Examining the COVID-19 impact on cancer surgery in Ireland using three national data sources.

Background: The healthcare system in Ireland was profoundly affected by COVID-19. This study aimed to explore the impact of the pandemic on cancer surgery in Ireland, from 2019 to 2022 using three national health data sources. Methods: A repeated cross-sectional study design was used and included: (i) cancer resections from the National Histopathology Quality Improvement (NHQI) Programmes; (ii) cancer surgery from the National Cancer Registry Ireland (NCRI), and (iii) cancer surgery from Hospital Inpatient Enquiry (HIPE) System. Cancer surgery was presented by invasive/in situ and invasive only cancers (NCRI & HIPE), and by four main cancer types (breast, lung, colorectal & melanoma for NCRI & HIPE data only). Results: The annual number of cancer resections (NHQI) declined by 4.4% in 2020 but increased by 4% in 2021 compared with 2019. NCRI data indicated invasive/in-situ cancer surgery for the four main cancer types declined by 14% in 2020 and 5.1% in 2021, and by 12.3% and 7.3% for invasive cancer only, compared to 2019. Within HIPE for the same tumour types, invasive/in situ cancer surgery declined by 21.9% in 2020 and 9.9% in 2021 and by 20.8% and 9.6% for invasive cancer only. NHQI and HIPE data indicated an increase in the number of cancer surgeries performed in 2022. Conclusions: Cancer surgery declined in the initial pandemic waves suggests mitigation measures for cancer surgery, including utilising private hospitals for public patients, reduced the adverse impact on cancer surgery.

Impact of the COVID-19 pandemic on electronic referrals to rapid access clinics for suspected breast, lung and prostate cancers in Ireland.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic impacted cancer services worldwide. We examined the effect of the first three pandemic waves on the number of electronic (e)-referrals to rapid access clinics (RACs) for breast, lung and prostate cancer in Ireland. METHODS: This study used a retrospective, repeated cross-sectional design. The predicted weekly number of e-referrals by suspected cancer types from March 2020 to May 2021 was calculated using the Holt-Winters seasonal smoothing method, based on the observed numbers from a representative pre-pandemic period (01 January 2019 to 01 March 2020) and compared this with the observed number across the first three pandemic waves (02 March 2020 to 09 May 2021). Percentage differences were calculated between observed and predicted numbers of e-referrals for the three RACs and patterns were examined in each wave. RESULTS: Observed e-referrals were lower than predicted for all three RACs in the first wave of the pandemic (15.7% lower for breast, 39.5% lower for lung and 28.1% lower for prostate) with varying levels of recovery in the second and third waves for the three e-referral types. CONCLUSIONS: The COVID-19 pandemic impacted patterns of e-referrals to RACs in the first three pandemic waves in Ireland. Early identification of changes in engagement with health services, such as a decrease in primary care presentations with a resultant decrease in e-referrals to RACs can allow for a rapid response from cancer control programmes. Continued surveillance of the impact of service disruption on cancer services allows policy makers and strategic leaders in cancer control programmes to respond rapidly to mitigate the impact on cancer outcomes.

Impact of the COVID-19 pandemic on cancer care in Ireland - Perspectives from a COVID-19 and Cancer Working Group.

Upon the COVID-19 pandemic onset in Ireland, cancer service disruptions occurred due to prioritisation of COVID-19 related care, redeployment of staff, initial pausing of screening, diagnostic, medical and surgical oncology procedures, staff shortages due to COVID-19 infection and impacts on the physical and mental health of cancer healthcare workers. This was coupled with reluctance among people with symptoms suspicious for cancer to attend for clinical evaluation, due to concerns of contracting the virus. This was further compounded by a cyber-attack on national health service IT systems on May 14th 2021. The Irish Cancer Society, a national cancer charity with a role in advocacy, research and patient supports, convened a multi-disciplinary stakeholder group (COVID-19 and Cancer Working Group) to reflect on and understand the impact of the pandemic on cancer patients and services in Ireland, and discuss potential mitigation strategies. Perspectives on experiences were gathered across domains including timeliness of data acquisition and its conversion into intelligence, and the resourcing of cancer care to address cancer service impacts. The group highlighted aspects for future research to understand the long-term pandemic impact on cancer outcomes, while also highlighting potential strategies to support cancer services, build resilience and address delayed diagnosis. Additional measures include the need for cancer workforce recruitment and retention, increased mental health supports for both patients and oncology professionals, improvements to public health messaging, a near real-time multimodal national cancer database, and robust digital and physical infrastructure to mitigate impacts of the current pandemic and future challenges to cancer care systems.