Introduction -
The COVID-19 pandemic led to diminished services across all areas of healthcare. This is likely more pronounced within regional Victoria, with lockdown measures exacerbating the existing challenges faced by those with limited access to healthcare.
Methods -
This is a retrospective audit of the 4 most common cancers (breast, lung, colorectal, and prostate) to the Gippsland Cancer Centre (GCC) between 2020-22. This was then analysed with timeframes correlating with Victorian COVID-19 lockdowns and compared to Victorian registry data.
Results
There was a 60-70% increase in breast cancer patients in 2021-22 compared to 2020. Despite this, the rates of stage 4 presentations fell by 3%.
2021 had the highest referrals of colorectal cancers with a 44% increase from 2020, but also had the lowest rate of stage 4 disease.
Lung cancer increased by 17% in 2021 from 2020, with a decrease of 16% in stage 4 presentations.
Majority of the prostate patients are stage 4, with a 70% increase in 2021 compared to 2020.
Quarter 3 and 4 of 2020 saw a decrease in new patient referrals due to the 1st lockdown, and then an increase in 2021 when lockdowns were lifted and vaccination rates increased.
Discussion
GCC clinics are comprised mainly of medical oncologists, who treat later stage cancers, which is one explanation for the higher rates of stage 4 cancer compared to Victorian data. Despite the large increase in referrals to GCC in 2021-22, there was a decrease in stage 4 patients in breast and lung. The temporary pause of breast screening in 2020 could explain the lower numbers compared to 2021-22. The increased awareness of respiratory symptoms due to COVID19, could explain the rise in lung cancer presentations. COVID 19 lockdowns didn’t appear to decrease the number of new cancer presentations as predicted, but it did decrease the proportion of patients presenting at a later stage.