The good news is doctors are getting better at making judgment calls on when to start treatment based on a patient’s individual risk. And a new tool is helping.
The OncCOVID app, developed by researchers at the University of Michigan’s Rogel Cancer Center and the School of Public Health, is designed to predict and avoid mortalities due to pandemic delays. Clinicians can enter 45 different patient-specific variables, including their age, location, cancer type and stage, treatment plan, underlying medical conditions, and the proposed length of a delay in care. The app then calculates the patient’s likely five-year survival rates, comparing immediate treatment and delayed treatment.
To create the tool, researchers extracted data from nearly 700,000 patients with 25 different cancer types and compared outcomes with cancer reporting databases and literature review. Their findings were published in JAMA Oncology on October 29.
“For many types of cancer, the data show delays in treatment lead to worse outcomes for patients,” the project’s lead researcher, Holly Hartman, a doctoral student in biostatistics at the University of Michigan, told MHealth Lab. “But each time a cancer patient goes to the hospital to receive care, they’re also putting themselves at higher risk of contracting COVID-19. So, it’s essential to balance the need for treatment for this very serious disease and the extra risk that COVID-19 poses for cancer patients, whose immune systems are often compromised.”
Why Do Treatment Delays Matter to Cancer Patients?
Along with his colleagues, Timothy Hanna, MD, PhD, a radiation oncologist and primary investigator for the Division of Cancer Care and Epidemiology at the Queen’s University Cancer Research Institute in Ontario, Canada, evaluated 34 studies published between January 1 and April 10, 2020, on a collective 1.2 million individuals with 17 different cancer types. Their research concluded that in 13 of the 17 conditions they reviewed, a four-week delay in treatment led to a significant mortality increase.
For cancer patients, treatment delays mean poorer outcomes, which Hanna’s research measured.
“When you make a cancer patient wait for treatment, you may not see the effects for years,” Hanna tells Verywell. “Our results can help to fine-tune prioritization strategies, and I’m hoping that our findings will help decision-makers understand the impact on cancer patients when they’re developing strategies.”
Why Are Cancer Patients Facing Treatment Delays?
COVID-19 has strained healthcare systems worldwide, leading to rationing of care in some places, including Canada.
“When the pandemic first hit, there were lockdown measures put in place and a lot of discussion about prioritization of patient care. We needed to preserve resources for the large wave of patients infected with COVID-19 who would come into the hospital,” Hanna says. “There wasn’t a lot that could let us determine the impact of treatment delays on mortality rates of cancer patients, and this is important when you are trying to prioritize which patients should get care when resources are limited.”
Hanna hopes that leading cancer organizations will use emerging data to develop guidelines for target treatment times in the future.
“Recommended treatment times are often are based on expert opinions and not hard data," he says. “I think these results are incredibly valuable for decision-makers in deciding what kind of wait time targets they want to aim for.”
Hanna plans to refine his findings further and expand his research to include other cancer types.
“There were a few forms of cancer where we did not find a statistical significance in treatment delay,” he says. “That does not mean there is no evidence. We did not have sufficient data to evaluate that particular case. There are many other forms of data that we haven’t addressed yet.”
Stay Up To Date on Screenings
The American Cancer Society (ACS) advises continued regular cancer screenings during the pandemic and recommends that healthcare facilities follow safety measures for infection control, like physical distancing and mask-wearing. The ACS also mentions that not all cancer screenings require an in-person appointment. For example:
A dermatologist can view suspicious skin lesions by virtual visit before recommending that a patient come into the office. Cologuard is an at-home option to screen for colorectal cancer in average-risk individuals. Some women may not need yearly mammograms or pap smears for breast and cervical screening.
The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.
