The COVID-19 pandemic significantly impacted healthcare services in Wales, resulting in rapid reorganisation of resources to be deployed to deal with the influx of COVID-19 patients. This analysis aims to understand the effect of this disruption on Welsh cancer patients across the cancer pathway for bowel and lung cancer.
This analysis looks at trends in symptom reporting, waiting times, diagnostic tests, hospital access and treatment between January 2019 and March 2022. It aims to help improve the understanding of which parts of the cancer pathway were most affected and how they could be better protected in any future healthcare crises.
There was a reduction in both lung and bowel cancer symptoms report to GPs in Wales due to the COVID-19 pandemic. This drop was more prominent for lung cancer symptoms, with a long-lasting drop in the number of symptom reports by people subsequently diagnosed with lung cancer.
The number of people starting treatment began to recover from around the start of 2021, though with a decreasing proportion of people starting treatment within 62 days for both lung and bowel cancer patients.
There was a drop in the number of people waiting for an x-ray and bronchoscopy throughout most of 2020, with a significant increase in the proportion waiting more than 8 weeks. The waiting list for colonoscopies started to steadily increase from around May 2020, especially for those waiting more than 8 weeks, with no improvement in sight by 2022.
There was reduced capacity to admit lung and bowel cancer patients to hospital throughout 2020. Emergency admittances were less affected, and there was a relatively quick recovery.
There was a drop in the number of surgeries for bowel cancer in the first half of 2020 followed by a relatively fast recovery. However there was a continual decrease in laparoscopic surgeries. The analysis found longer-lasting reduction in surgeries for lung cancer, with relative stabilisation towards the end of 2021.
Radiotherapy for bowel cancer was not much affected, increasing from 2021. There was a significant drop in radiotherapy for lung cancer patients for most of 2020 with a return to pre-pandemic levels from around June 2021.
Chemotherapy for bowel and lung cancer dropped with the onset of the pandemic, with only a short return back to pre-pandemic levels at the end of 2020.
This analysis highlighted the impacts of the COVID-19 pandemic across the patient pathway for lung and bowel cancer, and in some areas long-lasting effects.
This analysis highlights the importance of timely presentation of symptoms especially those that might be associated with lung cancer, increasing of diagnostic capacity and assuring of continual care for people living with cancer in times of healthcare crises.
Martina Slapkova, Shane Johnson, Rosie Hinchliffe, Scarlett Cartwright-Hughes.
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