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Cancer

2,000 cancer diagnoses may not have been made due to impact of Covid-19 on services

Referrals and attendances at clinics dipped significantly at the start of the pandemic.

THE HSE HAS estimated up to 2,000 diagnoses of cancer may not have been made this year due to the impact of Covid-19 on its cancer services and on presentations of patients.

Professor Risteárd Ó Laoide, national director of the National Cancer Control Programme (NCCP), shared data from breast, lung and prostate clinics today which show significant dips in activity in March and April.

Despite the drop, at breast clinics referrals have now significantly overshot 2019 figures and referrals to lung and prostate rapid access clinics are showing a similar recovery in recent months.

Attendances at prostate rapid access clinics however are still down on 2019 attendances, now at 76% having dipped to 40% in the early stages of the pandemic.

He said the figures show the HSE has diagnosed about 90% of breast, lung and prostate cancers compared to last year – that’s 371 cases of “lost cancers” that have not been diagnosed in these categories compared to last year.

It’s difficult to extrapolate to the larger number of cancer patients in Ireland but potentially it could be up to 2,000 cases of missed cancer which will presumably appear, we hope, later in the year.

There was also an impact on treatment, with surgical oncology dropping to 37%, now at 71%.

The most important thing that we’ve been trying to do is efficient and effective triage of patients who are referred. This is very important because this is seeking out the most urgent case which need to be seen quickly.

He said pre-Covid capacity of these clinics was already stretched and operating in the pandemic environment has slowed the delivery of services.

“They were running at full speed before Covid and now they have two stones on their back and they’re continuing to run at full speed to provide the service.”

He said the number of clinics has been increased and some services are being provided virtually. Professor Ó Laoide said the HSE is also using new pathways with imaging, such as getting CAT scans before patients come to a lung clinic, so there is less patient footfall in hospitals.

He said there is “significant funding” for cancer services in the HSE’s Winter Plan and National Service Plan which will help to deal with some of the issues in the system.

“The Achilles heel of the system really is community transmission because what will knock our ability to deliver cancer series most is if there is an increase in community transmission and increased infection among staff and palatines,” he said.

“That’s what closes the wards, that’s what closes the clinics and that’s what really has the most significant impact on our ability to deal with patients.”

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