Impact of COVID-19 Pandemic on Diagnosis of Cancer Symptoms: A View from Primary Care

The overall picture of cancer management in primary care is evolving rapidly in the face of the 2019 coronavirus disease (COVID-19) epidemic, from identifying cases to managing people living with cancer. .1Lancet oncologyCOVID-19: Global impact on oncology. Delayed patient, population, and healthcare system responses to suspected cancer symptoms appear unavoidable in the context of all forced avoidance except fear and essential clinical services.Screening, case identification, and referral in the diagnosis of symptomatic cancer are all affected by the COVID-19 pandemic. The UK national cancer screening program, which makes up about 5% of all cancer diagnoses each year, has been discontinued.2National Cancer Registration and Analysis ServiceRoute to diagnosis. As a result, early diagnosis from screening is delayed and symptom-based cancer diagnosis becomes more important.ThreeHamilton W Walter fm Rubin G Neil RD Improved early diagnosis of symptomatic cancer. Unfortunately, deferring screening sends a message to general and primary care that the cancer may wait.A timely presentation to the primary care of symptomatic patients should provide an assessment of the symptoms that need attention, the recognized or actual ability to consult a health care professional, the recognized consequences of seeking help, and the competition. It is driven by a combination of priorities for the goals to be achieved.FourScott SE Walter fm Webster A Sutton S Emery J Models of the Path to Treatment: Conceptualization and Integration with Existing Theory. Patients with well-recognized red light symptoms such as new lumps and rectal bleeding may continue to participate in primary care. However, because COVID-19 is at the forefront, vague cancer symptoms such as fatigue, changes in bowel habits, and weight loss may be dismissed as minor to the patient.FiveWhitaker KL Scott SE Winstanley k MacLeod U Wardle J Causes of cancer "alarm" symptoms in community samples. Respiratory symptoms, including persistent cough, may be due to COVID-19 and do not work. Patients may be reluctant to give presentations because of fear of interaction with others, limited ability to use video or teleconsultation, and concerns about doctors wasting time.6Forbes LJL Simon AE Warburton F otherCancer perceptions and beliefs between Australia, Canada, Denmark, Norway, Sweden, and the United Kingdom (International Cancer Benchmark Partnership): Do they contribute to the difference in cancer survival?, 7Slanwarn N New Bold J Burt J Campbell JL Roland M Are you wasting your doctor's time? A video-induced study of patients in primary care.For family doctors, the COVID-19 pandemic affects all aspects of normal working life, including reduced workforce due to illness and self-isolation, reduced availability of primary and secondary care appointments and studies. I am. A significant shift to telephone triage and video consultation can result in missing clues, diminished test results, and loss of clinician bowel sensation. Remote consulting may be less suitable for vulnerable patients or individuals with low socioeconomic backgrounds than for patients with high socioeconomic backgrounds, and inequalities already identified in early cancer diagnosis. Making it worse.8British public healthCOVID-19: Guidance for medical professionals. There is no consensus on how to manage or safeguard a pandemic if a patient with cancer is in primary care. When a patient is referred, it may be triaged or delayed.9British public healthA clinical guide for the management of non-coronavirus patients in need of acute treatment: cancer. For example, all cancellations other than emergency endoscopy inevitably extend the time to diagnosis of gastrointestinal cancer.The management and follow-up of cancer patients is also affected by the COVID-19 pandemic. Many cancer patients, especially those undergoing chemotherapy, definitive radiation therapy, and immunotherapy, are at increased risk of COVID-19 symptoms and sequelae. National Health Service guidelines indicate that the benefits of continuing aggressive cancer treatment outweigh the potentially serious risks of being infected with COVID-19, which may have a significant impact on primary care The patient wants to discuss whether or not.9British public healthA clinical guide for the management of non-coronavirus patients in need of acute treatment: cancer. The UK cancer charity Macmillan Cancer Support reports that a quarter of calls to support lines come from cancer patients worried about COVID-19.TenCovid-19 and long-term conditions: What if I have cancer, diabetes, or chronic kidney disease? Cancer philanthropy plays an important supporting role, but primary care must support the physical and mental health of patients whose treatment of potentially life-saving cancers has been postponed.Cancer treatment is a priority in the healthcare system, but as healthcare becomes more and more focused on caring for COVID-19 patients, these patients will inevitably become a priority. Patients in urgent need of treatment are being treated, but treatment is delayed if possible. Guidance to help make these difficult decisions can be unavoidable, variable, inconsistent, and rushing to risk patient outcomes. In this situation, the psychological impact on patients and clinical staff is immeasurable.The COVID-19 pandemic impacted primary care and the crisis highlighted potential solutions to address future global health threats. These are unprecedented times, but may increase the use of remote consultation. Increasing flexibility in access to healthcare may favor some population groups, but at the risk of disadvantage to others. When done properly, remote consulting can benefit previously unserved patient populations (ie, remote individuals).Behavioral interventions that facilitate the timely diagnosis of symptomatic cancers are important. Citizen awareness campaigns have shown that early requests for help are welcome and legitimate, and may use the growing social media and community networks in response to COVID-19. Clinicians are wary of the so-called diagnostic obscuring by COVID-19, the patient may have already significantly delayed the presentation and need additional support for the next step with regard to referrals and safety nets. Please remember that.If cancer is suspected, clinicians should not prevent urgent referral of patients due to COVID-19 or other future global health threats. However, healthcare professionals may need to accept triage and risk stratification of potentially serious patients. Biomarker and machine learning approaches can help prioritize the highest risk patients and divert medical resources towards managing critically ill patients.If the patient is diagnosed with or co-exists with cancer, the primary care provider will assist in making advanced planning decisions regarding cancer care, palliative care, resuscitation and priority treatment locations. , You may have to accept enhanced roles.There is an enormous backlog of patients with potential cancer symptoms that require urgent evaluation when normal services resume at the population and health care levels. Recovery planning should begin as soon as possible.We declare no competing interests. This study is linked to the Cancer Test Collaborative, funded by Cancer Research UK (C8640 / A23385). This RDN is an associate director and SES is a collaborator. It is sponsored by Health and Care Research, funded by the Wales Primary and Emergency Medicine Research Center (517195) and the Wales Cancer Research Center (517190), co-researchers and collaborators of KB.References1.COVID-19: Global impact on oncology.Lancet Oncol. 2020; twenty one: 4672.National Cancer Registration and Analysis ServiceRoute to diagnosis.3.Hamilton W Walter fm Rubin G Neil RD Improved early diagnosis of symptomatic cancer.Nat Rev Clin Oncol. 2016; 13: 740-749Four.Scott SE Walter fm Webster A Sutton S Emery J Models of the Path to Treatment: Conceptualization and Integration with Existing Theory.Br J Health Psychol. 2013; 18: 45-65Five.Whitaker KL Scott SE Winstanley k MacLeod U Wardle J Causes of cancer "alarm" symptoms in community samples.PLoS One. 2014; 9: 1-176.Forbes LJL Simon AE Warburton F otherCancer perceptions and beliefs between Australia, Canada, Denmark, Norway, Sweden, and the United Kingdom (International Cancer Benchmark Partnership): Do they contribute to the difference in cancer survival?Brit J Gun. 2013; 108: 292-3007.Slanwarn N New Bold J Burt J Campbell JL Roland M Are you wasting your doctor's time? A video-induced study of patients in primary care.Soc Sci Med. 2017; 176: 113-1228.COVID-19: Guidance for medical professionals.9.A clinical guide for the management of non-coronavirus patients in need of acute treatment: cancer.Ten.Covid-19 and long-term conditions: What if I have cancer, diabetes, or chronic kidney disease?BMJ. 2020; 368m1174Article informationPublication historyRelease Date: April, 30th, 2020identificationDOI: https://doi.org/10.1016/S1470-2045(20)30242-4Copyright© 2020 Elsevier Ltd. All rights reserved.ScienceDirectAccess this article with ScienceDirect Linked articles Pictures Credit

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