Impact of the COVID-19 pandemic on the symptomatic diagnosis of cancer: the view from primary care

The entire landscape of cancer management in primary care, from case identification to the management of people living with and beyond cancer, is evolving rapidly in the face of the coronavirus disease 2019 (COVID-19) pandemic.1 In a climate of fear and mandated avoidance of all but essential clinic...

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Vydané v:	The lancet oncology Ročník 21; číslo 6; s. 748 - 750
Hlavní autori:	Jones, Daniel, Neal, Richard D, Duffy, Sean R G, Scott, Suzanne E, Whitaker, Katriina L, Brain, Kate
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	England Elsevier Ltd 01.06.2020 Elsevier Limited
Predmet:	Betacoronavirus Cancer Cancer therapies Comment Coronavirus Infections - epidemiology Coronaviruses COVID-19 Early Detection of Cancer - statistics & numerical data Emergency medical care Fear Health care Hematology, Oncology, and Palliative Medicine Humans Medical diagnosis Medical research Medical screening National Health Programs - standards Neoplasms - diagnosis Neoplasms - psychology Neoplasms - therapy Pandemics Patients Physician's Role Pneumonia, Viral - epidemiology Primary care Primary Health Care - standards Primary Health Care - trends Remote Consultation - trends SARS-CoV-2 United Kingdom - epidemiology United Kingdom United Kingdom > UK Wales
ISSN:	1470-2045, 1474-5488, 1474-5488
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Abstract	The entire landscape of cancer management in primary care, from case identification to the management of people living with and beyond cancer, is evolving rapidly in the face of the coronavirus disease 2019 (COVID-19) pandemic.1 In a climate of fear and mandated avoidance of all but essential clinical services, delays in patient, population, and health-care system responses to suspected cancer symptoms seem inevitable. Patients might be reluctant to present because of fear of interacting with others, limited capacity to use video or teleconsultations, and concerns about wasting the doctor's time.6,7 For family doctors, the COVID-19 pandemic is affecting all aspects of normal working life, including a reduced workforce due to illness and self-isolation, and the reduced availability of appointments and investigations in primary and secondary care. The National Health Service guidelines state that patients will want to discuss whether the benefits of continuing active cancer treatment outweigh the risks of potentially being seriously unwell if they contract COVID-19, which is a role that could well fall to primary care.9 The UK cancer charity Macmillan Cancer Support reports that a quarter of calls to its support line are from patients with cancer who are anxious about COVID-19.10 Although cancer charities provide a vital support role, primary care needs to support the physical and mental health of patients for whom potentially lifesaving cancer treatments are being postponed.
AbstractList	The entire landscape of cancer management in primary care, from case identification to the management of people living with and beyond cancer, is evolving rapidly in the face of the coronavirus disease 2019 (COVID-19) pandemic.1 In a climate of fear and mandated avoidance of all but essential clinical services, delays in patient, population, and health-care system responses to suspected cancer symptoms seem inevitable. Patients might be reluctant to present because of fear of interacting with others, limited capacity to use video or teleconsultations, and concerns about wasting the doctor's time.6,7 For family doctors, the COVID-19 pandemic is affecting all aspects of normal working life, including a reduced workforce due to illness and self-isolation, and the reduced availability of appointments and investigations in primary and secondary care. The National Health Service guidelines state that patients will want to discuss whether the benefits of continuing active cancer treatment outweigh the risks of potentially being seriously unwell if they contract COVID-19, which is a role that could well fall to primary care.9 The UK cancer charity Macmillan Cancer Support reports that a quarter of calls to its support line are from patients with cancer who are anxious about COVID-19.10 Although cancer charities provide a vital support role, primary care needs to support the physical and mental health of patients for whom potentially lifesaving cancer treatments are being postponed.
Author	Jones, Daniel Whitaker, Katriina L Brain, Kate Scott, Suzanne E Neal, Richard D Duffy, Sean R G
Author_xml	– sequence: 1 givenname: Daniel surname: Jones fullname: Jones, Daniel email: d.j.jones@leeds.ac.uk organization: Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9NL, UK – sequence: 2 givenname: Richard D surname: Neal fullname: Neal, Richard D organization: Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9NL, UK – sequence: 3 givenname: Sean R G surname: Duffy fullname: Duffy, Sean R G organization: West Yorkshire and Harrogate Cancer Alliance, White Rose House, Wakefield, UK – sequence: 4 givenname: Suzanne E surname: Scott fullname: Scott, Suzanne E organization: Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Guy's Hospital, London, UK – sequence: 5 givenname: Katriina L surname: Whitaker fullname: Whitaker, Katriina L organization: School of Health Sciences, University of Surrey, Surrey, UK – sequence: 6 givenname: Kate surname: Brain fullname: Brain, Kate organization: Division of Population Medicine, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/32359404$$D View this record in MEDLINE/PubMed
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References_xml	– volume: 21 start-page: 467 year: 2020 ident: bib1 article-title: COVID-19: global consequences for oncology publication-title: Lancet Oncol – volume: 108 start-page: 292 year: 2013 end-page: 300 ident: bib6 article-title: Differences in cancer awareness and beliefs between Australia, Canada, Denmark, Norway, Sweden and the UK (the International Cancer Benchmarking Partnership): do they contribute to differences in cancer survival? publication-title: Brit J Cancer – volume: 18 start-page: 45 year: 2013 end-page: 65 ident: bib4 article-title: The model of pathways to treatment: conceptualization and integration with existing theory publication-title: Br J Health Psychol – volume: 9 start-page: 1 year: 2014 end-page: 17 ident: bib5 article-title: Attributions of cancer ‘alarm’ symptoms in a community sample publication-title: PLoS One – year: April 23, 2020 ident: bib8 article-title: COVID-19: Guidance for health professionals – year: March 23, 2020 ident: bib9 article-title: Clinical guide for the management of noncoronavirus patients requiring acute treatment: cancer – volume: 368 year: 2020 ident: bib10 article-title: Covid-19 and long term conditions: what if you have cancer, diabetes, or chronic kidney disease? publication-title: BMJ – ident: bib2 article-title: Routes to diagnosis – volume: 13 start-page: 740 year: 2016 end-page: 749 ident: bib3 article-title: Improving early diagnosis of symptomatic cancer publication-title: Nat Rev Clin Oncol – volume: 176 start-page: 113 year: 2017 end-page: 122 ident: bib7 article-title: Wasting the doctor's time? A video-elicitation study with patients in primary care publication-title: Soc Sci Med – volume: 368 year: 2020 ident: 10.1016/S1470-2045(20)30242-4_bib10 article-title: Covid-19 and long term conditions: what if you have cancer, diabetes, or chronic kidney disease? publication-title: BMJ – volume: 9 start-page: 1 year: 2014 ident: 10.1016/S1470-2045(20)30242-4_bib5 article-title: Attributions of cancer ‘alarm’ symptoms in a community sample publication-title: PLoS One doi: 10.1371/journal.pone.0114028 – volume: 21 start-page: 467 year: 2020 ident: 10.1016/S1470-2045(20)30242-4_bib1 article-title: COVID-19: global consequences for oncology publication-title: Lancet Oncol doi: 10.1016/S1470-2045(20)30175-3 – volume: 176 start-page: 113 year: 2017 ident: 10.1016/S1470-2045(20)30242-4_bib7 article-title: Wasting the doctor's time? A video-elicitation study with patients in primary care publication-title: Soc Sci Med doi: 10.1016/j.socscimed.2017.01.025 – volume: 108 start-page: 292 year: 2013 ident: 10.1016/S1470-2045(20)30242-4_bib6 article-title: Differences in cancer awareness and beliefs between Australia, Canada, Denmark, Norway, Sweden and the UK (the International Cancer Benchmarking Partnership): do they contribute to differences in cancer survival? publication-title: Brit J Cancer doi: 10.1038/bjc.2012.542 – volume: 18 start-page: 45 year: 2013 ident: 10.1016/S1470-2045(20)30242-4_bib4 article-title: The model of pathways to treatment: conceptualization and integration with existing theory publication-title: Br J Health Psychol doi: 10.1111/j.2044-8287.2012.02077.x – volume: 13 start-page: 740 year: 2016 ident: 10.1016/S1470-2045(20)30242-4_bib3 article-title: Improving early diagnosis of symptomatic cancer publication-title: Nat Rev Clin Oncol doi: 10.1038/nrclinonc.2016.109
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Snippet	The entire landscape of cancer management in primary care, from case identification to the management of people living with and beyond cancer, is evolving...
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SubjectTerms	Betacoronavirus Cancer Cancer therapies Comment Coronavirus Infections - epidemiology Coronaviruses COVID-19 Early Detection of Cancer - statistics & numerical data Emergency medical care Fear Health care Hematology, Oncology, and Palliative Medicine Humans Medical diagnosis Medical research Medical screening National Health Programs - standards Neoplasms - diagnosis Neoplasms - psychology Neoplasms - therapy Pandemics Patients Physician's Role Pneumonia, Viral - epidemiology Primary care Primary Health Care - standards Primary Health Care - trends Remote Consultation - trends SARS-CoV-2 United Kingdom - epidemiology
Title	Impact of the COVID-19 pandemic on the symptomatic diagnosis of cancer: the view from primary care
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