ArticleAsia-Pacific journal of clinical oncology2021
An inverse stage-shift model to estimate the excess mortality and health economic impact of delayed access to cancer services due to the COVID-19 pandemic.
Article in Asia-Pacific journal of clinical oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 4 of them syntheses that pooled it.
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Who cites it
58 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- The multifaceted impact of the COVID-19 pandemic on colorectal cancer care: a systematic review of management disruptions, stage migration, and survival outcomes.Frontiers in oncology · 2026Pooled it
- Cost of the COVID-19 pandemic versus the cost-effectiveness of mitigation strategies in EU/UK/OECD: a systematic review.BMJ open · 2023Pooled it
- Impact of the COVID-19 Pandemic on Colorectal Cancer Diagnosis and Treatment: a Systematic Review.Journal of gastrointestinal cancer · 2023Pooled it
- Physical and mental health outcomes of COVID-19 induced delay in oncological care: A systematic review.Frontiers in oncology · 2023Pooled it
- Subtype-specific health and economic impact of delayed breast cancer diagnosis during the early COVID-19 pandemic in Belgium: a Markov model analysis.Breast cancer research : BCR · 2025Article
- Model-Based Cost-Utility Analysis of Combined Low-Dose Computed Tomography Screening for Lung Cancer, Chronic Obstructive Pulmonary Disease, and Cardiovascular Disease.JTO clinical and research reports · 2025Article
- Modelling the impact of the COVID-19 pandemic on cancer stage migration and excess mortality in Ireland.Preventive medicine reports · 2025Article
- Disparities in Cancer Stage Shifts Associated with the COVID-19 Pandemic in California, 2020 to 2021.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025Article
- Impact of the COVID-19 pandemic on breast cancer patient pathways and outcomes in the United Kingdom and the Republic of Ireland - a scoping review.British journal of cancer · 2024Article
- Influence of the COVID-19 Pandemic on Patients with Rectal Cancer.Journal of clinical medicine · 2024Article
- Health Economic Consequences Associated With COVID-19-Related Delay in Melanoma Diagnosis in Europe.JAMA network open · 2024Article
- Impact of an Evidence-Based Prioritization System and Electronic Consultation in Early Diagnosis of Colorectal Cancer.Healthcare (Basel, Switzerland) · 2024Article
- Excess mortality in adults from Sao Paulo during the COVID-19 pandemic in 2020: analyses of all-cause and noncommunicable diseases mortality.Scientific reports · 2023Article
- Resource allocation during the coronavirus disease 2019 pandemic and the impact on patients with lung cancer: a systematic review.Interdisciplinary cardiovascular and thoracic surgery · 2023Article
- The impact of the COVID-19 pandemic on the diagnosis and treatment of skin cancers, a mini review.Cancer reports (Hoboken, N.J.) · 2023Review
- Effects of the Pandemic on the Care of Patients With Colorectal Cancer.Deutsches Arzteblatt international · 2023Review
- The benefit of early-stage diagnosis: A registry-based survey evaluating the quality of life in patients with melanoma.Skin health and disease · 2023Article
- Changes in lifestyle-related behaviour during the COVID-19 pandemic in Japan: a questionnaire survey for examinees who underwent an annual health check-up.The Journal of international medical research · 2023Article
- Not Waiting to Progress; How the COVID-19 Pandemic Nudged Neoadjuvant Therapy for Stage III Locally Advanced Melanoma Patients.Current oncology (Toronto, Ont.) · 2023Article
- Narrowing the therapeutic window?-A case-control study on the influence of the COVID-19 pandemic on the primary UICC stage of NSCLC.Journal of thoracic disease · 2023Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimDecreased cancer incidence and reported changes to clinical management indicate that the COVID-19 pandemic has delayed cancer diagnosis and treatment. This study aimed to develop and apply a flexible model to estimate the impact of delayed diagnosis and treatment on survival outcomes and healthcare costs based on a shift in the disease stage at treatment initiation.
methodsA model was developed and made publicly available to estimate population-level health economic outcomes by extrapolating and weighing stage-specific outcomes by the distribution of stages at treatment initiation. It was applied to estimate the impact of 3- and 6-month delays based on Australian data for stage I breast cancer, colorectal cancer, and lung cancer patients, and for T1 melanoma. Two approaches were explored to estimate stage shifts following a delay: (a) based on the relation between time to treatment initiation and overall survival (breast, colorectal, and lung cancer), and (b) based on the tumor growth rate (melanoma).
resultsUsing a conservative once-off 3-month delay and considering only shifts from stage I/T1 to stage II/T2, 88 excess deaths and $12 million excess healthcare costs were predicted in Australia over 5 years for all patients diagnosed in 2020. For a 6-month delay, excess mortality and healthcare costs were 349 deaths and $46 million over 5 years.
conclusionsThe health and economic impacts of delays in treatment initiation cause an imminent policy concern. More accurate individual patient data on shifts in stage of disease during and after the COVID-19 pandemic are critical for further analyses.
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