COVID-19: cancer diagnosis and care

COVID-19: cancer diagnosis and care: Covid-19 may have changed the way people have been diagnosed with cancer and how they receive care – new study to investigate by Natasha Meredith of the University of Surrey

An important new study from the University of Surrey and UCL is set to investigate how rapid changes in cancer care, caused by the Covid-19 pandemic, has impacted how people have experienced care and explore whether there are differences in more and less deprived areas of the UK.

Funded by the Health Foundation, the study will focus on colorectal cancer (bowel, colon and rectal cancer). Previous research has identified the existence of a deprivation gap for this type of cancer with people living in more deprived areas of the UK more likely to receive a late diagnosis, less likely to receive treatment and less likely to survive the disease. Concerns have been raised that changes in the healthcare service due to Covid-19 (i.e. the way someone can contact their GP and how people are tested for cancer) could widen this existing deprivation gap. For example, a shift to accessing care remotely (i.e. via video call) requires a smart phone or a computer which many do not possess or cannot fully use, and this may be more likely to disadvantage those living in more deprived backgrounds.

During the study, researchers will interview patients from different socioeconomic backgrounds, who have experienced a potential colorectal cancer symptom (e.g. change in bowel habits) in the past six months and sought help from their GP. The interviews will gage peoples’ experiences of contacting their GP during the pandemic and look at how these experiences vary by different groups.

Follow up interviews will also take place with those who are referred for further investigations and/or end up receiving treatment for colorectal cancer to learn more about their engagement with the health service. The study will also ask healthcare professionals about what they view as the main changes to care delivery during Covid-19 and the potential impact on the deprivation gap.

Findings from the study will help form a set of recommendations on how to manage cancer care (including referral, diagnosis and treatment) during future pandemics and share best practice with health care professionals on areas such as health inequalities and healthcare delivery.

Dr Katriina Whitaker, Reader in Cancer Care at the University of Surrey, said: “Populations from areas with high levels of deprivation are already disadvantaged when it comes to cancer care. We are concerned that the reasons for these differences (e.g. the way in which someone contacts their GP) will have been exasperated due to Covid-19. To ensure equal care in future pandemics, and to be responsive to any sudden change in the health sector we need to learn more about peoples’ experiences and champion ways to reduce the deprivation gap.”

Dr Georgia Black, UCL Institute of Epidemiology & Health, said: “Changes to the health system in response to Covid-19 could cause long term differences to colorectal cancer diagnosis. We want to understand how these changes have affected all parts of colorectal cancer care, including general practice and hospital services. We will gather data to understand how changes have affected people, and most importantly, provide recommendations for providing the best possible care and minimising the negative impacts on patients.”

Dr Jennifer Dixon, Chief Executive of the Health Foundation, said: “The Covid-19 pandemic has led to huge and rapid changes to the way that health and social care is delivered. The pandemic has also magnified pre-existing health inequalities in this country.

“This grant programme investigates these two areas. Are the changes in services beneficial and how did rapid change in provision happen? And what can we learn from the disproportionate effect Covid had on certain population groups? The aim is to use these insights to help future policy and service delivery decisions that could benefit the population.”