Impact of COVID-19 on cancer service delivery : results from an international survey of oncology clinicians

Grace Chazan; Fanny Franchini; Marliese Alexander; Susana Banerjee; Linda Mileshkin; Prunella Blinman; Rob Zielinski; Deme Karikios; Nick Pavlakis; Solange Peters; Florian Lordick; David Ball; Gavin Wright; Maarten IJzerman; Benjamin Solomon

doi:10.1136/esmoopen-2020-001090

Impact of COVID-19 on cancer service delivery : results from an international survey of oncology clinicians

Grace Chazan, Fanny Franchini, Marliese Alexander, Susana Banerjee, Linda Mileshkin, Prunella Blinman, Rob Zielinski, Deme Karikios, Nick Pavlakis, Solange Peters, Florian Lordick, David Ball, Gavin Wright, Maarten IJzerman, Benjamin Solomon

Research output: Contribution to journal › Article › peer-review

17 Citations (Scopus)

Abstract

Objectives: To report clinician-perceived changes to cancer service delivery in response to COVID-19. Design: Multidisciplinary Australasian cancer clinician survey in collaboration with the European Society of Medical Oncology. Setting: Between May and June 2020 clinicians from 70 countries were surveyed; majority from Europe (n=196; 39%) with 1846 COVID-19 cases per million people, Australia (AUS)/New Zealand (NZ) (n=188; 38%) with 267/236 per million and Asia (n=75; 15%) with 121 per million at time of survey distribution. Participants Medical oncologists (n=372; 74%), radiation oncologists (n=91; 18%) and surgical oncologists (n=38; 8%). Results: Eighty-nine per cent of clinicians reported altering clinical practices; more commonly among those with versus without patients diagnosed with COVID-19 (n=142; 93% vs n=225; 86%, p=0.03) but regardless of community transmission levels (p=0.26). More European clinicians (n=111; 66.1%) had treated patients diagnosed with COVID-19 compared with Asia (n=20; 27.8%) and AUS/NZ (n=8; 4.8%), p<0.001. Many clinicians (n=307; 71.4%) reported concerns that reduced access to standard treatments during the pandemic would negatively impact patient survival. The reported proportion of consultations using telehealth increased by 7.7-fold, with 25.1% (n=108) of clinicians concerned that patient survival would be worse due to this increase. 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 52.6% (n=190) of clinicians. Conclusion: Clinicians reported widespread 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 implications for healthcare delivery at large.

Original language	English
Article number	e001090
Number of pages	8
Journal	ESMO Open
Volume	5
Issue number	6
DOIs	https://doi.org/10.1136/esmoopen-2020-001090
Publication status	Published - 1 Dec 2020

Bibliographical note

Publisher Copyright:
© 2020 Author (s).

Open Access - Access Right Statement

© Author (s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC (https://creativecommons.org/licenses/by-nc/4.0/). No commercial re-use. Published by BMJ on behalf of the European Society for Medical Oncology.

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SDG 3 Good Health and Well-being

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10.1136/esmoopen-2020-001090

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Chazan, G., Franchini, F., Alexander, M., Banerjee, S., Mileshkin, L., Blinman, P., Zielinski, R., Karikios, D., Pavlakis, N., Peters, S., Lordick, F., Ball, D., Wright, G., IJzerman, M., & Solomon, B. (2020). Impact of COVID-19 on cancer service delivery : results from an international survey of oncology clinicians. ESMO Open, 5(6), Article e001090. https://doi.org/10.1136/esmoopen-2020-001090

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title = "Impact of COVID-19 on cancer service delivery : results from an international survey of oncology clinicians",

abstract = "Objectives: To report clinician-perceived changes to cancer service delivery in response to COVID-19. Design: Multidisciplinary Australasian cancer clinician survey in collaboration with the European Society of Medical Oncology. Setting: Between May and June 2020 clinicians from 70 countries were surveyed; majority from Europe (n=196; 39%) with 1846 COVID-19 cases per million people, Australia (AUS)/New Zealand (NZ) (n=188; 38%) with 267/236 per million and Asia (n=75; 15%) with 121 per million at time of survey distribution. Participants Medical oncologists (n=372; 74%), radiation oncologists (n=91; 18%) and surgical oncologists (n=38; 8%). Results: Eighty-nine per cent of clinicians reported altering clinical practices; more commonly among those with versus without patients diagnosed with COVID-19 (n=142; 93% vs n=225; 86%, p=0.03) but regardless of community transmission levels (p=0.26). More European clinicians (n=111; 66.1%) had treated patients diagnosed with COVID-19 compared with Asia (n=20; 27.8%) and AUS/NZ (n=8; 4.8%), p<0.001. Many clinicians (n=307; 71.4%) reported concerns that reduced access to standard treatments during the pandemic would negatively impact patient survival. The reported proportion of consultations using telehealth increased by 7.7-fold, with 25.1% (n=108) of clinicians concerned that patient survival would be worse due to this increase. 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 52.6% (n=190) of clinicians. Conclusion: Clinicians reported widespread 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 implications for healthcare delivery at large.",

author = "Grace Chazan and Fanny Franchini and Marliese Alexander and Susana Banerjee and Linda Mileshkin and Prunella Blinman and Rob Zielinski and Deme Karikios and Nick Pavlakis and Solange Peters and Florian Lordick and David Ball and Gavin Wright and Maarten IJzerman and Benjamin Solomon",

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Chazan, G, Franchini, F, Alexander, M, Banerjee, S, Mileshkin, L, Blinman, P, Zielinski, R, Karikios, D, Pavlakis, N, Peters, S, Lordick, F, Ball, D, Wright, G, IJzerman, M & Solomon, B 2020, 'Impact of COVID-19 on cancer service delivery : results from an international survey of oncology clinicians', ESMO Open, vol. 5, no. 6, e001090. https://doi.org/10.1136/esmoopen-2020-001090

TY - JOUR

T1 - Impact of COVID-19 on cancer service delivery : results from an international survey of oncology clinicians

AU - Chazan, Grace

AU - Franchini, Fanny

AU - Alexander, Marliese

AU - Banerjee, Susana

AU - Mileshkin, Linda

AU - Blinman, Prunella

AU - Zielinski, Rob

AU - Karikios, Deme

AU - Pavlakis, Nick

AU - Peters, Solange

AU - Lordick, Florian

AU - Ball, David

AU - Wright, Gavin

AU - IJzerman, Maarten

AU - Solomon, Benjamin

PY - 2020/12/1

Y1 - 2020/12/1

N2 - Objectives: To report clinician-perceived changes to cancer service delivery in response to COVID-19. Design: Multidisciplinary Australasian cancer clinician survey in collaboration with the European Society of Medical Oncology. Setting: Between May and June 2020 clinicians from 70 countries were surveyed; majority from Europe (n=196; 39%) with 1846 COVID-19 cases per million people, Australia (AUS)/New Zealand (NZ) (n=188; 38%) with 267/236 per million and Asia (n=75; 15%) with 121 per million at time of survey distribution. Participants Medical oncologists (n=372; 74%), radiation oncologists (n=91; 18%) and surgical oncologists (n=38; 8%). Results: Eighty-nine per cent of clinicians reported altering clinical practices; more commonly among those with versus without patients diagnosed with COVID-19 (n=142; 93% vs n=225; 86%, p=0.03) but regardless of community transmission levels (p=0.26). More European clinicians (n=111; 66.1%) had treated patients diagnosed with COVID-19 compared with Asia (n=20; 27.8%) and AUS/NZ (n=8; 4.8%), p<0.001. Many clinicians (n=307; 71.4%) reported concerns that reduced access to standard treatments during the pandemic would negatively impact patient survival. The reported proportion of consultations using telehealth increased by 7.7-fold, with 25.1% (n=108) of clinicians concerned that patient survival would be worse due to this increase. 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 52.6% (n=190) of clinicians. Conclusion: Clinicians reported widespread 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 implications for healthcare delivery at large.

AB - Objectives: To report clinician-perceived changes to cancer service delivery in response to COVID-19. Design: Multidisciplinary Australasian cancer clinician survey in collaboration with the European Society of Medical Oncology. Setting: Between May and June 2020 clinicians from 70 countries were surveyed; majority from Europe (n=196; 39%) with 1846 COVID-19 cases per million people, Australia (AUS)/New Zealand (NZ) (n=188; 38%) with 267/236 per million and Asia (n=75; 15%) with 121 per million at time of survey distribution. Participants Medical oncologists (n=372; 74%), radiation oncologists (n=91; 18%) and surgical oncologists (n=38; 8%). Results: Eighty-nine per cent of clinicians reported altering clinical practices; more commonly among those with versus without patients diagnosed with COVID-19 (n=142; 93% vs n=225; 86%, p=0.03) but regardless of community transmission levels (p=0.26). More European clinicians (n=111; 66.1%) had treated patients diagnosed with COVID-19 compared with Asia (n=20; 27.8%) and AUS/NZ (n=8; 4.8%), p<0.001. Many clinicians (n=307; 71.4%) reported concerns that reduced access to standard treatments during the pandemic would negatively impact patient survival. The reported proportion of consultations using telehealth increased by 7.7-fold, with 25.1% (n=108) of clinicians concerned that patient survival would be worse due to this increase. 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 52.6% (n=190) of clinicians. Conclusion: Clinicians reported widespread 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 implications for healthcare delivery at large.

UR - https://hdl.handle.net/1959.7/uws:60338

U2 - 10.1136/esmoopen-2020-001090

DO - 10.1136/esmoopen-2020-001090

M3 - Article

C2 - 33262203

SN - 2059-7029

VL - 5

JO - ESMO Open

JF - ESMO Open

IS - 6

M1 - e001090

ER -

Impact of COVID-19 on cancer service delivery : results from an international survey of oncology clinicians

Abstract

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UN SDGs

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