Covid-19’s impact on cancer treatment is “catastrophic” and “made us realise the real human cost of neglecting a non-communicable disease like cancer,” WHO Director for Europe Hans Kluge said.
On World Cancer Day, the executive recalled that one out of three European countries has partially or completely disrupted oncology services. Due to travel restrictions and the huge strain on health systems in the fight against Covid-19, cancer services have been disrupted across the WHO European Region, significantly delaying diagnosis and treatment, and directly affecting the chances of cure or survival for hundreds of thousands of cancer patients.
“We cannot ignore a cancer epidemic.”
The impact of COVID-19 on cancer in Europe is complex, and has been referred to by some as a “deadly relationship“. He acknowledged that ensuring continuity of cancer care during the fight against Covid-19 has been a huge challenge for countries in the WHO European Region, but recalled that this continent accounts for approximately one-third of all cases and deaths recorded to date – more than 750,000 lives lost.
“In a normal year, cancer kills close to 2.2 million people in the Europe Region: a far-too-heavy toll when we know that these deaths could have been prevented.”
In the Netherlands and Belgium, in the first 2020 lockdown, the number of cancers diagnosed decreased by 30-40%. The WHO further estimates that the delay in diagnosis and treatments in the UK will result in an increase in the number of deaths from colorectal cancer (15%), and breast cancer (9%) over the next 5 years.
“A pandemic-driven crisis of non-communicable diseases, including cancer, is emerging.”
In a typical year, non-communicable diseases such as cancer, chronic respiratory diseases and diabetes are the leading cause of death and disability in the WHO European Region, accounting for more than 80% of deaths.
The high cost of cancer drugs and treatments is a challenge for all countries, even the richest. With pre-existing inequalities increasing due to the economic crisis, the WHO announced the start of a Pan-European Cancer Initiative to ensure better cancer control and prevention in different countries.
In 2020, 4.8 million Europeans were diagnosed with cancer. That’s more than 13 000 people every day, 546 every hour, nine every minute. “One in 3 of us in western European countries and 1 in 4 of us in eastern European countries will develop cancer in our lifetimes.”
The impact in Portugal
In Portugal, the number of cancer diagnoses decreased between 60 and 80% during 2020 due to Covid-19. According to data from the Portuguese League Against Cancer, between March and June 2020 alone, more than a thousand cancers remained undiagnosed due to the interruption of population-based screening, i.e. breast, cervical or colorectal cancers.
“We all know that when a cancer diagnosis is made, whatever it may be, at very early stages, the greater the probability of cure,” explained Ana Raimundo, president of the Portuguese Oncology Society.
In statements to SIC Notícias (News), he stressed that the decrease in diagnoses are related to the “reduction in demand for medical care by patients for fear of contracting the covid-19 infection” and the “diminished response capacity of the health system“. This delay in diagnosis may have an impact in the future.
“We need to set priorities, be vigilant and remember that although we are concerned about covid-19, the other diseases have not disappeared. They are there, they also kill and cancer kills more than Covid-19. It does not have an immediate impact like covid-19, but in the coming months, in the coming years we will feel the impact of this delay in diagnosis, the delay in the start of treatment,” he stresses.
Breast cancer screenings resumed in June, but very slowly and with less capacity to be performed as a precaution due to the pandemic. Despite the importance that an initial diagnosis has in the treatment of cancer, Ana Raimundo admits that, due to the existing pressure on the National Health Service, it will not be possible to carry out all the routine examinations or screenings that were normally done.
Currently, in the treatment unit for espphagus and stomach cancers at the Lisbon IPO, there are no waiting lists, “because fear of covid-19 has kept patients away from health units, which also have fewer means to diagnose them”.
The coordinator of the Upper Digestive Unit of the Portuguese Institute of Lisbon (IPO), Rui Casaca, told Lusa news agency that diagnosed patients need to know that there are Covid-19 free units they can turn to and receive a timely response.
About the future, the SPO president cannot anticipate very positive goals for the year 2021. “I don’t see that the in next few months, until the middle of the year, can be very easy to respond to what was left behind. I think there should have been a plan for cancer patients because the waiting lists that already existed will continue to grow. I don’t think it will be possible to recover so quickly,” he concludes.
