Cancer is a leading cause of death worldwide, and accounts for nearly one in six deaths. The good news before COVID-19 was that countries across the world, even in low-income regions, had improved their diagnosis and treatment capability, and cancer survival outcomes were improving. www.theguardian.com/commentisfree/2022/nov/18/covid-epidemic-cancer-diagnosis-pandemic-europe?
But the pandemic has reversed these gains. A report from the Lancet Oncology Commission, examining 44 European countries, notes that the pandemic has resulted in late cancer diagnosis, delayed intervention, disruption in treatment and many deaths, due to COVID-19, among cancer sufferers. This is largely a result of health services being overwhelmed or repurposed and of too many infections and COVID hospital admissions, leading to long national lockdowns in some countries. The report estimates that as many as a million cancer diagnoses may have been missed in Europe during that time.
The pandemic showed us that healthcare resources are finite, and so when demand associated with one disease increases, it affects all patients.
In Britain, due to the large first and second waves, the NHS effectively became the COVID Health Service for much of 2020. And this is likely to have had a detrimental impact on cancer outcomes: another Lancet study estimated in 2020 that delayed diagnosis and treatment in England could increase the amount of breast, colorectal and lung cancers by up to 9.6%, 16.6% and 5.3%, respectively, in the coming years. This is largely due to screening services being disrupted and people – even with worrying symptoms – not coming forward to primary care. Of course, countries that were able to contain COVID-19 quickly and limit their patient numbers in 2020 managed to keep their health services running relatively well.
There is a term for this, taken from the 2014 Ebola outbreak in west Africa, when women died during childbirth because health care facilities were closed and childhood vaccination schedules disrupted: the “uncounted dead”. This was how UNICEF referred to the people who died from the indirect impacts of Ebola but needed to be taken into account as casualties of the outbreak. We are now facing one of what will probably be many hidden and uncounted costs of COVID-19.
Lalita Panicker is consulting editor, views, Hindustan Times, New Delhi