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dc.creatorSud, A.
dc.creatorJones, M. E.
dc.creatorJ. Broggio
dc.creatorLoveday, C.
dc.creatorTorr, B.
dc.creatorGarrett, A.
dc.creatorNico, D. L.
dc.creatorJhanji, S.
dc.creatorBoyce, S. A.
dc.creatorGronthoud, F.
dc.creatorWard, P.
dc.creatorHandy, J. M.
dc.creatorYousaf, N.
dc.creatorLarkin, J.
dc.creatorSuh, Y-E.
dc.creatorScott, S.
dc.creatorPharoah, P. D. P.
dc.creatorSwanton, C.
dc.creatorAbbosh, C.
dc.creatorWilliams, M.
dc.creatorLyratzopoulos, G.
dc.creatorHoulston, R.
dc.creatorTurnbull, C.
dc.date.accessioned2020-07-09T19:43:56Z
dc.date.available2020-07-09T19:43:56Z
dc.date.created2020
dc.identifier.issn0923-7534spa
dc.identifier.otherhttps://doi.org/10.1016/j.annonc.2020.05.009spa
dc.identifier.urihttp://hdl.handle.net/20.500.12010/10383
dc.description.abstractBackground: Cancer diagnostics and surgery have been disrupted by the response of health care services to the coronavirus disease 2019 (COVID-19) pandemic. Progression of cancers during delay will impact on patients’ longterm survival. Patients and methods: We generated per-day hazard ratios of cancer progression from observational studies and applied these to age-specific, stage-specific cancer survival for England 2013e2017. We modelled per-patient delay of 3 and 6 months and periods of disruption of 1 and 2 years. Using health care resource costing, we contextualise attributable lives saved and life-years gained (LYGs) from cancer surgery to equivalent volumes of COVID-19 hospitalisations. Results: Per year, 94 912 resections for major cancers result in 80 406 long-term survivors and 1 717 051 LYGs. Perpatient delay of 3/6 months would cause attributable death of 4755/10 760 of these individuals with loss of 92 214/208 275 life-years, respectively. For cancer surgery, average LYGs per patient are 18.1 under standard conditions and 17.1/15.9 with a delay of 3/6 months (an average loss of 0.97/2.19 LYGs per patient), respectively. Taking into account health care resource units (HCRUs), surgery results on average per patient in 2.25 resourceadjusted life-years gained (RALYGs) under standard conditions and 2.12/1.97 RALYGs following delay of 3/6 months. For 94 912 hospital COVID-19 admissions, there are 482 022 LYGs requiring 1 052 949 HCRUs. Hospitalisation of community-acquired COVID-19 patients yields on average per patient 5.08 LYG and 0.46 RALYGs. Conclusions: Modest delays in surgery for cancer incur significant impact on survival. Delay of 3/6 months in surgery for incident cancers would mitigate 19%/43% of LYGs, respectively, by hospitalisation of an equivalent volume of admissions for community-acquired COVID-19. This rises to 26%/59%, respectively, when considering RALYGs. To avoid a downstream public health crisis of avoidable cancer deaths, cancer diagnostic and surgical pathways must be maintained at normal throughput, with rapid attention to any backlog already accrued. Key words: COVID-19, delay, diagnostics, oncology, survivalspa
dc.format.extent10 páginasspa
dc.format.mimetypeapplication/pdfspa
dc.publisherScience Directeng
dc.sourcereponame:Expeditio Repositorio Institucional UJTLspa
dc.sourceinstname:Universidad de Bogotá Jorge Tadeo Lozanospa
dc.subjectCollateral damagespa
dc.subjectCancer surgeryspa
dc.subjectCOVID-19spa
dc.subjectPandemicspa
dc.titleCollateral damage: the impact on outcomes from cancer surgery of the COVID-19 pandemicspa
dc.type.localArtículospa
dc.subject.lembSíndrome respiratorio agudo gravespa
dc.subject.lembCOVID-19spa
dc.subject.lembSARS-CoV-2spa
dc.subject.lembCoronavirusspa
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.type.hasversioninfo:eu-repo/semantics/acceptedVersionspa
dc.identifier.doihttps://doi.org/10.1016/j.annonc.2020.05.009spa


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