2021), whereas the northern region, composed by the states of Maranhão, Piauí, Ceará, Rio Grande do Norte, Paraíba, Pernambuco, Alagoas, Sergipe, and Bahia, had the lowest (3·28 surgeries per 10 000 inhabitants in 2021). A difference was also noticed in 2020, when the southern region recorded a ratio of 22·51 surgeries per 10 000 inhabitants whereas the northern region recorded only 5·87 surgeries per 10 000 inhabitants.InterpretationBecause of the need to reorganise hospital flow to meet the demands of the COVID-19 pandemic, the number of oncological surgeries in Brazil in 2021 was the lowest of the past 6 years (2015–21). Although the number of surgical procedures for patients with cancer started to decline in 2020, the change was more pronounced in the following year, as changes in hospital procedures were done throughout 2020 due to the sudden emergence of the pandemic. The discrepancy in the numbers between the regions of the country, especially the northern and southern regions, also highlights disparities in the organisational capacity of the public system in each region during 2020 and 2021. The sudden and substantial reduction in the number of oncological surgeries performed in this period might result in a national health-care system overloaded with patients with advanced stages of cancer.FundingNone.