The national lockdown in England is likely to result in up to 3621 avoidable cancer-related deaths over the next five years due to diagnostic delays because of the pandemic.
This is the conclusion of a new modelling study by a team from Guy’s and St Thomas’ Trust, London.
The team used the English NHS cancer registry and hospital administrative datasets for patients aged 15-84 years of age, diagnosed with breast, colorectal, oesophageal and lung cancer between January 2010 and December 2012 with follow-up dates to December 2015.
They used a route-to-diagnosis framework to estimate the impact of a diagnostic delay over a 12-month period. For instance, patients who would normally be diagnosed through a screening and routine referral pathway were reallocated to a 2-week-wait and emergency pathway.
In the second scenario, they modelled the effect of an 80% reduction in workload via this pathway (which was already observed as a result of the lockdown) and the third scenario assumed an even longer wait time due to the backlog of cases created by the lockdown. The dataset included a total of over 93,500 patients with the four cancers.
Compared with pre-pandemic figures, they estimated up to 9.6% extra breast cancer deaths up to five years after diagnosis. Together with the other cancers, this was projected to result in between 3291 and 3621 additional deaths over 5 years.
The authors concluded that there was an urgent need for policy interventions to manage the backlog in cases and to mitigate the impact of COVID-19 on patients with cancer.
Maringe C et al. The impact of the COVID-19 pandemic on cancer deaths due to delays in diagnosis in England, UK: a national, population-based modelling study. Lancet Oncol 2020; July 20.