Background: In early 2020, the COVID-19 pandemic has spread across the world, posing serious challenges for oncology medical practice. Despite existing general guidelines and policies implemented for oncology, the actual impact the pandemic had on cancer patients and their treatment has not been well quantified and summarized.
Objectives: To summarize recent studies that directly measured the impact of COVID-19 on oncology treatment practice patterns
Methods: A systematic literature review was conducted using PubMed. Inclusion criteria included studies that focused on cancer treatment practice during the COVID-19 pandemic. All studies published from January 1, 2020 to January 30, 2021 were considered for review. Commentaries and reviews that only reported guideline recommendations without quantifiable summary of practice impact were excluded. Studies that only included clinical trial data were also excluded.
Results: A total of 169 articles resulted from the search and after screening, 50 articles were included in final extraction. The majority of studies were conducted in the US (24%), globally (20%), Italy (10%), or other parts of Europe (16%). Middle east, India, and East Asia each had 4 (8%) studies. The majority of data came from online surveys (60%) while only 3 (6%) used registry or database study. Although 36% of studies used some form of institutional medical data, only 12% specified medical records review. Patient responders comprised 5 (16.7%) of the surveys while the remaining were reported by physicians or institutions. The most common cancer subtypes were gynecological (12%), breast (8%), and colorectal (8%) although nearly half (46%) of studies did not focus on a specific site. Nineteen (38%) studies reported statistics on change in total volume of visits or treatments, with 17 studies reporting a reduction in volume (average 47.1% reduction). The majority of studies (60%) reported the proportion of delays, which varied greatly by country, cancer subtype, and stage. The average unweighted proportion of responders reporting presence of any treatment delay was around 40%. Finally, the usage of telemedicine was a measure included in 19 (38%) studies, with usage reported by an average of 67.18% of responders.
Conclusions: In the COVID-19 era, the global scientific community has relied heavily on surveys to understand changes in oncology treatment practice. Telemedicine is gaining steady traction and implementation after the onset of the pandemic. Most oncology practices were affected to some degree with a reduction in volume of patient visits, treatments, and delay of treatment. However, the extent of delay is heterogeneous and higher severity cancers had less delay.
