The ongoing Covid pandemic has disrupted healthcare systems globally leading to widening the gap between treatment and patient care of non-Covid disease including cancer. Cancer is a major contributor to the disease burden worldwide. Several studies have projected that the global cancer burden will continue to grow for at least next two decades.
The Covid pandemic has undoubtedly delayed the cancer screenings, diagnosis, and treatment around the world. The cancer cases in India increased at an average annual rate of 1.1-2 per cent from 2010-2019, and deaths in the country also went up at an average rate of 0.1-1 per cent in the same period, according to the analysis by the Institute for Health Metrics and Evaluation (IHME), University of Washington School of Medicine.
The new cancer patients registration, follow up for old patients and surgery had recorded considerable decline in India between March and May 2020, compared to the same period in 2019 as per a Lancet study of May 2021. The ambidirectional cohort study was conducted at 41 cancer centres across India that were members of the National Cancer Grid of India to compare provision of oncology services between March 1 and May 31, 2020, with the same time period in 2019.
A total of 54 per cent reduction was recorded in the new patients registration between this period. The number of new patients registered decreased from 1,12,270 to 51,760 between March 1 and May 31, 2020, as per the study. On the same line, a total of 46 per cent reduction, from 6,34,745 to 3,40,984 patients, was registered in the number of patients who had follow-up visits to the hospital.
Dr Anshuman Kumar, Delhi based cancer specialist, told IANS that in the absence of decentralised cancer care centres in India, the patients have largely been ignored in the first and second Covid wave. "Patients coming from rural areas of different states were stopped to visit for follow-up and even for first time treatment as all transport communication channels was closed. All of sudden, premier health institutions like AIIMS and others started refusing patient admissions other than Covid which impacted the cancer care in India adversely.
Highlighting the Lancet study, he said that 54 per cent reduction in the new patients registration among 41 cancer care centers nationwide was due to the illogical decision of shutting doors of premier health institution for non Covid patients.
According to a study from AIIMS Oncology department, total 51 per cent reduction was recorded in new case registration in OPD and around one third reduction was noticed in the cancer surgeries. The Lancet study points out that the hospital admissions decreased from 88,801 to 56,885 (36 per cent reduction) and outpatient chemotherapy decreased from 1,73,634 to 1,09,107 (37 per cent reduction) in 41 cancer centres.
These reductions were even more marked between April and May, 2020. Cancer screening was stopped completely or was functioning at less than 25 per cent of usual capacity at more than 70 per cent of centres during these months, the study said.
The ongoing Covid pandemic has also impacted adversely the research and development in the cancer. "The COVID pandemic has impeded the R&D of cancer treatment in 3 ways. Firstly, patient enrolment in oncology clinical trials of chemotherapeutic drugs has gone down. Second, the trials of modes of administering these therapies also got impacted adversely. Oncotherapy medicines have to be protected from Bacterial Contamination and the health care worker (HCW) has to be protected from getting chemically contaminated by these drugs. Trials of advanced closed system transfer devices got stalled. Thirdly, R&D in Oncology also suffered as there was also a conscious effort by many cancer researchers to focus their effort on Covid," said Pavan Choudary, Chairman Medical Technology Association of India.
(Avinash Prabhakar can be reached at Avinash.p@ians.in)
Source : IANS