Our research into the impact of COVID-19 on cancer

This research, led by Professor Eva Morris at the Big Data Institute in Oxford with input from the Cancer Intelligence team at CRUK, investigates the impact of the COVID-19 pandemic on the detection and management of colorectal cancer in England. It is the first study to provide operational detail, rather than modelled estimates, in near real time, using data from January 2019 to October 2020. The results show impact across the cancer pathway, with a sustained reduction in the number of people referred, diagnosed, and treated for colorectal cancer during the COVID-19 pandemic, which are likely to have a significant impact on disease prognosis.

This work uses data provided by patients and collected by the NHS as part of their care and support.

Morris E, Goldacre R, Spata E, et al. Impact of the COVID-19 pandemic on the detection and management of colorectal cancer in England: a population-based study. Lancet 2021. Doi: 10.1016/S2468-1253(21)00005-4.

Cancer Research UK (CRUK), The National Cancer Research Institute (NCRI) and Public Health England’s National Disease Registration Service (PHE NCRAS) hosted a Cancer/COVID-19 Research Summit with researchers from different disciplines to identify key research themes or questions around COVID-19’s impact on cancer prevention, early diagnosis and screening. Also, to discuss how the impact of COVID-19 on cancer patients can be mitigated through effective research.

Several areas in which further research is needed were identified, as well as lessons from the pandemic to improve research, cancer care, and help prepare for future crises. These include understanding the biological and psychological effects of COVID-19 on cancer patients, risk factors associated with COVID-19 and cancer, the influence of COVID-19 on health-related behaviours and the impact of COVID-19 on cancer care pathways. The full meeting report can be found here.

The COVID-19 pandemic has presented challenges for healthcare professionals working in Primary care. We are carrying out surveys to help us better understand the impact of the pandemic on how GPs deliver cancer prevention and manage the care of patients who they suspect might have cancer. We are running our Cancer Research UK Health Professional Tracker survey in August with UK GPs and Practice Nurses. This will explore their knowledge, attitudes and behaviour around cancer prevention, screening and early diagnosis and we will be able to compare the results with those from the 2018 survey to see if there have been any changes. This year we are also collecting data on the impact of COVID-19, specifically we have included question on;

• The impact of COVID-19 on delivery of smoking cessation and weight management advice
• How GPs follow up or ‘safety net’ patients who have symptoms.
• GPs access to and use of Faecal Immunochemical Testing (FIT) for patients with lower GI symptoms.
• Challenges to managing and referring patients with respiratory symptoms

We are also tracking how GPs feel about some of these key issues on a monthly basis over the summer with some ‘snapshot’ surveys. We will be using the results of these surveys to inform our work with Health Services and with Health Professionals.

For more information please contact cancerintelligence@cancer.org.uk

To understand the impact of the COVID-19 pandemic on the UK public’s attitudes, awareness and behaviours in relation to key topics across prevention, early diagnosis and screening, we developed a COVID-Cancer Awareness Measure ‘Plus’ (COVID-CAM+) survey. The COVID-CAM+ survey collected data from a UK-representative sample of adults twice – once in August/September 202, and again in February/March 2021.

Specifically our research aimed to understand the following:

• How much are people smoking, drinking (alcohol), and exercising?
• Do people know what potential symptoms of cancer are?
• To what extent are people delaying going to see their GP for potential cancer symptoms?
• What is putting people off going to their GP and hospitals right now?
• How do people feel about cancer screening programmes?

The survey was developed in collaboration with a research team led by Prof Kate Brain (Cardiff University) with funding from UK Research and Innovation. See more on the wider study here: https://cabs-study.yolasite.com/

Reports published from this work can be found on the CAM+ archive webpage.

Soon after the start of the COVID-19 pandemic and the implementation of ‘lockdown’ we learnt that the outbreak of COVID-19 was negatively affecting the testing, treatment and care of cancer patients. We needed to learn more about the impact of COVID-19 on people affected by cancer, and to quantify this by engaging with a large sample of cancer patients. In response we launched the CRUK Cancer Patient Experience Survey.

We developed this survey in collaboration with academics and cancer patients and collected data during May 2020 on a range of topics, including:

• Impact of COVID-19 on cancer services (testing, treatment & care)
• Emotional impact of the pandemic on cancer patients 
• What do people with cancer think CRUK should be doing now and after COVID-19?
• What do people with cancer think the government should be doing now and after COVID-19?

Where possible, existing survey measures were adopted from surveys such as NHS England’s ‘Cancer Patient Experience Survey’ and the Wellcome Trust’s ‘UK COVID-19 Questionnaire’. The survey also collected qualitative data from open questions and these results were complemented by case studies from 6 cancer patients who provided an in-depth, first-hand account of their experiences.

Cancer Research UK. Cancer Research UK Cancer Experience Survey 2020: The impact of COVID-19 on Cancer patients in the UK. July 2020.

Primary Care has worked incredibly hard to rapidly adapt to how they offer care to keep patients and staff safe while maintaining services during the Covid-19 pandemic which has resulted in a shift to remote consultation modalities. CRUK are keen to build understanding of any potential impact of remote consultations on the diagnosis of cancer. This slide set summarises our top line evidence review and key findings from our in-house research.  

Remote Consultations - Evidence and Insight

If you have any questions about this slide set, please contact The Strategic Evidence Team, Cancer Research UK.
 

Throughout the COVID-19 pandemic guidance was published by both public and professional bodies to outline guidance for changes to cancer treatment that could help to protect patient safety and optimise use of changing capacity within the NHS. This slide set summarises CRUK’s (non-exhaustive) collection of the guidance published for different cancer sites, in order to understand the potential changes that may have occurred to cancer treatment during the COVID-19 pandemic and potential positive adaptations. More detail is available upon request.

COVID innovations in cancer treatment

If you have any questions about this slide set please contact The Strategic Evidence Team, Cancer Research UK.