Cancer won’t wait for COVID-19 to end

COVID-19 is thought to be the first disease in the modern era to disrupt cancer services in Australia as fears over coronavirus turned people away from check-ups and surgery.

At its height the pandemic drastically reduced cancer services with the effects still being felt in June, according to the first national report by Cancer Australia.

Released on Monday night, the report showed some services for skin, breast and colorectal cancer dropped between 16 per cent to 57 per cent.

Authorities had to be sure the health system could cope with the predicted, potentially large surge in COVID-19 cases, said Professor Dorothy Keefe, CEO of Cancer Australia.

“While no one ever said 'Don’t go to hospital', the messaging in seeing doctors and nurses in full PPEs was off-putting," she said, referring to personal protective equipment.

"Also, GP clinics, reluctant to see people face-to-face, switched to telehealth and the message people got was to stay away. This combined with the lockdown and [the message to] not get too close to others.”

The report's authors had expected the impact from the pandemic would appear from March and they were correct.

Their report, which covers the first wave, ends in June, by which time there had been some, but not uniform, recovery in the provision of cancer services. An analysis for July and August is pending.

“Cancer can’t and won’t wait”, said Professor Keefe. “Our biggest concern is that any potential delays in investigations may lead to more advanced stages of cancer at diagnosis and poorer outcomes.

“We urge people not to delay following up on symptoms and to see their doctor if they find a change to their bodies which is unusual for them.”

To help identify such changes, Cancer Australia has launched a new interactive body map that shows symptoms of the most common cancers in different parts of the body.

In another COVID-19 initiative it has released a video, "Cancer Won’t Wait".

Healthcare professionals had noticed reductions in cancer services this year and to get a fix on this, Cancer Australia investigated Medicare Benefits Schedule claims. To understand seasonal variation, data was compared with the equivalent period in 2019.

While all cancers were likely affected, the report concentrated on three common cancers because, through them, trends would be seen very quickly.

“We wanted to check if this effect was real," Professor Keefe said. “With every subsequent wave there is the potential for this to happen again.”

The report found a notable reduction in diagnostic procedures during March to May. Colorectal cancer, which is investigated with colonoscopies, sigmoidoscopies and the removal of polyps, was considered a particularly high risk for the COVID-19 period.

Although early diagnosis makes a seriously significant difference for this cancer, investigations in April were half of those in March. While they increased in May and June, they remained lower than March.

With breast cancer, imaging procedures to detect disease decreased by 37 per cent between March and April.

Surgery was notably lower in May than in March and April for colorectal cancer and for mastectomies, lumpectomies and lymph node procedures for breast cancer.

For skin cancer, surgical and other treatments for basal cell and squamous cell carcinomas decreased 16 to 30 per cent from March to April.

For melanoma, surgical services in May and June were 25 per cent less than in March.

With skin cancers, Professor Keefe said people probably didn’t want to bother their GP, coupled with telehealth consultations being mostly by phone, not video.