The impact of the COVID-19 pandemic on cancer deaths due to delays in diagnosis in England, UK: a national, population-based, modelling study

SPS commentary:

Predictions across different scenarios compared with pre-pandemic figures are as follows:

 

• 7·9–9·6% increase in number of deaths due to breast cancer up to year 5 after diagnosis, corresponding to between 281 (95% CI 266–295) and 344 (329–358) additional deaths.

 

• For colorectal cancer, 1445 (1392–1591) to 1563 (1534–1592) additional deaths, a 15·3–16·6% increase; for lung cancer, 1235 (1220–1254) to 1372 (1343–1401) additional deaths, a 4·8–5·3% increase; and for oesophageal cancer, 330 (324–335) to 342 (336–348) additional deaths, 5·8–6·0% increase up to 5 years after diagnosis.

 

This is one of two modelling studies in The Lancet. The other study estimated that delays in presentation via the 2-week-wait pathway over a 3-month lockdown period (with an average presentational delay of 2 months per patient) would result in:

 

• 181 additional lives and 3316 life-years lost as a result of a backlog of referrals of 25%
• 361 additional lives and 6632 life-years lost for a 50% backlog of referrals
• 542 additional lives and 9948 life-years lost for a 75% backlog in referrals

 

A commentary discusses how large is the loss of life from cancer resulting from the COVID-19 pandemic. It notes two very different figures from these modelling studies, reflecting their different methods, cancer sites, and assumptions. It adds that both studies omit changes occurring before entry into secondary care and changed treatment regimens for those already diagnosed with cancer, which will further affect the total number of deaths. However it acknowledges that perhaps a precise figure is not needed as the loss of life is big, whatever the method used and what is most important is the recovery plan. It suggests that one long-term legacy of the COVID-19 pandemic in the UK might be increased capacity in diagnostic services, but the cost has been considerable.