An umbrella review of systematic reviews on the impact of the COVID-19 pandemic on cancer prevention and management, and patient needs

  1. Taulant Muka
  2. Joshua J X Li
  3. Sahar J Farahani
  4. John PA Ioannidis  Is a corresponding author
  1. University of Bern, Switzerland
  2. Chinese University of Hong Kong, Hong Kong
  3. Stony Brook University, United States
  4. Stanford University, United States

Abstract

The COVID-19 pandemic led to relocation and reconstruction of health care resources and systems, and to a decrease in healthcare utilization, and this may have affected the treatment, diagnosis, prognosis, and psychosocial well-being of patients with cancer. We aimed to summarize and quantify the evidence on the impact of the COVID-19 pandemic on the full spectrum of cancer care. An umbrella review was undertaken to summarize and quantify the findings from systematic reviews on impact of the COVID-19 pandemic on cancer treatment modification, delays, and cancellations; delays or cancellations in screening and diagnosis; psychosocial well-being, financial distress, and use of telemedicine as well as on other aspects of cancer care. PubMed and WHO COVID-19 Database was searched for relevant systematic reviews with or without meta-analysis published before November 29th, 2022. Abstract, full text screening and data extraction were performed by two independent reviewers. AMSTAR-2 was used for critical appraisal of included systematic reviews. 51 systematic reviews evaluating different aspects of cancer care were included in our analysis. Most reviews were based on observational studies judged to be at medium and high risk of bias. Only 2 of the included reviews had high or moderate scores based on AMSTAR-2. Findings suggest treatment modifications in cancer care during the pandemic versus the pre-pandemic period were based on low level of evidence. Different degrees of delays and cancellations in cancer treatment, screening and diagnosis were observed, with low-and-middle income countries and countries that implemented lockdowns being disproportionally affected. A shift from in-person appointments to telemedicine use was observed, but utility of telemedicine, challenges in implementation and cost-effectiveness in different areas of cancer care were little explored. Evidence was consistent in suggesting psychosocial well-being (e.g., depression, anxiety, and social activities) of patients with cancer deteriorated, and cancer patients experienced financial distress, albeit results were in general not compared to pre-pandemic levels. Impact of cancer care disruption during the pandemic on cancer prognosis was little explored. In conclusion, Substantial but heterogenous impact of COVID-19 pandemic on cancer care has been observed. Evidence gaps exist on this topic, with mid- and long-term impact on cancer care being most uncertain.

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Author details

  1. Taulant Muka

    Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
    Competing interests
    The authors declare that no competing interests exist.
  2. Joshua J X Li

    Department of Anatomical and Cellular Pathology, Chinese University of Hong Kong, Hong Kong, Hong Kong
    Competing interests
    The authors declare that no competing interests exist.
  3. Sahar J Farahani

    Department of Pathology and Laboratory Medicine, Stony Brook University, New York, United States
    Competing interests
    The authors declare that no competing interests exist.
  4. John PA Ioannidis

    Meta-Research Innovation Center at Stanford, Stanford University, Stanford, United States
    For correspondence
    jioannid@stanford.edu
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0003-3118-6859

Funding

No funding was provided for this project.

Copyright

© 2023, Muka et al.

This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.

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  1. Taulant Muka
  2. Joshua J X Li
  3. Sahar J Farahani
  4. John PA Ioannidis
(2023)
An umbrella review of systematic reviews on the impact of the COVID-19 pandemic on cancer prevention and management, and patient needs
eLife 12:e85679.
https://doi.org/10.7554/eLife.85679

Share this article

https://doi.org/10.7554/eLife.85679

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