KINGSTON, Ontario — The coronavirus pandemic is squeezing many medical providers to their limits as cases rise across the globe again. During the peak of cases in the spring, overwhelmed hospitals and clinics forced doctors to prioritize surgeries and may have forced many patients to wait longer for treatment. But holding off on necessary care can put people in danger, and that’s especially the case for those suffering from cancer. A new study shows that delaying treatment for a month raises the risk of death by 10 percent for cancer patients.
Researchers at Queen’s University in Canada warn that the longer treatments are delayed for, the higher the risk of death. That’s the case whether a patient is undergoing chemotherapy or radiation. With many countries’ health systems being stretched by the COVID-19 pandemic, there is an urgent need to understand how these delays affect patients.
“A four week delay in treatment is associated with an increase in mortality across all common forms of cancer treatment, with longer delays being increasingly detrimental,” says Dr. Timothy Hanna, who led the research, in a media release. “In light of these results, policies focused on minimizing system level delays in cancer treatment initiation could improve population level survival outcomes.”
No matter the type of cancer treatment, delays raise death risk
A review and analysis of all relevant studies into the subject published between January 2000 and April 2020, was carried out by the researchers. Data on treatments for seven forms of cancer, including bladder, breast, colon, rectum, lung, cervix and head and neck, were included in the studies. Collectively these account for 44 per cent of all new cancer cases globally.
The researchers found 34 suitable studies involving more than 1.2 million patients, who needed to be treated for 17 types of cancer. Delays were found to increase mortality for 13 of these 17 conditions.
Delays in surgery, systemic therapy or radiotherapy from when patients were diagnosed to their first treatment or from one treatment to the next, were measured by the researchers. The risk of death per-four week delay for each condition was then calculated.
Across all three types of treatment, a delay of four weeks increase a patient’s chances of dying.
“For surgery, this was a six to eight percent increase in the risk of death for every four-week treatment delay,” says Hanna. “Whereas the impact was even more marked for some radiotherapy and systemic indications, with a nine per cent and 13 percent increased risk of death for definitive head and neck radiotherapy and adjuvant (follow-up) systemic treatment for colorectal cancer, respectively.”
Breast cancer patients face a 17 percent higher chance of death after eight weeks, rising to 26 percent by 12 weeks. In other words, if surgery is delayed by 12 weeks for all breast cancer patients in the U.S. over a year, an extra 6,100 patients will die. This is assuming surgery is the first treatment in 83 percent of cases and death rates without delay remain at 12 percent.
Hanna notes that the study is observational and that there are certainly other factors that could be behind a patient’s death.
“It was possible that patients with longer treatment delays were destined to have inferior outcomes for reasons of having multiple illnesses or treatment morbidity,” he says. “Nevertheless, the analysis was based on a large amount of data and we ensured high quality studies that had high validity were included, meaning they accurately measured what they were investigating.”
The study is published in the journal The BMJ.
SWNS reporter Tom Campbell contributed to this report.