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The onset of the COVID-19 pandemic disrupted many aspects of human life, not least healthcare. As resources were redistributed towards the crisis, social isolation rules also limited access to medical professionals. In particular, these measures may have affected many aspects of cancer care, such as early detection or treatment.
Many studies have aimed to capture the impact of these changes, but most have been observational, with researchers recording events without trying to impose a controlled design. These investigations also often faced limitations such as small sample sizes, or only focusing on one aspect of cancer care. Systemic reviews, which synthetize and assess existing research on a topic, have helped to bypass these constraints. However, they are themselves not devoid of biases. Overall, a clear, unified picture of the impact of COVID-19 on cancer care is yet to emerge.
In response, Muka et al. carried an umbrella analysis of 51 systematic reviews on this topic. They used a well-known critical appraisal tool to assess the methodological rigor of each of these studies, while also summarising their findings. This work aimed to capture many aspects of the patients’ experience, from diagnosis to treatment and the financial, psychological, physical and social impact of the disease.
The results confirmed that the pandemic had a substantial impact on cancer care, including delays in screening, diagnosis and treatment. Throughout this period cancer patients experienced increased rates of depression, post-traumatic stress and fear of their cancer progressing. The long-term consequences of these disruptions remain to be uncovered.
However, Muka et al. also showed that, overall, these conclusions rely on low-quality studies which may have introduced unaccountable biases. In addition, their review highlights that most of the data currently available has been collected in high- and middle-income countries, with evidence lacking from regions of the world with more limited resources.
In the short-term, these results indicate that interventions may be needed to mitigate the negative impact of the pandemic on cancer care; in the long-term, they also demonstrate the importance of rigorous systematic reviews in guiding decision making. By shining a light on the ripple effects of certain decisions about healthcare resources, this work could also help to shape the response to future pandemics.
