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The impact of the COVID-19 pandemic on cancer diagnosis and service access in New Zealand–a country pursuing COVID-19 elimination
BACKGROUND: The COVID-19 pandemic has disrupted cancer services globally. New Zealand has pursued an elimination strategy to COVID-19, reducing (but not eliminating) this disruption. Early in the pandemic, our national Cancer Control Agency (Te Aho o Te Kahu) began monitoring and reporting on servic...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7983868/ https://www.ncbi.nlm.nih.gov/pubmed/33778794 http://dx.doi.org/10.1016/j.lanwpc.2021.100127 |
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author | Gurney, Jason K. Millar, Elinor Dunn, Alex Pirie, Ruth Mako, Michelle Manderson, John Hardie, Claire Jackson, Chris G.C.A. North, Richard Ruka, Myra Scott, Nina Sarfati, Diana |
author_facet | Gurney, Jason K. Millar, Elinor Dunn, Alex Pirie, Ruth Mako, Michelle Manderson, John Hardie, Claire Jackson, Chris G.C.A. North, Richard Ruka, Myra Scott, Nina Sarfati, Diana |
author_sort | Gurney, Jason K. |
collection | PubMed |
description | BACKGROUND: The COVID-19 pandemic has disrupted cancer services globally. New Zealand has pursued an elimination strategy to COVID-19, reducing (but not eliminating) this disruption. Early in the pandemic, our national Cancer Control Agency (Te Aho o Te Kahu) began monitoring and reporting on service access to inform national and regional decision-making. In this manuscript we use high-quality, national-level data to describe changes in cancer registrations, diagnosis and treatment over the course of New Zealand's response to COVID-19. METHODS: Data were sourced (2018–2020) from national collections, including cancer registrations, inpatient hospitalisations and outpatient events. Cancer registrations, diagnostic testing (gastrointestinal endoscopy), surgery (colorectal, lung and prostate surgeries), medical oncology access (first specialist appointments [FSAs] and intravenous chemotherapy attendances) and radiation oncology access (FSAs and megavoltage attendances) were extracted. Descriptive analyses of count data were performed, stratified by ethnicity (Indigenous Māori, Pacific Island, non-Māori/non-Pacific). FINDINGS: Compared to 2018–2019, there was a 40% decline in cancer registrations during New Zealand's national shutdown in March-April 2020, increasing back to pre-shutdown levels over subsequent months. While there was a sharp decline in endoscopies, pre-shutdown volumes were achieved again by August. The impact on cancer surgery and medical oncology has been minimal, but there has been an 8% year-to-date decrease in radiation therapy attendances. With the exception of lung cancer, there is no evidence that existing inequities in service access between ethnic groups have been exacerbated by COVID-19. INTERPRETATION: The impact of COVID-19 on cancer care in New Zealand has been largely mitigated. The New Zealand experience may provide other agencies or organisations with a sense of the impact of the COVID-19 pandemic on cancer services within a country that has actively pursued elimination of COVID-19. FUNDING: Data were provided by New Zealand's Ministry of Health, and analyses completed by Te Aho o Te Kahu staff. |
format | Online Article Text |
id | pubmed-7983868 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-79838682021-03-23 The impact of the COVID-19 pandemic on cancer diagnosis and service access in New Zealand–a country pursuing COVID-19 elimination Gurney, Jason K. Millar, Elinor Dunn, Alex Pirie, Ruth Mako, Michelle Manderson, John Hardie, Claire Jackson, Chris G.C.A. North, Richard Ruka, Myra Scott, Nina Sarfati, Diana Lancet Reg Health West Pac Research Paper BACKGROUND: The COVID-19 pandemic has disrupted cancer services globally. New Zealand has pursued an elimination strategy to COVID-19, reducing (but not eliminating) this disruption. Early in the pandemic, our national Cancer Control Agency (Te Aho o Te Kahu) began monitoring and reporting on service access to inform national and regional decision-making. In this manuscript we use high-quality, national-level data to describe changes in cancer registrations, diagnosis and treatment over the course of New Zealand's response to COVID-19. METHODS: Data were sourced (2018–2020) from national collections, including cancer registrations, inpatient hospitalisations and outpatient events. Cancer registrations, diagnostic testing (gastrointestinal endoscopy), surgery (colorectal, lung and prostate surgeries), medical oncology access (first specialist appointments [FSAs] and intravenous chemotherapy attendances) and radiation oncology access (FSAs and megavoltage attendances) were extracted. Descriptive analyses of count data were performed, stratified by ethnicity (Indigenous Māori, Pacific Island, non-Māori/non-Pacific). FINDINGS: Compared to 2018–2019, there was a 40% decline in cancer registrations during New Zealand's national shutdown in March-April 2020, increasing back to pre-shutdown levels over subsequent months. While there was a sharp decline in endoscopies, pre-shutdown volumes were achieved again by August. The impact on cancer surgery and medical oncology has been minimal, but there has been an 8% year-to-date decrease in radiation therapy attendances. With the exception of lung cancer, there is no evidence that existing inequities in service access between ethnic groups have been exacerbated by COVID-19. INTERPRETATION: The impact of COVID-19 on cancer care in New Zealand has been largely mitigated. The New Zealand experience may provide other agencies or organisations with a sense of the impact of the COVID-19 pandemic on cancer services within a country that has actively pursued elimination of COVID-19. FUNDING: Data were provided by New Zealand's Ministry of Health, and analyses completed by Te Aho o Te Kahu staff. Elsevier 2021-03-22 /pmc/articles/PMC7983868/ /pubmed/33778794 http://dx.doi.org/10.1016/j.lanwpc.2021.100127 Text en © 2021 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Research Paper Gurney, Jason K. Millar, Elinor Dunn, Alex Pirie, Ruth Mako, Michelle Manderson, John Hardie, Claire Jackson, Chris G.C.A. North, Richard Ruka, Myra Scott, Nina Sarfati, Diana The impact of the COVID-19 pandemic on cancer diagnosis and service access in New Zealand–a country pursuing COVID-19 elimination |
title | The impact of the COVID-19 pandemic on cancer diagnosis and service access in New Zealand–a country pursuing COVID-19 elimination |
title_full | The impact of the COVID-19 pandemic on cancer diagnosis and service access in New Zealand–a country pursuing COVID-19 elimination |
title_fullStr | The impact of the COVID-19 pandemic on cancer diagnosis and service access in New Zealand–a country pursuing COVID-19 elimination |
title_full_unstemmed | The impact of the COVID-19 pandemic on cancer diagnosis and service access in New Zealand–a country pursuing COVID-19 elimination |
title_short | The impact of the COVID-19 pandemic on cancer diagnosis and service access in New Zealand–a country pursuing COVID-19 elimination |
title_sort | impact of the covid-19 pandemic on cancer diagnosis and service access in new zealand–a country pursuing covid-19 elimination |
topic | Research Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7983868/ https://www.ncbi.nlm.nih.gov/pubmed/33778794 http://dx.doi.org/10.1016/j.lanwpc.2021.100127 |
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