Aim
To present the impact of COVID-19 on inpatient cancer care across Victorian health services by comparing health service activity between 2019 and 2020.
Background
The COVID-19 pandemic disrupted cancer care, including delaying diagnoses and treatment, and halting clinical trials. Despite cancer-related services classified as vital and remaining available, utilisation reportedly dropped due to patient reluctance to access services.
The five most common cancers represent approximately 60% of all cancer diagnoses. From these alone it’s estimated there will be an additional 3000 - 4000 cancer presentations over the next 12 months due to delayed diagnosis. Furthermore, based on reduced notifications, the Victorian Cancer Registry (VCR) estimate 2530 cancer diagnoses were either delayed or missed during Victoria’s strictest lockdown periods (April to October 2020).
Method
Analysis of cancer activity across Victorian health services to understand the change in activity between 2019 and 2020 using a subset of cancer-specific patient data from the Victorian Admitted Episode Dataset (VAED).
Results
Analysis of VAED data shows 29067 fewer admissions (-10%) and 18079 fewer patients (-6.1%) for patients with both malignant and non-malignant neoplasms in Victoria between 2019 to 2020. The most significant decline in admissions were in May (-22.5%) and August (-17.6%) which coincides with Victoria’s major lockdown periods:
• Stage 3 lockdown beginning 28th March 2020
• Stage 4 lockdown beginning 2nd August 2020
A review of activity for malignant only neoplasms found a similar trend with a decrease of 16.6% in May and 10.7% in August.
Conclusions
Previous trends have shown ~4% annual increase in activity across Victoria however between 2019 and 2020 there was a ~6% decrease with decline peaking during lockdown periods. Our analysis mirrors anecdotal evidence that COVID-19 has negatively impacted cancer care across Victoria which would suggest a surge in activity and late stage cancer diagnoses in early 2021.