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The impact of the COVID-19 pandemic on cancer diagnosis and service access in New Zealand–a country pursuing COVID-19 elimination

journal contribution
posted on 2022-06-24, 23:37 authored by Jason K Gurney, Elinor Millar, Alex Dunn, Ruth Pirie, Michelle MakoMichelle Mako, John Manderson, Claire Hardie, Chris GCA Jackson, Richard North, Myra Ruka, Nina Scott, Diana Sarfati
BACKGROUND: The COVID-19 pandemic has disrupted cancer services globally. New Zealand has pursued an elimination strategy to COVID-19, reducing (but not eliminating) this disruption. Early in the pandemic, our national Cancer Control Agency (Te Aho o Te Kahu) began monitoring and reporting on service access to inform national and regional decision-making. In this manuscript we use high-quality, national-level data to describe changes in cancer registrations, diagnosis and treatment over the course of New Zealand's response to COVID-19. METHODS: Data were sourced (2018-2020) from national collections, including cancer registrations, inpatient hospitalisations and outpatient events. Cancer registrations, diagnostic testing (gastrointestinal endoscopy), surgery (colorectal, lung and prostate surgeries), medical oncology access (first specialist appointments [FSAs] and intravenous chemotherapy attendances) and radiation oncology access (FSAs and megavoltage attendances) were extracted. Descriptive analyses of count data were performed, stratified by ethnicity (Indigenous Māori, Pacific Island, non-Māori/non-Pacific). FINDINGS: Compared to 2018-2019, there was a 40% decline in cancer registrations during New Zealand's national shutdown in March-April 2020, increasing back to pre-shutdown levels over subsequent months. While there was a sharp decline in endoscopies, pre-shutdown volumes were achieved again by August. The impact on cancer surgery and medical oncology has been minimal, but there has been an 8% year-to-date decrease in radiation therapy attendances. With the exception of lung cancer, there is no evidence that existing inequities in service access between ethnic groups have been exacerbated by COVID-19. INTERPRETATION: The impact of COVID-19 on cancer care in New Zealand has been largely mitigated. The New Zealand experience may provide other agencies or organisations with a sense of the impact of the COVID-19 pandemic on cancer services within a country that has actively pursued elimination of COVID-19. FUNDING: Data were provided by New Zealand's Ministry of Health, and analyses completed by Te Aho o Te Kahu staff.

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Preferred citation

Gurney, J. K., Millar, E., Dunn, A., Pirie, R., Mako, M., Manderson, J., Hardie, C., Jackson, C. G. C. A., North, R., Ruka, M., Scott, N. & Sarfati, D. (2021). The impact of the COVID-19 pandemic on cancer diagnosis and service access in New Zealand–a country pursuing COVID-19 elimination. The Lancet Regional Health - Western Pacific, 10, 100127-100127. https://doi.org/10.1016/j.lanwpc.2021.100127

Journal title

The Lancet Regional Health - Western Pacific

Volume

10

Publication date

2021-05-01

Pagination

100127-100127

Publisher

Elsevier BV

Publication status

Published

Contribution type

Article

Online publication date

2021-05-01

ISSN

2666-6065

eISSN

2666-6065

Article number

100127

Language

en

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