COVID-19 related delays to cancer treatment could cost thousands of lives, research shows

Scientists at the Institute of Cancer Research (ICR) are warning that delays to cancer surgery and other treatment caused by the COVID-19 pandemic could be linked to thousands of additional deaths in England.

Cancer patients could face delays of several months to their treatment in the wake of the pandemic, including in operations to remove tumours. Those whose cancer will have progressed during the delay and who might otherwise have been cured by surgery could now be at risk of their cancer returning and shortening survival.

Scientists at The ICR analysed existing Public Health England data on delays to cancer surgery on patients’ five-year survival rates to estimate the effect of three-month or six-month delays, respectively.

Their modelling, which took into account the risk of hospital-acquired COVID-19-infection, showed “dramatic differences in the impact of delay on cancer survival depending on patients’ age, their cancer type and whether it was earlier- or later-stage cancer”, the Institute said.

According to the team's findings, a delay of three months across all 94,912 patients who would have had surgery to remove their cancer over the course of a year would lead to an additional 4,755 deaths. Accounting for the length of time that patients are expected to live after surgery, the delay would amount to 92,214 years of life lost.

The researchers estimated that surgery for cancer affords on average 18.1 life years per patient, of which on average 1.0 years are lost for a three-month delay or 2.2 years are lost with a six-month delay. 'Considering healthcare resource more broadly, they compared this with hospital treatment for COVID-19, from which on average 5.1 life years were currently gained per patient.', the ICR noted.

“The Covid-19 crisis has put enormous pressure on the NHS at every stage of the cancer pathway, from diagnosis right across to surgery and other forms of treatment. Our study shows the impact that delay to cancer treatment will have on patients, with England, and the UK more widely, potentially set for many thousands of attributable cancer deaths as a result of the pandemic,” said study leader Professor Clare Turnbull, Professor of Cancer Genomics at The Institute of Cancer Research, London, and consultant clinician at The Royal Marsden NHS Foundation Trust.

“Our findings should help policymakers and clinicians make evidence-based decisions as we continue deal with the effects of the pandemic on other areas of medicine. We have to ensure that both patients with COVID-19 and also those with cancer get the best possible care. That means finding ways for the NHS to get back to normal service on cancer diagnostics and surgery as soon as possible, prioritising certain cancer types in particular.”

The new study, published in Annals of Oncology, was funded by The ICR with support from Cancer Research UK.