dc.contributor.author | Sud, A | |
dc.contributor.author | Jones, ME | |
dc.contributor.author | Broggio, J | |
dc.contributor.author | Loveday, C | |
dc.contributor.author | Torr, B | |
dc.contributor.author | Garrett, A | |
dc.contributor.author | Nicol, DL | |
dc.contributor.author | Jhanji, S | |
dc.contributor.author | Boyce, SA | |
dc.contributor.author | Gronthoud, F | |
dc.contributor.author | Ward, P | |
dc.contributor.author | Handy, JM | |
dc.contributor.author | Yousaf, N | |
dc.contributor.author | Larkin, J | |
dc.contributor.author | Suh, Y-E | |
dc.contributor.author | Scott, S | |
dc.contributor.author | Pharoah, PDP | |
dc.contributor.author | Swanton, C | |
dc.contributor.author | Abbosh, C | |
dc.contributor.author | Williams, M | |
dc.contributor.author | Lyratzopoulos, G | |
dc.contributor.author | Houlston, R | |
dc.contributor.author | Turnbull, C | |
dc.date.accessioned | 2020-06-02T08:56:11Z | |
dc.date.issued | 2020-08-01 | |
dc.identifier.citation | Annals of oncology : official journal of the European Society for Medical Oncology, 2020, 31 (8), pp. 1065 - 1074 | |
dc.identifier.issn | 0923-7534 | |
dc.identifier.uri | https://repository.icr.ac.uk/handle/internal/3664 | |
dc.identifier.eissn | 1569-8041 | |
dc.identifier.doi | 10.1016/j.annonc.2020.05.009 | |
dc.description.abstract | BACKGROUND: Cancer diagnostics and surgery have been disrupted by the response of health care services to the coronavirus disease 2019 (COVID-19) pandemic. Progression of cancers during delay will impact on patients' long-term survival. PATIENTS AND METHODS: We generated per-day hazard ratios of cancer progression from observational studies and applied these to age-specific, stage-specific cancer survival for England 2013-2017. We modelled per-patient delay of 3 and 6 months and periods of disruption of 1 and 2 years. Using health care resource costing, we contextualise attributable lives saved and life-years gained (LYGs) from cancer surgery to equivalent volumes of COVID-19 hospitalisations. RESULTS: Per year, 94 912 resections for major cancers result in 80 406 long-term survivors and 1 717 051 LYGs. Per-patient delay of 3/6 months would cause attributable death of 4755/10 760 of these individuals with loss of 92 214/208 275 life-years, respectively. For cancer surgery, average LYGs per patient are 18.1 under standard conditions and 17.1/15.9 with a delay of 3/6 months (an average loss of 0.97/2.19 LYGs per patient), respectively. Taking into account health care resource units (HCRUs), surgery results on average per patient in 2.25 resource-adjusted life-years gained (RALYGs) under standard conditions and 2.12/1.97 RALYGs following delay of 3/6 months. For 94 912 hospital COVID-19 admissions, there are 482 022 LYGs requiring 1 052 949 HCRUs. Hospitalisation of community-acquired COVID-19 patients yields on average per patient 5.08 LYG and 0.46 RALYGs. CONCLUSIONS: Modest delays in surgery for cancer incur significant impact on survival. Delay of 3/6 months in surgery for incident cancers would mitigate 19%/43% of LYGs, respectively, by hospitalisation of an equivalent volume of admissions for community-acquired COVID-19. This rises to 26%/59%, respectively, when considering RALYGs. To avoid a downstream public health crisis of avoidable cancer deaths, cancer diagnostic and surgical pathways must be maintained at normal throughput, with rapid attention to any backlog already accrued. | |
dc.format | Print-Electronic | |
dc.format.extent | 1065 - 1074 | |
dc.language | eng | |
dc.language.iso | eng | |
dc.publisher | ELSEVIER | |
dc.rights.uri | https://creativecommons.org/licenses/by/4.0 | |
dc.subject | Humans | |
dc.subject | Pneumonia, Viral | |
dc.subject | Coronavirus Infections | |
dc.subject | Neoplasms | |
dc.subject | Treatment Outcome | |
dc.subject | Hospitalization | |
dc.subject | Adult | |
dc.subject | Aged | |
dc.subject | Aged, 80 and over | |
dc.subject | Middle Aged | |
dc.subject | Female | |
dc.subject | Male | |
dc.subject | Pandemics | |
dc.subject | Time-to-Treatment | |
dc.subject | Betacoronavirus | |
dc.subject | COVID-19 | |
dc.subject | SARS-CoV-2 | |
dc.title | Collateral damage: the impact on outcomes from cancer surgery of the COVID-19 pandemic. | |
dc.type | Journal Article | |
dcterms.dateAccepted | 2020-05-10 | |
rioxxterms.versionofrecord | 10.1016/j.annonc.2020.05.009 | |
rioxxterms.licenseref.uri | https://creativecommons.org/licenses/by/4.0 | |
rioxxterms.licenseref.startdate | 2020-08 | |
rioxxterms.type | Journal Article/Review | |
dc.relation.isPartOf | Annals of oncology : official journal of the European Society for Medical Oncology | |
pubs.issue | 8 | |
pubs.notes | No embargo | |
pubs.organisational-group | /ICR | |
pubs.organisational-group | /ICR/Primary Group | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Breast Cancer Research | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Breast Cancer Research/Aetiological Epidemiology | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Clinical Studies | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Clinical Studies/Melanoma and Kidney Cancer | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Clinical Studies/Melanoma and Kidney Cancer/Melanoma and Kidney Cancer (hon.) | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Genetics and Epidemiology | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Genetics and Epidemiology/Aetiological Epidemiology | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Genetics and Epidemiology/Cancer Genomics | |
pubs.organisational-group | /ICR/Primary Group/Royal Marsden Clinical Units | |
pubs.organisational-group | /ICR/Students | |
pubs.organisational-group | /ICR/Students/PhD and MPhil | |
pubs.organisational-group | /ICR/Students/PhD and MPhil/19/20 Starting Cohort | |
pubs.organisational-group | /ICR | |
pubs.organisational-group | /ICR/Primary Group | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Breast Cancer Research | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Breast Cancer Research/Aetiological Epidemiology | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Clinical Studies | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Clinical Studies/Melanoma and Kidney Cancer | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Clinical Studies/Melanoma and Kidney Cancer/Melanoma and Kidney Cancer (hon.) | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Genetics and Epidemiology | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Genetics and Epidemiology/Aetiological Epidemiology | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Genetics and Epidemiology/Cancer Genomics | |
pubs.organisational-group | /ICR/Primary Group/Royal Marsden Clinical Units | |
pubs.organisational-group | /ICR/Students | |
pubs.organisational-group | /ICR/Students/PhD and MPhil | |
pubs.organisational-group | /ICR/Students/PhD and MPhil/19/20 Starting Cohort | |
pubs.publication-status | Published | |
pubs.volume | 31 | |
pubs.embargo.terms | No embargo | |
icr.researchteam | Melanoma and Kidney Cancer | |
icr.researchteam | Aetiological Epidemiology | |
icr.researchteam | Cancer Genomics | |
dc.contributor.icrauthor | Sud, Amit | |
dc.contributor.icrauthor | Jones, Michael | |
dc.contributor.icrauthor | Pemberton - Whiteley, Bethany | |
dc.contributor.icrauthor | Garrett, Alice | |
dc.contributor.icrauthor | Houlston, Richard | |
dc.contributor.icrauthor | Turnbull, Clare | |