Delaying cancer treatment by just a month can put patients at a sharply greater risk of dying, according to research published Wednesday, the latest to sound the alarm over the coronavirus pandemic's impact on other health conditions.

Passengers wearing face masks get on and off a train at a subway station in Toronto, Canada, on November 3. Photo: Xinhua

Treatment delays happen in normal times, but the spread of COVID-19 has caused unprecedented disruption to healthcare services.

In a new study published in the BMJ medical journal, researchers in the UK and Canada found that delays in treatment - whether for surgery, radiotherapy, or other treatments such as chemotherapy - for seven types of cancers had a significant impact on patient mortality. 

"There has never been a systematic attempt to look at all the evidence on what delays in different types of treatment mean for cancer patient outcomes," said coauthor Ajay Aggarwal, a clinical oncologist and associate professor at the London School of Hygiene and Tropical Medicine. 

"Because we know this is happening to cancer patients during the COVID-19 pandemic it is essential to understand the real impact." 

The study found even a one-month postponement could mean a patient had a 6 to 13 percent higher risk of dying. The longer the wait for treatment, the higher the risk.

The authors described the findings, based on dozens of international studies published over the last two decades, as "sobering."

The research suggests that "for the majority of the major cancers and treatments there is no 'safe' treatment delay," Aggarwal told AFP.

Researchers estimated that a delay in surgery of 12 weeks for all patients with breast cancer - during COVID-19 lockdowns and their aftermath, for example - would, over the course of a year, lead to 1,400 excess deaths in the UK, 6,100 in the US, 700 in Canada, and 500 in Australia. 

Many hospitals with major coronavirus outbreaks were initially forced to postpone nonemergency procedures to avoid putting patients at risk. 

In Britain, the researchers said a number of conditions were considered safe to be delayed by 10 to 12 weeks, including all colorectal surgery.

"Our study suggests that this is not the case and could in fact increase the risk of premature death by approximately 20 percent. A similar duration of delay for bowel cancer chemotherapy could increase the risk of death by 44 percent," Aggarwal said. He called for urgent measures to tackle backlogs and the use of alternative treatment methods for patients, such as "shorter but equally effective radiation therapies."

Researchers based their calculations on analysis of 34 studies, with data on procedures for cancers of the bladder, breast, colon, rectum, lung, and cervix, as well as the head-and-neck. 

Overall, they found that a four-week delay in surgery increased the risk of death by 6 to 8 percent. 

There were even greater negative impacts for stalling other treatments, with a four-week postponement of some systemic treatments for colorectal cancer linked to a 13 percent increase in the risk of death.

Responding to the study, Justin Stebbing, professor of Cancer Medicine and Medical Oncology at Imperial College London, said it was important to balance COVID-19 risks with those associated with delays.
Newspaper headline: Study warns of patient mortality impact