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Changes in systemic cancer therapy in Australia during the COVID-19 pandemic: a population-based study

BACKGROUND: Since the emergence of COVID-19 there have been increasing global concerns about delays and/or discontinuations in cancer care. However, it is unclear to what extent systemic cancer therapy was impacted by COVID-19 in countries with relatively low COVID-19 infection rates. We examined ch...

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Autores principales: Tang, Monica, Daniels, Benjamin, Aslam, Maria, Schaffer, Andrea, Pearson, Sallie-Anne
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8329989/
https://www.ncbi.nlm.nih.gov/pubmed/34368796
http://dx.doi.org/10.1016/j.lanwpc.2021.100226
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author Tang, Monica
Daniels, Benjamin
Aslam, Maria
Schaffer, Andrea
Pearson, Sallie-Anne
author_facet Tang, Monica
Daniels, Benjamin
Aslam, Maria
Schaffer, Andrea
Pearson, Sallie-Anne
author_sort Tang, Monica
collection PubMed
description BACKGROUND: Since the emergence of COVID-19 there have been increasing global concerns about delays and/or discontinuations in cancer care. However, it is unclear to what extent systemic cancer therapy was impacted by COVID-19 in countries with relatively low COVID-19 infection rates. We examined changes in systemic cancer therapy in Australia during the COVID-19 pandemic. METHODS: We conducted a national observational study using de-identified records of government-subsidised cancer medicines dispensed to a random 10% sample of Australians between January 2017 to December 2020. We reported monthly dispensing and initiation rates of antineoplastic (chemo-, immuno- and targeted therapy), endocrine and supportive medicines per 100,000 population. We reported monthly discontinuation rates (defined as ≥90 days gap between cancer medicine dispensings) per 1,000 people treated. We used interrupted time series analysis to examine changes during times of increased COVID-19 risk and related public health measures (March, April and July 2020). FINDINGS: Between January 2017 and December 2020, 1,011,255 cancer medicines were dispensed to 51,515 people. Overall, there were no reductions in antineoplastic dispensing or initiation during the COVID-19 pandemic. In March 2020, we observed a temporary increase of 39/100,000 (95% CI: 14 to 65/100,000) in antineoplastic dispensing, driven by immunotherapy and targeted therapy. In April 2020, we observed a temporary decrease in chemotherapy initiation (-2/100,000, 95% CI: -4 to -1/100,000) and temporary increase in discontinuation of all antineoplastic medicines (35/1,000, 95% CI: 20 to 51/1,000), but these changes were not sustained. INTERPRETATION: The effective control of COVID-19 in Australia appears to have mitigated the initial impact of COVID-19 on systemic cancer therapy. We observed only small and temporary changes in the use of some cancer medicines early in the pandemic. FUNDING: National Health and Medical Research Council; National Breast Cancer Foundation; Translational Cancer Research Network, supported by the Cancer Institute NSW.
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spelling pubmed-83299892021-08-03 Changes in systemic cancer therapy in Australia during the COVID-19 pandemic: a population-based study Tang, Monica Daniels, Benjamin Aslam, Maria Schaffer, Andrea Pearson, Sallie-Anne Lancet Reg Health West Pac Research Paper BACKGROUND: Since the emergence of COVID-19 there have been increasing global concerns about delays and/or discontinuations in cancer care. However, it is unclear to what extent systemic cancer therapy was impacted by COVID-19 in countries with relatively low COVID-19 infection rates. We examined changes in systemic cancer therapy in Australia during the COVID-19 pandemic. METHODS: We conducted a national observational study using de-identified records of government-subsidised cancer medicines dispensed to a random 10% sample of Australians between January 2017 to December 2020. We reported monthly dispensing and initiation rates of antineoplastic (chemo-, immuno- and targeted therapy), endocrine and supportive medicines per 100,000 population. We reported monthly discontinuation rates (defined as ≥90 days gap between cancer medicine dispensings) per 1,000 people treated. We used interrupted time series analysis to examine changes during times of increased COVID-19 risk and related public health measures (March, April and July 2020). FINDINGS: Between January 2017 and December 2020, 1,011,255 cancer medicines were dispensed to 51,515 people. Overall, there were no reductions in antineoplastic dispensing or initiation during the COVID-19 pandemic. In March 2020, we observed a temporary increase of 39/100,000 (95% CI: 14 to 65/100,000) in antineoplastic dispensing, driven by immunotherapy and targeted therapy. In April 2020, we observed a temporary decrease in chemotherapy initiation (-2/100,000, 95% CI: -4 to -1/100,000) and temporary increase in discontinuation of all antineoplastic medicines (35/1,000, 95% CI: 20 to 51/1,000), but these changes were not sustained. INTERPRETATION: The effective control of COVID-19 in Australia appears to have mitigated the initial impact of COVID-19 on systemic cancer therapy. We observed only small and temporary changes in the use of some cancer medicines early in the pandemic. FUNDING: National Health and Medical Research Council; National Breast Cancer Foundation; Translational Cancer Research Network, supported by the Cancer Institute NSW. Elsevier 2021-08-03 /pmc/articles/PMC8329989/ /pubmed/34368796 http://dx.doi.org/10.1016/j.lanwpc.2021.100226 Text en © 2021 The Author(s) 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
Tang, Monica
Daniels, Benjamin
Aslam, Maria
Schaffer, Andrea
Pearson, Sallie-Anne
Changes in systemic cancer therapy in Australia during the COVID-19 pandemic: a population-based study
title Changes in systemic cancer therapy in Australia during the COVID-19 pandemic: a population-based study
title_full Changes in systemic cancer therapy in Australia during the COVID-19 pandemic: a population-based study
title_fullStr Changes in systemic cancer therapy in Australia during the COVID-19 pandemic: a population-based study
title_full_unstemmed Changes in systemic cancer therapy in Australia during the COVID-19 pandemic: a population-based study
title_short Changes in systemic cancer therapy in Australia during the COVID-19 pandemic: a population-based study
title_sort changes in systemic cancer therapy in australia during the covid-19 pandemic: a population-based study
topic Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8329989/
https://www.ncbi.nlm.nih.gov/pubmed/34368796
http://dx.doi.org/10.1016/j.lanwpc.2021.100226
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