Doctors who oversee cancer clinics say that new patients are arriving for treatment with more advanced disease than before the COVID-19 pandemic, according to a new survey from the American Society for Radiation Oncology (ASTRO). The national survey of radiation therapy practice leaders fielded this winter also indicates that treatment postponements and deferrals that were common a year ago have largely subsided and that clinics continue to use a variety of enhanced safety measures to protect their patients and staff.
"One year into the COVID-19 pandemic, we already see the consequences of pandemic-driven drops in cancer screening and diagnostics," said Thomas J. Eichler, MD, FASTRO, Chair of the ASTRO Board of Directors.
Two-thirds of the radiation oncologists (66%) said new patients are presenting with more advanced-stage cancers. Nearly three-fourths (73%) said physicians in their practice are noticing that patients are not receiving cancer screenings, and many also said existing patients experienced an interruption in their radiation treatment due to the pandemic (66%).
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"Because the pandemic and cancer cause disproportionately more harm for Black and other medically underserved populations, these rates may be even higher for some vulnerable communities," added Dr. Eichler.
Enhanced safety protocols remain widespread at radiation therapy clinics. Masking for patients and staff (99%), social distancing in the clinic (100%) and screening patients and staff for COVID-19 exposure (95%) are nearly universal. Increased sterilization (93%), face shields for staff during procedures (80%) and no-visitor policies (73%) are also common.
"Safety is at the core of radiation oncology, and clinics were ready to adapt quickly and ramp up protective measures that keep their staff and patients safe from COVID-19 exposure," said Dr. Eichler.
The survey also found that clinics have largely stopped deferring or postponing radiation treatments. Only 15% reported postponing treatment in January/February 2021, compared to 92% in April 2020. Similarly, 12% reported deferring any new patient visits in 2021, compared to 75% in the early weeks of the pandemic.
Four in 10 practices still reported difficulty accessing personal protective equipment, medical-grade hand sanitizer or other critical supplies in the initial months of 2021. More alarmingly, many physicians said that COVID-19 vaccination efforts at their practice were limited by access to the vaccine (53%), and by hesitation to receive the vaccine among staff (59%) and patients (52%). The high rates of hesitancy echo findings that more than half of frontline health care workers in the U.S. were unvaccinated as of early March 2021.