Cancer consultations fell by 49.1 per cent during lockdown: Study

BENGALURU: Several key health issues are inadvertently being overlooked due to the pandemic, bearing impact on mortality and other outcomes, particularly for patients with cancer. 

A study titled 'Decreased Cancer Consultations in the COVID-19 era: A concern for delay in early cancer diagnosis in India' was submitted by HCG Hospitals and will be published in the JCO Global Oncology journal.

The study reports that among 24 oncology centres of HCG Cancer Hospitals across India, a cumulative drop of 49.1 % was witnessed immediately after lockdown was imposed.  

Interestingly, they noticed a gradual rise (9.9%) in new consultations once the extension of lockdown was announced. However, once the unlock was enforced, there was a progressive decline in new consultations (12.1%).

"Initially, in the early phase of the pandemic, the fear and panic linked with the announcement of lockdown and virus spread might have forced patients to postpone their health checkups. With the continuous imposition of restrictions and prevailing uncertainties, the patients summoned the courage to visit the hospitals and to get examined. A matter of grave concern, however, is the progressive gradual drop of new consultations (12.1%) even after the announcement of the unlock," an excerpt of the study reads. 

Dr. Vishal Rao, chief of Head and Neck Surgical Oncology and Robotic surgery at HCG Cancer Centre and one of the authors of the study said," 80% of cancer cases generally get diagnosed late and patients present in an advanced stage. COVID worsened this aspect. Educated and aware people kept postponing their consultation and ignored symptoms such as swelling, ulcers, small amounts of bleeding, etc."

Factors behind drop in consultation after the lockdown reported by the study include, individuals having anxiety over contracted COVID-19 while commuting or in the health care settling, many patients may have been unsure about the adequacy and capacity of essential non-COVID health care services, misconception that COVID testing is mandatory for undertaking any treatment at the hospital, many government and private cancer screening programmes were temporarily halted or working as slow pace after unlock and lastly, prevailing stay-at-home order in densely populated areas affect segments of the population known to share both an increased risk for COVID-19 and for head and neck cancer.

"The disturbing findings of fewer consultations even after the announcement of unlock warrant immediate attention. If the delay in early consultations continues unabated, it may negatively influence early cancer detection, resulting in increasing tumor burden and a likely upstaging of TNM classification, negatively affecting outcomes and overall quality of life of patients with head and neck cancer," it read.

TNM classification refers to a global standard to classify malignant tumours. Dr. Rao added that the delay in consultation has led to recurrence of tumours in some patients.

The first 2 years after a person's cancer treatment involves close follow-up every 2 months but this did not happen during the pandemic, he added.