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The majority of patients who have cancer or are suspected of having cancer do not access health services in the United Kingdom or the United States because of the COVID-19 pandemic, the first report of an estimated species.
As a result, there will be an excess of deaths among patients suffering from cancer and some comorbidities in both countries during the current coronavirus emergency, the report warns.
The authors calculated that there would be 6270 excess deaths among cancer patients 1 year from now in the UK and 33,890 deaths among cancer patients in the United States. (In the United States, estimates of the number of excess deaths only apply to patients older than 40 years, they note.)
“The underlying underlying cause of this excess death may be due to cancer, COVID-19 or comorbidities (such as myocardial infarction),” Alvina Lai, PhD, University College London, England, and colleagues observed.
“Our data have highlighted how cancer patients with multimorbidity are a very risk group during the current pandemic,” they stressed.
That research was published at ResearchGate as a preprint and has not yet undergone peer review.
Comment on the study of UK Science Media Center, some experts stressed the lack of peer review, noting that this interpretation of data needs to be further refined based on these inputs. One expert suggested that there was “substantial uncertainty that this paper did not communicate enough.” But others argue that this topic is important enough to guarantee the initial release of data.
Chris Bunce, PhD, University of Birmingham, UK, said the research represented “an invaluable contribution.”
“It is universally accepted that early diagnosis and treatment and adherence to treatment regimens save lives,” he said.
“Therefore, the impact related to COVID-19 will cause casualties,” Bunce said.
“And if this information is to influence cancer care and guide policy during the COVID-19 crisis, it is important that the findings are disseminated and discussed immediately, guaranteeing their release in front of the peers’ views,” he added.
In England Medscape comment, oncologist Karol Sikora, MD, PhD, believes that “restarting cancer services cannot come soon.”
“Estimated Numeric Number Estimates”
“It is well known that there have been many changes in the provision of health care for many conditions, including cancer, as a result of all measures to deal with the COVID-19 crisis,” said Kevin McConway, PhD, emeritus professor of applied fields. statistics, Open University, Milton Keynes, United Kingdom.
“It seems inevitable that there will be an increase in deaths in cancer patients if they are infected with a virus or because of changes in the health services available to them, and very possibly also from the socioeconomic effects of the response to the crisis,” he said. continue.
“This study is the first that I have seen that yields a fairly debatable numerical estimate of the number of excess deaths of people with cancer arising from these factors in the United Kingdom and the United States,” he added.
Declining Urgent Reference and the Presence of Chemo
For this study, the team used DATA-CAN, the UK National Center for Health Data Research for Cancer, to assess weekly returns for urgent cancer referrals for early diagnosis and also the presence of chemotherapy for hospitals in Leeds, London and Northern Ireland going back to 2018.
The data reveal that there is a large decrease in the presence of chemotherapy. On average there was a 60% reduction in the prandemic level in eight hospitals in the three regions assessed.
Urgent cancer referrals have fallen by an average of 76% compared to prandemic levels in the three regions.
On the conservative assumption that the COVID-19 pandemic will only affect patients with newly diagnosed cancers (incident cases), the researchers estimate that the proportion of the population affected by an emergency (PAE) is 40% and that the relative impact of an emergency. (RIE) is 1.5.
PAE is a summary measure of exposure to adverse health consequences of emergencies; RIE is a summary measure of the combined impact on infection deaths, changes in health care, physical distance, and economic decline, the authors explain.
“Comorbidity is common in people with cancer,” the study authors wrote. For example, more than a quarter of the study population has at least one comorbidity; more than 14% have two.
For incident cancer, the number of excess deaths continues to increase along with the increase in the number of comorbidities, so that more than 80% of deaths occur in patients with one or more comorbidities.
“When considering the prevalent cancer and the joint incidence with COVID-19 PAE by 40%, we estimate 17,991 excess deaths at RIE 1.5; 78.1% of these deaths occur in patients with comorbidities ≥1,” the authors report.
“The excess risk of death in people living with cancer during COVID-19 emergencies may not only be caused by COVID-19 infection, but also due to unintended health consequences of changes in health service provision, physical or psychological effects from social distance, and economic upheaval, “they declared.
“This is the first study to show recent major changes in the delivery of cancer care at several centers,” the authors observed.
Lai did not disclose relevant financial relationships. Several joint authors have a variety of relationships with industry, as stated in their articles. The commentators did not disclose the relevant financial relationships.
This study is available for download from ResearchGate website.
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