The Profile of the Oncological Refugee Patient from Ukraine ― Single Institution Experience

Abstract

The aim of the study was to assess the patient's profile according to the ICD-10 code and the cancer pathway, with particular emphasis on the use of radiotherapy (RT). Due to the outbreak of war in Ukraine on February 24, 2022 and the influx of refugees to Poland, including patients (pts) with suspected or diagnosed cancer or during oncological treatment, actions were taken to coordinate care for this group of pts. At the request of the National Health Fund and the Association of Public Oncology Centers, an ONCOHOTLINE was launched and further activities were coordinated by the National Health Fund and the National Institute of Public Health NIH - National Research Institute. A refugee coordinator was appointed in each voivodeship. All oncology centers were obliged to send once a week to the Refugee Coordinator in a given voivodeship schedules regarding free dates in their clinics according to diagnoses, patient admission hours, location of a given clinic. Pts were registered in accordance with the queue for Polish citizens, with particular emphasis on the urgent mode for pts during treatment, whose treatment was interrupted due to the ongoing war in Ukraine. The records of pts are kept based on the following categories: date of border crossing, date of admission to the treatment center, ICD-10 code, reason for hospitalization, additional information. The official list of pts - refugees from Ukraine admitted to Lower Silesian Oncology, Hematology and Pulmonology Center in Wroclaw (DCOPiH) - was analyzed. From March 14, 2022 to February 10, 2023 149 refugees from Ukraine were admitted to DCOPiH - 105 women, 44 men; the average age was 56 (SD 16). Among the refugees 107 cancer pts were identified - 74 women, 33 men; average age 54 (SD 14). The profile of diagnoses according to the clinical classification code was: C50 - 22, C34 - 10, C53 - 10, C18 - 8, C16 - 7, C92 - 6, C20 - 5, C90 - 4, C56 - 4, C54 - 4, C61- 3, C91- 3, C85 - 3, C43 - 2, C49 - 2; 13 with single diagnoses: C38, C19, C62, C95, C11, C09, C08, C81, C12, C67, C71, C51. 28 of 107 pts required RT - 19 women, 9 men; mean age 52 (SD 15). 21 pts - 75% of the total received definitive RT and respectively 7 (25%) palliative. The collected data was collated with the total number of pts treated with RT in DCOPiH in this period. 7 pts diagnosed with C50 underwent adjuvant definitive RT after breast conserving surgery (another 10 are during RT planning), which was 1,8 % of pts with C50 and RT; respectively for C53 - 10 pts which was 13,7 % and for C61 - 3 pts, which was 0,8 %. Despite a small group of refugees from Ukraine treated with RT, % of pts diagnosed with cervical cancer is significant, the most common cancer among women is breast cancer and it is consistent with the worldwide profile of cancers and so the intention of treatment. The centrally adopted coordination solutions made it possible to distribute pts to many oncology centers. Granting full reimbursement rights and Personal ID Number implement to obtain a full range of services for each Ukrainian patient.