The hidden curve behind COVID-19 outbreak: the impact of delay in treatment initiation in cancer patients and how to mitigate the additional risk of dying-the head and neck cancer model

Leandro L Matos, Carlos Henrique Q Forster, Gustavo N Marta, Gilberto Castro Junior, John A Ridge, Daisy Hirata, Adalberto Miranda-Filho, Ali Hosny, Alvaro Sanabria, Vincent Gregoire, Snehal G Patel, Johannes J Fagan, Anil K D'Cruz, Lisa Licitra, Hisham Mehanna, Sheng-Po Hao, Amanda Psyrri, Sandro Porceddu, Thomas J Galloway, Wojciech GolusinskiNancy Y Lee, Elcio H Shiguemori, José Elias Matieli, Ana Paula A C Shiguemori, Letícia R Diamantino, Luiz Felipe Schiaveto, Lysia Leão, Ana F Castro, André Lopes Carvalho, Luiz Paulo Kowalski

Research output: Contribution to journalArticlepeer-review

Abstract

PURPOSE: The rapid spread of the SARS-CoV-2 pandemic around the world caused most healthcare services to turn substantial attention to treatment of these patients and also to alter the structure of healthcare systems to address an infectious disease. As a result, many cancer patients had their treatment deferred during the pandemic, increasing the time-to-treatment initiation, the number of untreated patients (which will alter the dynamics of healthcare delivery in the post-pandemic era) and increasing their risk of death. Hence, we analyzed the impact on global cancer mortality considering the decline in oncology care during the COVID-19 outbreak using head and neck cancer, a known time-dependent disease, as a model.

METHODS: An online practical tool capable of predicting the risk of cancer patients dying due to the COVID-19 outbreak and also useful for mitigation strategies after the peak of the pandemic has been developed, based on a mathematical model. The scenarios were estimated by information of 15 oncological services worldwide, given a perspective from the five continents and also some simulations were conducted at world demographic data.

RESULTS: The model demonstrates that the more that cancer care was maintained during the outbreak and also the more it is increased during the mitigation period, the shorter will be the recovery, lessening the additional risk of dying due to time-to-treatment initiation.

CONCLUSIONS: This impact of COVID-19 pandemic on cancer patients is inevitable, but it is possible to minimize it with an effort measured by the proposed model.

Original languageEnglish
Pages (from-to)459-471
Number of pages13
JournalCancer Causes & Control
Volume32
Issue number5
Early online date11 Mar 2021
DOIs
Publication statusPublished - May 2021

Bibliographical note

Funding Information:
Hisham Mehanna is the director and a shareholder of Warwickshire Head and Neck Clinic LTD, he also reports personal fees from AstraZeneca, personal fees from MSD, personal fees from Sanofi Pasteur, personal fees from Merck, grants from GSK Biologicals, grants from MSD, grants from Sanofi Pasteur, grants from AstraZeneca, non-financial support from Merck, non-financial support from MSD, all disclosures are outside the submitted work. Leandro L. Matos, Carlos Henrique Q. Forster, Gustavo N. Marta, Gilberto Castro Junior, John A. Ridge, Daisy Hirata, Adalberto Miranda-Filho, Ali Hosny, Alvaro Sanabria, Vincent Gregoire, Snehal G. Patel, Johannes J. Fagan, Anil K. D’Cruz, Lisa Licitra, Sheng-Po Hao, Amanda Psyrri, Sandro Porceddu, Thomas J. Galloway, Wojciech Golusinski, Nancy Y. Lee, Elcio H. Shiguemori, José Elias Matieli, Ana Paula A. C. Shiguemori, Letícia R. Diamantino, Luiz Felipe Schiaveto, Lysia Leão, Ana F. Castro, André Lopes Carvalho, Luiz Paulo Kowalski declare that they have no conflict of interest.

Keywords

  • COVID-19
  • Head and Neck Neoplasms
  • Mortality
  • Risk Evaluation and Mitigation
  • Time-to-Treatment

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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