Pandemic-related cancer surgery slowdowns may lead to shorter life spans for patients: Ontario study

Pandemic-related slowdowns of cancer surgeries may result in shorter survival rates for patients with cancer, according to a new modelling study published in CMAJ (Canadian Medical Association Journal). https://www.cmaj.ca/lookup/doi/10.1503/cmaj.202380

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In March 2020, the number of cancer surgeries and other elective surgeries was reduced to allow Ontario's health system to respond to the pandemic, which led to a backlog of procedures and longer waits.

Based on real-world population data on cancer care in 2019 and 2020, researchers simulated models on patients awaiting cancer surgery in Ontario before and during the first six months of the pandemic. The study included patients with breast, gastrointestinal, genitourinary, gynecological, head and neck, and lung cancers. The aim of the study was to understand the long-term and unintended consequences of these surgery delays on survival for patients in Ontario.

With simulated surgical slowdowns that reflected the surgical volumes in Ontario within the first six months of the pandemic, there were 843 life-years lost across the province's cancer population. The largest proportion of life-years lost was in patients with nonprostate genitourinary, gastrointestinal and head and neck cancers, which are known to have a high risk of death.

"Although our model was a simplification of the diverse disease trajectories, the notable differences in survival by disease site suggest a need for measures of surgical prioritization during pandemic-related slowdowns," writes Dr. Kelvin Chan, the senior author of this study and a medical oncologist, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, with coauthors.

"Balancing poorer oncologic outcomes in patients with cancer with the overall goals of a health care system need to be considered, and future models should incorporate noncancer surgeries, as well as account for the system's ability to manage a surge from a human and physical resource perspective," the authors write.

The study adds to the growing body of evidence examining the unintended consequences of the pandemic on patients with cancer.

"These results highlight the importance of data-driven strategies to prioritize cancer surgery during times of surgical resource constraint," the authors write.

"Impact of cancer surgery slowdowns on patient survival during the COVID-19 pandemic: a microsimulation modelling study" is published March 21, 2022.