Cancer prevales on COVID-19: To maintain high quality standard concerning diagnosis and oncological care even during a pandemic.

Dear Editor,

Recently, Yang et al have analyzed retrospectively clinical characteristics and outcomes of 52 cancer patients with novel coronavirus disease‐19 (COVID‐19). They concluded that the infection rate of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) in cancer patients was higher than the general population, cancer patients with COVID‐19 showed deteriorating conditions and poor outcomes. Vrdoljak et al have analyzed precisely the situation of the “oncological world,” suggesting that there is a anecdotal evidence that patients are starting to fear a COVID‐19 diagnosis more than a cancer diagnosis based on the modeling on which public health measures are being taken as well as the socio‐political and media narrative is entirely focused on COVID‐19 mortality and morbidity with no consideration for the impact of control measures on increasing morbidity and mortality in cancer, or indeed any other health condition. Before, Liang et al analyzed data of cancer patients during the SARS‐CoV‐2 infection (18 patients with cancer [1%] of 1590 COVID‐19 cases from 575 hospitals in China). They proposed three major strategies for patients with cancer in this COVID‐19 crisis and in future attacks of severe infectious disease: an intentional postponing od adjuvant chemotherapy or elective surgery for stable cancer, a stronger personal protection previsions for patients with cancer or cancer survivors and a more intensive surveillance or treatment when patients with cancer are infected with SARS‐CoV‐2 (especially in older patients or those with other comorbidities). More recently, Dinmohamed et al showed a drop in cancer diagnosis during the COVID‐19 epidemic in Their Country (17% in about 1 month for all sites (excluding skin cancers) and 16% for skin cancers (excluding basal cell carcinoma)). The aim of this paper is to investigate the progress and the timing of new diagnosis of solid tumors at our medical oncology unit before and after the adoption of COVID‐19 lockdown in our Country. (Figure 1)

Figure 1

The new diagnosis of solid tumors in the reference period divided in group 1 (before the adoption of COVID‐19 lockdown in our Country), group 2 (after the adoption of COVID‐19 lockdown in our Country). COVID‐19, coronavirus disease 2019

A retrospective analysis of all consecutives patients with new solid tumors admitted to our medical oncology unit between 13th January and 30th April 2020 was performed. The case study has been divided into 2 cohorts: admitted from 13th January to 8th March 2020 (group 1, before the adoption of COVID‐19 lockdown in our Country) and admitted from 9th March to 30th April 2020 (group 2) (after the adoption COVID‐19 lockdown in our Country). We have decided to started at 13th January 2020 to have two groups balanced each other on concerning the number of working days.

We evaluated 72 patients with new diagnosis of solid tumors in the reference period: 39 in group 1 (39 working days) and 33 in group 2 (39 working days), with a drop of 15.4% in the new diagnosis of solid tumors. The median time of pathological diagnosis has no statistically significant differences between group 1 (8 days, range, 1‐17 days) and group 2 (8 days, range, 1‐31 days). No patients in group 2 were COVID‐19 positive.

From our analysis, there is evidence of the adoption of COVID‐19 lockdown has led to a drop in the number of new diagnosis of solid tumors (−15.4%) and these results are in line with other bigger case studies in other Country. Despite this, it is important to remarke (to date not yet explained) that the quality of the service (in this case the time of pathological diagnosis) has not deteriorated even in times of COVID‐19 pandemic. So, to the shareable opinions of other Authors , , , , and the inevitable drop in cases, we also add the importance to maintain a high quality standard concerning diagnosis and oncological care. In particular, we recommend not to decrease the multidisciplinary cancer team meetings activities, that could suggest a potential delay in patient management.

CONFLICT OF INTERESTS

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

AUTHOR CONTRIBUTIONS

JG and AB contributed equally to (a) conception and design, acquisition of data, or analysis and interpretation of data; (b) drafting the article and revising it critically for important intellectual content; and (c) final approval of the version to be published.