Impact of the COVID-19 Pandemic on a Cancer Fast-Track Programme

Years of life lost due to cancer in Ecuador

BACKGROUND

Cancer is the leading cause of death worldwide. In the Americas, it is also one of the leading causes of death. In Ecuador, studies on the burden of disease are limited and none analyze or estimate the burden of all types of cancer in a single study. Therefore, the aim of this study is to estimate the years of life lost prematurely due to cancer in Ecuador from 2014 to 2022.

METHODS

Cross-sectional observational analysis study. The databases of general deaths from the years 2014 to 2022, population projections from 2014 to 2021 and the population census for the year 2022 of the Republic of Ecuador were used. Deaths registered with ICD-10 code C00-C96 were included as deaths from cancer. The mortality rate and years of life lost prematurely due to cancer were estimated, considering the life tables of the Coale-Demeny West model and a standard time discount of 3 % was implemented without weighting by age.

RESULTS

An increase in mortality and premature years of life lost was observed in the period 2014-2019, but in 2020 a reduction in mortality was seen in several types of cancer. In 2021 and 2022 mortality increased again, reaching the maximum peak of mortality and premature years of life lost in the entire study. Approximately 1,3 million years of life lost prematurely due to cancer were estimated. The types of cancer with the greatest number of years of life lost prematurely were malignant tumors of the stomach (188.180), uterus (117.142), which include both uterine cancer and cervical cancer, and leukemia (107.440). In men, in descending order, these were tumors of the stomach (101.112), prostate (67.624) and leukemia (55.654), while in women, these were malignant tumors of the uterus (117.142), breast (100.217) and stomach (87.067).

CONCLUSIONS

The results of this study provide a broader basis for debate on public health policies, efficient allocation of resources, and enable monitoring of cancer and prevention strategies over time.

Utility of a quick diagnostic unit during the SARS-CoV-2 pandemic for the diagnosis of cancer

OBJECTIVES

To analyse changes in health care activity, time of referral and diagnosis intervals and the incidence of cancer during the first two years of the SARS-CoV-2 pandemic in a quick diagnosis unit.

MATERIALS AND METHODS

A retrospective observational study was carried out during the prepandemic year (March 1, 2019, to February 29, 2020) and the first two years of the pandemic (March 1, 2020, to February 28, 2022). Demographic and clinical variables, the first visit interval, the diagnosis interval and the first visit-diagnosis interval were evaluated and compared.

RESULTS

During the first pandemic wave, there was a reduction in referrals (-32.6%), which then increased 8.1% and 17.7% from the second wave until the end of the first pandemic year and the second pandemic year, respectively. An increase in referrals to primary care and a decrease in emergencies were identified. The increase in cancer diagnoses of 2.7% and 15.7% in the two years of the pandemic was proportional to the increase in referrals. No changes were observed in benign processes or in cancer locations and stages. The first visit interval was higher for benign diseases (p<0.0001). A prolongation of the diagnosis interval was observed in cancer patients, although during the three years of the study the median was <15 days.

CONCLUSIONS

The impact of the pandemic affected the length of intervals and the origins of referrals. The quick diagnosis units constitutes and urgent complementary cancer diagnostic route with a high diagnosis yield.