Screening backlogs cause an influx of patients with advanced cancer, according to Ontario doctors

Doctors across Ontario talk to Toronto Star The impact of the pandemic on cancer screening, treatment, and surgery in the state.

In mid-March, Ontario put a breast, cervical, and colorectal cancer screening program on hold to pool more available resources to address the pandemic.

According to data shared by Ontario Health with Stars, screening mammograms were reduced by 97% (158,967 to 4,065), Papanicolaou trials were reduced by 88% (219,079 to 26,269), and stool tests were reduced by 73% (141,251 to 38,000). ..

It’s not just about Ontario. In April, CBC News estimated that there were nearly 100,000 patients across Canada. Surgical procedure was delayed due to COVID-19.

Irish spoke As it happens Host Carol Off about the impact of untreated doses on patients and the healthcare system, and what to do as many parts of the country are caught up in the second wave of COVID-19. Here are some of their conversations.

Dr. Ireland, how advanced is the cancer you see in some of your patients?

It’s really hard to measure. There are 14 regional directors for cancer surgery throughout the state, and patients are said to have more advanced illnesses.

So I can speak personally as a head [and] A cervical cancer surgeon, and my unit, had 10 laryngectomy. Currently, laryngectomy is the most advanced surgery for voicebox cancer or laryngeal cancer. We’ve also done more in the last two months than in a normal year.

Well, that’s an anecdote. However, we hear from colleagues and the field that patients are presenting with increasingly advanced cancer. And, of course, this has implications. That means more advanced surgery, longer surgery, longer hospital stays, and, of course, all types of postoperative care, including radiation and chemotherapy.

Is this related to the pandemic, your senses, as well as the senses of other doctors? This is also an anecdote.

I don’t think there is any doubt. So, for example, we know that patients rarely visit their GPs. In fact, we know that the number of CT and MRI scans performed in the state is much lower than at the same time last year.

Colorectal cancer screening programs, breast cancer mammography, and cervical cytology screening for cervical cancer have decreased by more than 80%.

And, of course, that pipeline, the diagnostic pipeline that spans the entire pathway through the patient’s system from primary care to diagnosis, CT, MRI, and screening, ultimately slows down the patient’s diagnostic pipeline. And I guess they are presenting with more advanced cancer.

Are you choosing patients who have not been pre-screened or who do not see a doctor just for routine purposes? [or] If they feel there’s something they have to see … or is the system not allowing them?

I think it’s a little bit of both. So I know that some patients have been diagnosed with cancer but are afraid to come to the hospital for treatment, and so do my colleagues. Frankly because they are afraid to sign … COVID-19 while they are in the hospital.

So I think there are elements of fear here going to the doctor, going to the hospital, and of course, ignoring the symptoms more and more and presenting with more advanced cancer. Therefore, there are elements of the system.

The Chief Health Officer has ordered selective services to close on March 17th this year and open in May. And while we’re putting together the service, we’re still looking at the patient’s backlog.

We have certainly proven that we can slow down rapidly to develop capacity for COVID-19 patients. However, it was much more difficult to launch after being instructed to slow down the service to create that resource for COVID-19 patients.

As an oncologist, everything you and your colleagues have spent years encouraging people to screen, see, and participate in the regular screening process is an early diagnosis. It was only an important part of the success of cancer treatment, but how much did you lose during this period?

It’s hard to tell exactly how much we’ve lost. But how do we feel? Obviously, we feel frustrated.Whether we are cardiac surgeons [or] Whether we are cancer surgeons … The ability to detect cancer early in the process is absolutely important.

And over the last two decades, one of the ways we have been able to push the needle to improve cancer survival is for the most part, early detection and screening.

By the time the COVID-19 pandemic is finally over, Canadian physicians may face another medical crisis due to the vast backlog of surgery and procedures that strain the already expanding system. 2:04

We are about to enter this second wave. Or perhaps you have already entered many parts of the country. What advice would you give to people who are hesitant to be screened?

We hope that patients will receive the message that they will not ignore their symptoms, their cancer symptoms, or their symptoms such as heart disease or stroke.

The other part of this is to be aggressive, not responsive, to clear the backlog of surgery. Therefore, I know more about COVID-19 than last March. And understand that it is a regional pandemic and can be regionalized on how healthcare services should be scaled down to care for COVID-19 patients and how to safely launch and protect patients. doing. There is no COVID-19, but please take care in a COVID-19 environment.

Therefore, we understand that we do not need to take the approach of mass casualties that closed services as in March to improve the care capacity of patients. We now understand that we have far more choices in how to create resources for our patients. This corresponds to how the regional rise in patients with COVID-19 is occurring.

Written by Jonathan Ole and produced by Katie Geref. Q & A edited for length and clarity.