This only lasted a few weeks, but the shutdown of part of the hospital activity as well as the postponement of public screening programs during the confinement of this spring will still have had collateral consequences that the ‘we are starting, for some, just to apprehend, in particular on the support of people with cancer.
If the majority of people already diagnosed were able to continue to be followed adequately during the first “lockdown” despite, sometimes, significant reductions in staff in the services, delays in diagnosis in patients not yet identified could be responsible for thousands of cases. additional cancer deaths in the next few years.
In France, this figure would oscillate, for the first wave, between 1,000 and 6,000 more deaths, according to a search published in December and conducted between January and June 2020 by researchers from the Unicancer hospital network. Cancer diagnoses would have recorded a drop of 30 to 50% depending on the location, without being caught up thereafter.
Disorganization of health services
France is not the only one to have observed this trend. Many countries saw their health services partially or completely disrupted during the first wave of the epidemic. According to the World Health Organization, which has looked into the issue in a study published in early June, out of 155 countries surveyed, 42% would have seen their oncology services being affected in their operation.
We have the impression that we are seeing more patients arriving at the hospital with more advanced stages of cancer, and therefore with a possibly less favorable prognosis.
Postponements in public screening programs – for example for breast or cervical cancer – have also occurred in more than 50% of the nations surveyed. Same story from the Netherlands. A search published in July in the European Cancer Journal estimates that between March and April 2020, the number of people newly diagnosed with cancer would have fallen by 30% compared to the figures normally expected.
And what about in Switzerland? “If the patients affected by cancer were afraid to come to the hospital during the first wave to follow their treatments, it is reassuring to see that this is no longer the case today, notes Professor Pierre-Yves Dietrich, head of the oncology department of the Geneva University Hospitals (HUG). However, the situation looks different for people who are not yet known to have cancer. Although it is still difficult to quantify, we have the impression, over the last six months, to see more patients arriving at the hospital with more advanced stages of cancer, and therefore with a possibly less favorable prognosis. “
For the specialist, it is likely that a certain number of individuals remain on the defensive because of the health situation and therefore still find it difficult to consult their attending physician. “The essential message is that you should not hesitate to go see your doctor in the event of new symptoms, because effective protective measures have been put in place,” adds Pierre-Yves Dietrich.
This observation linked to delays in diagnosis is also shared by the Swiss League against cancer: “We have indeed realized that the screening programs had suffered from the health situation during the confinement of this spring, explains Stefanie de Borba. – speech of the organization. However, this delay would have been made up during the summer, if we refer to the returns from certain hospitals. It is nevertheless difficult to have a clear and quantified view of the phenomenon at the national level, because screening programs are the responsibility of the cantons. ”
Exactly. In the canton of Vaud, for example, screenings were stopped in the spring, while they were maintained during the second wave. “We know that screening reduces cancer mortality. The device could not adapt to such unpredictability and had to stop for a short time during the first wave. Subsequently, I am not sure that we were able to communicate sufficiently and reassure people who had to carry out this type of exams about the perfectly secure environment, supports Professor Solange Peters, head of the medical oncology service of the Hospital Center. Vaud University (CHUV). It is essential to wait for the figures, because the situation can vary significantly from one region to another, but I am sure that we will see effects of these diagnostic delays in one or two years, including in Swiss.”