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The COVID-19 pandemic has disrupted cancer care at every stage, from screenings to follow-ups, with effects still being felt almost 2 years after the World Health Organization (WHO) officially declared the end of the health emergency on May 5, 2023.

A recent analysis published in Nature Cancer highlights the global impact of the pandemic on cancer care. Richa Shah, PhD, MHSc, and colleagues from the International Agency for Research on Cancer in Lyon, France, examined how the pandemic affected cancer services worldwide. “The COVID-19 pandemic, through both direct (infection-related) and indirect (disruption of health systems) routes, has resulted in an estimated 21.5 to 38.6 million excess deaths as of June 18, 2023 and severely impacted cancer services and programs from prevention and early detection to treatment,” the authors noted.

The WHO reported a 25% drop in human papillomavirus vaccination rates, which is a key preventive measure for cervical cancer. Lockdowns have disrupted screening programs and delayed treatments and led to modifications in treatment protocols to accommodate overburdened health systems.

Global Consequences

“Understanding the impact of the pandemic on cancer care is crucial, not only for healthcare professionals but also for policymakers, patients, and the general public,” the authors emphasized. Their study, a literature review and meta-analysis, analyzed data from 245 articles across 46 countries from five regions (Europe, the Americas, Asia, Oceania, and Africa). The findings are striking: Compared with the pre-pandemic period, during the pandemic, there was a decline in the number of patients participating in cancer screening (39.0%), diagnoses (23.0%), diagnostic procedures (24.0%), and treatments (28.0%). Systemic treatments were particularly affected, showing a 35% reduction, while radiotherapy saw a 15% decline.

The impact varied based on the Human Development Index (HDI) of the countries involved and the type of cancer. The authors noted that most of the studies focused on countries with a high HDI. In particular, 33 had a very high HDI, 8 had a high HDI, and 5 had a medium HDI.

None of the studies included countries with a low HDI. The data are similar when considering income: 29 high-income countries, with only 9 upper-middle-income countries and 8 lower-middle-income countries.

Italy’s Recovery

In Italy too, the COVID-19 pandemic has significantly impacted oncological care pathways. To examine its effects on national cancer screening programs, Univadis Italy, a Medscape Network platform, spoke with Paola Mantellini, MD, director of the Complex Structure for Screening and Secondary Prevention at Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO) in Florence, Italy. She explained that organized cancer screening for breast, cervical, and colorectal cancer experienced significant disruptions across most Italian regions in March and April 2020, with some programs resuming by May. Compliance with safety measures slowed operations, causing delays of up to 4-5 months. In addition to reduced service availability, participation rates also dropped due to fears of infection.

Recovery efforts in 2021 helped prevent worsening cancer diagnoses, and by 2023, screening coverage had significantly improved. Mantellini is optimistic that regional disparities will continue to narrow.

Lessons Learned

Despite these challenges, the pandemic has highlighted opportunities for more flexible and effective interventions for cancer care. “The pandemic has taught us that we can adopt more flexible interventions, and in some cases, even more useful for citizens. There is evidence of constant recovery, but we cannot be complacent,” noted Mantellini.

She stressed the need for continued investment in screening programs to reduce the burden of cancer and improve recovery rates, in line with European health objectives.

This story was translated and adapted from Univadis Italy using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.