Show simple item record

dc.contributor.authorSud, A
dc.contributor.authorJones, ME
dc.contributor.authorBroggio, J
dc.contributor.authorLoveday, C
dc.contributor.authorTorr, B
dc.contributor.authorGarrett, A
dc.contributor.authorNicol, DL
dc.contributor.authorJhanji, S
dc.contributor.authorBoyce, SA
dc.contributor.authorGronthoud, F
dc.contributor.authorWard, P
dc.contributor.authorHandy, JM
dc.contributor.authorYousaf, N
dc.contributor.authorLarkin, J
dc.contributor.authorSuh, Y-E
dc.contributor.authorScott, S
dc.contributor.authorPharoah, PDP
dc.contributor.authorSwanton, C
dc.contributor.authorAbbosh, C
dc.contributor.authorWilliams, M
dc.contributor.authorLyratzopoulos, G
dc.contributor.authorHoulston, R
dc.contributor.authorTurnbull, C
dc.date.accessioned2020-06-02T08:56:11Z
dc.date.issued2020-08
dc.identifier.citationAnnals of oncology : official journal of the European Society for Medical Oncology, 2020, 31 (8), pp. 1065 - 1074
dc.identifier.issn0923-7534
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/3664
dc.identifier.eissn1569-8041
dc.identifier.doi10.1016/j.annonc.2020.05.009
dc.description.abstractBackground 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.formatPrint-Electronic
dc.format.extent1065 - 1074
dc.languageeng
dc.language.isoeng
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.subjectHumans
dc.subjectPneumonia, Viral
dc.subjectCoronavirus Infections
dc.subjectNeoplasms
dc.subjectTreatment Outcome
dc.subjectHospitalization
dc.subjectAdult
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectMiddle Aged
dc.subjectFemale
dc.subjectMale
dc.subjectPandemics
dc.subjectTime-to-Treatment
dc.subjectBetacoronavirus
dc.subjectCOVID-19
dc.subjectSARS-CoV-2
dc.titleCollateral damage: the impact on outcomes from cancer surgery of the COVID-19 pandemic.
dc.typeJournal Article
dcterms.dateAccepted2020-05-10
rioxxterms.versionofrecord10.1016/j.annonc.2020.05.009
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by/4.0
rioxxterms.licenseref.startdate2020-08
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfAnnals of oncology : official journal of the European Society for Medical Oncology
pubs.issue8
pubs.notesNo 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-statusPublished
pubs.volume31
pubs.embargo.termsNo embargo
icr.researchteamMelanoma and Kidney Canceren_US
icr.researchteamAetiological Epidemiologyen_US
icr.researchteamCancer Genomicsen_US
dc.contributor.icrauthorTorr, Bethanyen
dc.contributor.icrauthorHoulston, Richarden
dc.contributor.icrauthorLarkin, Jamesen
dc.contributor.icrauthorSud, Amiten
dc.contributor.icrauthorTurnbull, Clareen
dc.contributor.icrauthorGarrett, Aliceen
dc.contributor.icrauthorJones, Michaelen


Files in this item

Thumbnail

This item appears in the following collection(s)

Show simple item record

https://creativecommons.org/licenses/by/4.0
Except where otherwise noted, this item's license is described as https://creativecommons.org/licenses/by/4.0