Care for children with cancer has been disrupted at nearly 80 percent of hospitals globally because of the coronavirus disease 2019 (Covid-19) pandemic, a survey published Wednesday by The Lancet Child & Adolescent Health found.
More than 40 percent of hospitals surveyed last summer reported that they had made fewer new cancer diagnoses than expected, and about one-third saw a rise in the number of pediatric cancer patients abandoning treatment, the data showed.
Seven percent of the responding hospitals said they had closed their pediatric cancer units at some point during the pandemic.
Hospitals in low- and middle-income countries were disproportionately affected, with unavailability of chemotherapy, treatment abandonment and disrupted radiotherapy among issues most frequently cited, the researchers behind the survey said.
Globally, more than 300,000 children are diagnosed with cancer each year, and over 10,000 are diagnosed in the United States, according to the American Childhood Cancer Organization.
“Our findings suggest that Covid-19 has had a greater impact on childhood cancer care globally than single-region studies had suggested,” co-author Dr. Daniel Moreira said in a press release.
“Hospitals in low- and middle-income countries were under strain even before the pandemic, with fewer resources and less access to care for children with cancer, so our results seem to reflect the relative strength of different healthcare systems around the world,” said Moreira, a pediatric oncologist at St. Jude Children’s Research Hospital in Memphis.
The findings are based on a survey of more than 300 clinicians from 200 hospitals in 79 countries, including the United States, conducted between June and August last year, the researchers said.
Of the hospitals surveyed, 78 percent reported that pediatric cancer care was disrupted in some way because of the pandemic, with 43 percent indicating that they had diagnosed fewer new cases than expected.
In addition, 34 percent said that they had seen a rise in the number of childhood cancer patients who had abandoned treatment, likely due to fears related to Covid-19.
The cancer centers that closed because of the pandemic did so temporarily, typically for one to two weeks, according to the researchers.
The vast majority of temporarily shuttered facilities were in low- and middle-income countries.
Seventy-nine percent of the hospitals surveyed said that they experienced a reduction in the number of cancer surgeries performed during the pandemic, while 60 percent experienced blood supply shortages and 57 percent saw similar shortages in key chemotherapy drugs.
These shortfalls, which disrupted chemotherapy treatment at roughly 40 percent of responding hospitals, were likely due to disruptions in supply chains caused by the Covid-19 pandemic, according to the researchers.
One-third of hospitals surveyed also experienced decreased financial support, while two-thirds reported a reduction in available clinical staff.
And about one in five hospitals saw a reduction in the availability of pediatric cancer beds, with more hospital beds devoted to care for patients with Covid-19.
Most of the responding hospitals implemented new policies and guidelines to support pediatric cancer care during the pandemic, with 69 percent using new or adapted patient and staff safety checklists and 63 percent instituting new processes for communication with patients and families, according to the researchers.
“The long-term impacts on childhood cancer outcomes are not yet clear,” co-author Dr. Dylan Graetz said in a statement.
“Our findings highlight the need for ongoing assessment of resource needs during the pandemic and the sharing of successful strategies to tackle the negative effects on pediatric cancer care,” said Graetz, a fellow in pediatric hematology and oncology who works with Moreira at St. Jude.