Main Article Content

Authors

Aim:


We analyze the impact of the COVID-19 pandemic on oncology service demand in a middle-income country with universal health coverage.


Methods:


We collected data from January 1st-2017, to December 31th-2021 at a reference center in Bogotá-Colombia regarding first-time consultations of cross-cutting services (clinical oncology, hematology, palliative care, radiation oncology); specialized multidisciplinary units (breast, prostate, lung, stomach); inpatient and outpatient systemic therapy; radiotherapy; oncology surgery; and bone marrow transplant. In addition, a descriptive time series analysis was performed, estimating monthly percent change and endemic channels.


Results:


Starting the confinement (April 2020), a general decrease in service demand was observed (R: -14.9% to -90.0%), with an additional but lower reduction in August 2020 coinciding with the first pandemic wave (R: -11.3% to -70.0%). Follow-up visits and ambulatory treatment showed no consistent reductions. New patients’ consultations for cross-cutting services had a speedy recovery (1 month), but clinical oncology, specialized units, and in-hospital treatment resumed more slowly. Only breast and stomach cancer showed a sustained reduction in early-stage disease. Women and older patients had a more significant reduction in service demand.


Conclusion:


Despite no changes in service supply, the confinement induced a significant reduction in service demand. Variations by cancer type, service type, and population demographics deserve careful consideration for a suitable response to the emergency. The speedy recovery and the absence of a significant decrease during subsequent waves of the pandemic suggest patient resiliency and a lower impact than expected in middle-income settings in the presence of universal health insurance.

Maria Zuluaga, Centro Javeriano de Oncología - Hospital Universitario San Ignacio

orcid_id14.png https://orcid.org/0000-0002-4656-6064

Maria Camila Luna, Centro Javeriano de Oncología - Hospital Universitario San Ignacio

orcid_id14.png https://orcid.org/0000-0003-1053-9731

Natallie Jurado, Departamento Medicina Interna – Hospital Universitario San Ignacio

orcid_id14.png https://orcid.org/0000-0002-5388-8192

Beatriz Soto-Cala, Facultad de Medicina – Pontificia Universidad Javeriana

https://orcid.org/0000-0002-0658-4268

Julio César Solano, Centro Javeriano de Oncología - Hospital Universitario San Ignacio

orcid_id14.png https://orcid.org/0000-0002-5150-3041

Ricardo Sánchez-Forero, Centro Javeriano de Oncología - Hospital Universitario San Ignacio

orcid_id14.png https://orcid.org/0000-0002-2241-3020

Raúl Murillo, Centro Javeriano de Oncología - Hospital Universitario San Ignacio

orcid_id14.png https://orcid.org/0000-0001-7187-9946

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Received 2021-12-06
Accepted 2022-10-24
Published 2023-05-04