Mitigating the long-term impact of the COVID‑19 epidemic on cancer control and care
The COVID‑19 pandemic is causing major disruptions to several activities related to cancer control, prevention, and care. Cancer screening and prevention are now scaled back to prevent exposure of participants to the coronavirus. Many cancer diagnostic procedures and treatments have been delayed, modified, or suspended. As the containment measures are extended over several months, losses in the quality and quantity of cancer control and care will eventually lead to increases in incidence of cancers preventable via screening and vaccination, more advanced disease at diagnosis, and lower survival. The proposed research aims to study the long-term impact of the COVID‑19 epidemic on cancer prevention, screening, and care to design evidence-driven mitigation strategies. First, we will assess the spectrum of cancer control and care activities that have been suppressed or altered because of the epidemic. Via a panel of oncologists from all subspecialties, public health experts, nurses, and pathologists we will identify processes of cancer control and care and estimate quantitatively the extent of influence on these processes by the epidemic and associated actions by the healthcare system. Second, we will conduct an in-depth literature review to obtain estimates of screening effectiveness and of the effects of delays in cancer diagnosis on clinical outcomes, such as stage at diagnosis and disease-free survival. Thirdly, based on the quantitative parameters obtained in the latter two research activities, we will develop models representing the population of Canada to estimate the impact of the pandemic on site-specific cancer trajectories. The models will be used to estimate the pandemic’s impact in terms of cancer incidence (due to delays in diagnosis and suspended/deferred screening) and survival (due to delays in diagnosis and altered/suspended treatments) and based on these projections, we will propose strategies to reduce cancer morbidity and mortality.