Cancers are still cancers during a pandemic, so charities, the Government and the NHS, need to work together to ensure patients still get the urgent treatment they need.
Wednesday, April 29, 2020

Delays and changes to treatment as a result of the COVID-19 emergency in England could result in at least 20% more deaths over the next 12 months in people who have been newly diagnosed with cancer. Sarcoma UK describe the analysis as 'extremely distressing' and call for charities, Government and the NHS to 'work together to ensure patients still get the urgent treatment they need'.

The UCL study with DATA-CAN: The Health Data Research Hub for Cancer in the UK, published today as a preprint, is the first to focus on the impact of the emergency on mortality rates in people with cancer and uses data from the health records of over 3.5 million patients in England.

The study estimates that pre-COVID-19, about 31,354 newly diagnosed cancer patients would die within a year in England. As a result of the emergency, there could be at least 6,270 additional deaths in newly diagnosed cancer patients alone. This number could rise to an estimated 17,915 additional deaths if all people currently living with cancer are considered.

The researchers analysed recent weekly data from major cancer centres in the UK and found a 76% decrease in urgent referrals from GPs for people with suspected cancers and a 60% decrease in chemotherapy appointments for cancer patients compared to pre-COVID-19 levels.

The researchers analysed recent weekly data from major cancer centres in the UK and found a 76% decrease in urgent referrals from GPs for people with suspected cancers and a 60% decrease in chemotherapy appointments for cancer patients compared to pre-COVID-19 levels.

The paper also models publicly available US data and shows an additional 33,890 deaths in the US in newly diagnosed cancer patients over the next year. The study estimates that pre-COVID-19, about 169,433 newly diagnosed cancer patients would die within a year in the US.

Senior author Professor Harry Hemingway, (Director, UCL Institute of Health Informatics), added: 'The overall impact of the COVID-19 emergency on deaths in cancer patients could be substantial. There are many factors operating here including rapid changes to diagnosis and treatment protocols, social distancing measures, changes in people’s behaviour in seeking medical attention and the economic impact of COVID-19, as well as deaths due to COVID-19 infection.'

Professor Mark Lawler (Queen’s University Belfast and Scientific Lead DATA-CAN) said: 'We applied our model to new cancers in the UK and the US, using publicly available data. The results are concerning. We believe countries need to rapidly understand how the emergency is affecting cancer outcomes, otherwise we risk adding cancer and other underlying health conditions to the escalating death toll of the COVID-19 pandemic.'

This research provides a comprehensive picture of how people living with a range of different cancers are affected by other often treatable long-term conditions including cardiovascular disease, hypertension, obesity and diabetes. Nearly eight out of ten of the additional deaths in people with cancer are estimated to occur in people with one or more of these long-term conditions.

Lead author, Dr Alvina Lai (UCL Institute of Health Informatics) said: 'Our findings demonstrate the serious potential for unintended consequences of the response to the COVID-19 pandemic, which may negatively impact on patients with cancer and other underlying health conditions. It is vital that these patients are recognised as being vulnerable and that their care is managed appropriately'.

Dr Charlie Davie (DATA-CAN Hub Director), said: 'Our study highlights the value of bringing together data from multiple sources to enable researchers, health systems and policy makers to improve cancer management for our patients, both during and after this pandemic.'

Pete Wheatstone, a patient and a member of the Public and Patient Involvement and Engagement group of DATA-CAN added: 'This research demonstrates the value to cancer patients, the wider public and decision-makers when trusted professionals use our patient data to help decide the best course of action. It also highlights the urgent need to be able to analyse these data quickly and accurately to inform and influence current events.'

The researchers say it is crucial for weekly national data on mortality and cancer services activity to be made available urgently, to enable better understanding of which disease combinations pose the greatest risk to life and inform how health services should be prioritised, both now and in the near future, in order to give patients the best possible life chances.

Richard Davidson, Chief Executive of national bone and soft tissue cancer charity Sarcoma UK, says:

'This is extremely distressing to hear about the potential number of excess deaths of cancer patients that are a result of delays and changes to treatment caused by COVID-19.

'Any large drop in admissions for chemotherapy, in addition to the 76% drop in urgent referrals from GPs we’ve seen reported last week, makes for grim reading, especially for any cancer like sarcoma where treatments are already limited and chemotherapy is crucial to managing the illness.

'We always knew COVID-19 would have an impact on cancer patients. The emerging picture we’re getting now, with the predicted spike in cancer deaths in England in the thousands, should be a warning we sit up and take notice of. 

'As a national cancer charity, we know how difficult and confusing these times are for cancer patients and healthcare professionals. Let’s not add to that. Cancers are still cancers during a pandemic, so charities, the Government and the NHS, need to work together to make sure patients still get the urgent treatment they need.'

The Sarcoma UK Support Line specialists are here for every person affected by sarcoma. Talk to us, email or text for information and support.