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The impact of COVID-19 on cancer care in a tertiary hospital in Korea: possible collateral damage to emergency care
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Shin Hye Yoo, Jin-Ah Sim, Jeongmi Shin, Bhumsuk Keam, Jun-Bean Park, Aesun Shin
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Epidemiol Health. 2022;44:e2022044. Published online May 1, 2022
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DOI: https://doi.org/10.4178/epih.e2022044
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 Abstract
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 PDF Supplementary Material
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Abstract
OBJECTIVES
We investigated the impact of the COVID-19 pandemic on cancer care in a tertiary hospital in Korea without specific lockdown measures.
METHODS A retrospective cohort of cancer patients from one of the largest tertiary hospitals in Korea was used to compare healthcare utilization in different settings (outpatient cancer clinic, the emergency department [ED], and admissions to the hematology/oncology ward) between January 1 and December 31, 2020 and the same time period in 2019. The percent changes in healthcare utilization between the 2 periods were calculated.
RESULTS A total of 448,833 cases from the outpatient cohort, 26,781 cases from the ED cohort, and 14,513 cases from the admission cohort were reviewed for 2019 and 2020. The total number of ED visit cases significantly decreased from 2019 to 2020 by 18.04%, whereas the proportion of cancer patients remained stable. The reduction in ED visits was more prominent in patients with symptoms suspicious for COVID-19, high-acuity cases, and those who lived in non-capital city areas. There were no significant changes in the number of total visits, new cases in the outpatient clinic, or the total number of hospitalizations between the 2 periods.
CONCLUSIONS During the pandemic, the number of ED visits significantly decreased, while the use of the outpatient clinic and hospitalizations were not affected. Cancer patients’ ED visits decreased after the COVID-19 outbreak, suggesting the potential for collateral damage outside the hospital if patients cannot reach the ED in a timely manner.
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Summary
Korean summary
코로나19 이전인 2019년에 비해 코로나19 유행 첫 해인 2020년에 암환자의 1개 상급종합병원 응급실 방문이 유의하게 감소하였고, 특히 코로나19 의심 증상이 있거나, 중증도가 높거나, 비수도권 지역에 거주하는 환자에서 응급실 방문의 감소가 뚜렷하였다. 코로나19 이전과 코로나19 유행 시 외래 방문 암환자의 수, 신환 수는 큰 차이가 없었고, 입원한 암환자의 수 역시 유의한 차이가 없었다. 코로나19 대유행 시 암환자의 응급실 방문 감소는 병원 밖에서 적시에 응급실에 방문하지 못하는 부수적 피해의 가능성을 시사하여, 이에 대한 관심이 필요하다.
Key Message
The study identified a significant decrease in the emergency department visits of the cancer patients at a tertiary hospital in Korea during the COVID-19 pandemic. There were no significant changes in the number of total visits, new cases in the outpatient clinic, or the total number of hospitalizations between pre-COVID-19 and during-COVID-19 periods.
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Citations
Citations to this article as recorded by  - Government Initiatives for Research Ethics During COVID-19 Pandemic in Korea
Young Su Park, Ock-Joo Kim
Journal of Korean Medical Science.2024;[Epub] CrossRef - Impact of coronavirus disease 2019 on cancer care: How the pandemic has changed cancer utilization and expenditures
Jinah Sim, Jihye Shin, Hyun Jeong Lee, Yeonseung Lee, Young Ae Kim, Chong-Chi Chiu
PLOS ONE.2024; 19(2): e0296808. CrossRef - Impact of the Early COVID-19 Pandemic on Emergency Department Visits of Adult Cancer Patients With Fever or Respiratory Symptoms: A Korean Nationwide Population-Based Study, 2016–2020
Kyung Shin Lee, Ho Kyung Sung, Youn Young Choi, Changwoo Han, Hye Sook Min
Journal of Korean Medical Science.2024;[Epub] CrossRef - Changes in the Utilization of Health Care Services by Cancer Patients during the COVID-19 Pandemic
Seung Hee Seo, Sooyoung Cho, Shin Hye Yoo, Bhumsuk Keam, Aesun Shin
Yonsei Medical Journal.2023; 64(7): 463. CrossRef - COVID-19 Outbreak in Daegu City, Korea and Response to COVID-19: How Have We Dealt and What Are the Lessons?
Shin-Woo Kim
Journal of Korean Medical Science.2022;[Epub] CrossRef
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The impact of COVID-19 on screening for colorectal, gastric, breast, and cervical cancer in Korea
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Hyeree Park, Seung Hee Seo, Jong Heon Park, Shin Hye Yoo, Bhumsuk Keam, Aesun Shin
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Epidemiol Health. 2022;44:e2022053. Published online June 21, 2022
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DOI: https://doi.org/10.4178/epih.e2022053
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14,708
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462
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16
Web of Science
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18
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Abstract
Summary
PDFSupplementary Material
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Abstract
OBJECTIVES
The coronavirus disease 2019 (COVID-19) pandemic has affected the utilization of healthcare services, including participation in cancer screening programs. We compared cancer screening participation rates for colorectal, gastric, breast, and cervical cancers among participants in the National Cancer Screening Program (NCSP) in 2019 and 2020 to address the potential distraction effect of COVID-19 on cancer screening.
METHODS Data from the NCSP for 4 cancer types (stomach, colorectal, breast, and cervical) in 2019 and 2020 were used to calculate cancer screening participation rates by calendar month, gender, age group, and geographical region. Monthly participation rates were analyzed per 1,000 eligible individuals.
RESULTS The screening participation rate decreased in 2020 compared to 2019 for all 4 cancers: colorectal (40.5 vs. 35.3%), gastric (61.9 vs. 54.6%), breast (63.8 vs. 55.8%), and cervical (57.8 vs. 52.2%) cancers. Following 2 major COVID-19 waves in March and December 2020, the participation rates in the 4 types of cancer screening dropped compared with those in 2019. The highest decline was observed in the elderly population aged 80 years and older (percentage change: -21% for colorectal cancer; -20% for gastric cancer; -26% for breast cancer; -20% for cervical cancer).
CONCLUSIONS After the 2 major COVID-19 waves, the screening participation rate for 4 types of cancer declined compared with 2019. Further studies are needed to identify the indirect effects of the COVID-19 pandemic on cancer patients, such as delayed diagnoses of cancer or excess cancer deaths.
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Summary
Korean summary
본 연구는 코로나 대유행 기간 전과 후 대장암, 위암, 유방암, 자궁경부암 검진 수검률 차이를 비교하고자 하였다. 첫 코로나 확진자가 발생한 2020년을 코로나 대유행 기간, 전년도 기간인 2019년을 코로나 대유행 전 기간으로 설정하며 국민건강보험공단에서 집계된 전수자료를 이용하여 암 검진 대상자 수와 수검자 수를 비교 분석하였다. 4개 암종 모두에서 2019년도와 비교하여 2020년도에 전국적으로 수검률이 감소하는 경향이 있었으며, 1차 대유행이 있었던 3월과 3차 대유행 시기인 12월에 2019년도 동기간과 비교하여 수검률이 크게 감소하였고, 80대 이상 노인 인구에서 감소폭이 다른 연령대와 비교하여 크게 나타났다.
Key Message
We found decline of the colorectal, gastric, breast and cervical cancer screening participation rates in 2020 following the two major COVID-19 waves, compared with those of 2019, and the highest decline was observed in the elderly population aged 80 years and older.
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Citations
Citations to this article as recorded by - Emergency department visits of newly diagnosed cardiovascular disease patients in Korea during the COVID-19 pandemic
Ji Yoon Baek, Seung Hee Seo, Sooyoung Cho, Jun-Bean Park, Bhumsuk Keam, Shin Hye Yoo, Aesun Shin
Scientific Reports.2024;[Epub] CrossRef - Decline in Cancer Diagnoses during the ‘Zero COVID’ Policy in Hong Kong: Indirect Spillover Impact of the COVID-19 Pandemic
H.M. Youn, Y. Zhang, A. Liu, C.S. Ng, J. Liang, G.K.K. Lau, S.F. Lee, J. Lok, C.L.K. Lam, E.Y.F. Wan, J. Quan
Clinical Oncology.2024; 36(3): 157. CrossRef - Impact of coronavirus disease 2019 on cancer care: How the pandemic has changed cancer utilization and expenditures
Jinah Sim, Jihye Shin, Hyun Jeong Lee, Yeonseung Lee, Young Ae Kim, Chong-Chi Chiu
PLOS ONE.2024; 19(2): e0296808. CrossRef - Access to colorectal cancer screening in populations in China, 2020: A coverage‐focused synthesis analysis
Yan‐Jie Li, Xin Wang, Yu‐Jie Wu, Xin‐Yi Zhou, Jibin Li, Jiangmei Qin, Wanghong Xu, Jie‐Bin Lew, Wanqing Chen, Ju‐Fang Shi
International Journal of Cancer.2024; 155(3): 558. CrossRef - Delayed treatment in breast cancer patients during the COVID-19 pandemic: a population health information research infrastructure (PHIRI) case study
Francisco Estupiñán-Romero, Santiago Royo-Sierra, Javier González-Galindo, Natalia Martínez-Lizaga, Petronille Bogaert, Nienke Schutte, Liesbet Van Eycken, Nancy Van Damme, Kris Henau, Ronan A Lyons, Sarah J Aldridge, Andrea Faragalli, Flavia Carle, Rosar
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