Screening and diagnostic procedures for liver cancer as well as transplant programs and curative/palliative treatments were modified or delayed due to the COVID-19 pandemic, a new survey says.
The first wave of the COVID-19 pandemic had a significant impact on routine care for patients with liver cancer, with a particularly substantial impact on screenings.
These effects were reported in international survey results presented at the 2021 European Association for the Study of Liver’s Digital Liver Cancer Summit.
“The coronavirus disease 2019 (COVID-19) pandemic has posed unprecedented challenges to healthcare systems and it may have heavily impacted patients with liver cancer (LC),” the researchers wrote. “Herein, we evaluated whether the schedule of LC screening or procedures has been interrupted or delayed because of the COVID-19 pandemic.”
The researchers analyzed the impact of the pandemic on clinical practice and clinical trials from March 2020 to June 2020 at 76 liver cancer treatment centers from Europe, South America, North America, Asia and Africa. There was a focus on hepatocellular carcinoma, the most common type of primary liver cancer, and intrahepatic cholangiocarcinoma, a cancer that develops in cells within the bile ducts both inside and outside the liver.
Altogether, the centers typically treated around 9,600 new patients per year before the pandemic. In 2019, they carried out nearly 40,000 follow-ups for hepatocellular carcinoma and 6,000 for intrahepatic cholangiocarcinoma, according to a press release.
It was found that 10 of the 76 centers did not report making any changes to their clinical practice during the pandemic. Patients at three of these centers reported increased reluctance to schedule appointments out of fear of contracting COVID-19.
Out of the 66 centers who did change their clinical practice, 80.9% delayed their screening procedures, 40.8% modified their diagnostic procedures, 50% cancelled curative and/or palliative treatments and 41.7% changed their liver transplantation programs. At the centers in which clinical trials were running, 65.2% modified their treatments in that setting, while 58.1% were able to recruit new patients. Additionally, phone call service was modified at 51.4% of the centers who offered this service prior to the pandemic.
“The modifications in liver cancer management due to this crisis raise the possibility of more patients being diagnosed with a later stage of cancer,” said lead author Dr. Sergio MuÑoz-MartÍnez, of the Barcelona Clinic Liver Cancer Group at the Hospital Clinic of Barcelona, in the press release.
However, several positive statistics were also noted. According to the release, 93% of clinics continued to provide systemic therapy for the most advanced cancer patients, even during the peak of the pandemic. Specialized liver oncology nurses also proved to be essential for patient telephone and digital consultation to patients and their families, which demonstrates their importance to patient care, said Dr. MuÑoz-MartÍnez.
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