More than 4,000 Quebecers with cancer would not have been diagnosed in the spring, during the first wave of the COVID-19 pandemic, reveals a new government study.
In a report published this week by the Ministry of Health and Social Services (MSSS), the province concretely figures for the first time the gaping hole caused by the health crisis in terms of cancer screening and treatment. From March to June 2020, the health network suffered a 16% drop in oncological surgeries, due to the load shedding, which represents a little more than 1,500 fewer surgeries against cancer.
Just for the month of April, the number of operations dropped by 32%, and about 36% fewer cancers were diagnosed, relying on the drop in pathology reports, often written when a tumor is found. .
The first wave also blew up the wait for many people with cancer, as in April and May, delays of more than 56 days accounted for a quarter of pending surgeries. The provincial goal is 28 days.
Worse to come?
“Unfortunately, the numbers are likely to be worse in the second wave […] oncology is not as protected as it used to be [au printemps] », Worries the Director General of the Quebec Cancer Foundation, Marco Décelles.
If the screening suffered greatly in the spring, this winter, it is half of the surgeries that Quebec was forced to cancel.
“We had not made up for this delay in October”, adds the Dr Martin A. Champagne, president of the Association of hematologists and oncologists of Quebec.
“We are living on our credit card now, debts are piling up and it will cost us dearly as a society,” he fears, both in human and financial terms. Cancer diagnosed later also becomes a heavy burden to cure.
“We underestimate the number of surgeries to be repeated”, adds the Dre Mélanie Bélanger, head of the Association des gastro-enterologues du Québec.
She fears the repercussions of the delay in screening, especially for colorectal cancer. She says that when a colonoscopy determines the presence of polyps in the colon, they are easily removed. But the longer it drags on, the greater the risk of these lesions turning into cancer.
“These patients don’t have a voice because they don’t have symptoms and they don’t know they need surgery,” continues the doctor.
“There is every reason to worry”, concludes Dr Martin A. Champagne, fearing an increase in cancer mortality in the years to come.
Fear of seeing and going to health facilities can also delay diagnoses.
The extent of the delay
4,119 people with cancer were not diagnosed in Quebec from March to July.
1,539 fewer cancer surgeries from April to June 2020, compared to the same period last year. Surgeries performed in more than 56 days fell from 7% in May 2019 to 17% in May 2020.
Radiation therapy treatments decreased 9% from April to June 2020, compared to the same period last year.
The most common screening test for prostate cancer saw a 58% drop in spring 2020 compared to 2019.
▶ Lung cancer
As the leading cause of cancer death in both men and women, the decline in screening and surgery for lung cancer is worrying.
Medical imaging exams that can detect this cancer fell by 21% last spring.
The number of surgeries fell by 18% from April to June 2020. For the month of April alone, however, the decrease was 42%.
Last year, the number of patients who had to wait more than 56 days for surgery was minimal. In the spring, one in five pending surgeries exceeded this deadline.
▶ Colorectal cancer
The slowdown in oncology activities has strongly affected screening for colorectal cancer, one of the most common in both men and women.
At the height of the health crisis in the spring, the number of stool blood tests to detect this cancer early fell by 74%, from more than 175,000 tests in 2019 to less than 45,000 in April. to June.
There were also three times fewer colonoscopies during the same period, or about 22,000 compared to the 66,000 performed the previous year. At the same time, so-called “out of time” requests doubled.
Surgeries for colorectal cancer have also fallen by 30%.
“The pandemic seems to have had a marked effect on the trajectory of care and services for colorectal cancer, particularly on the screening of this cancer and its investigation”, one can read in the report published by the MSSS.
▶ Breast cancer
Screening activities for women at risk of breast cancer were outright stopped during confinement.
They did not restart until June, but an increase compared to last year.
Stopping screening activities will probably result in a significant number of surgeries when resuming activities and, therefore, repercussions on access if a greater volume of cases is detected over a short period, ”the provincial report points out.
Nonetheless, about 18% fewer surgeries were performed last spring, or about 400 fewer than in spring 2019.
The report notes a decrease in pending surgeries, most likely linked to the cessation of screening.