Cancer care under systemic shock: utilization declines and cost increases during the COVID-19 pandemic in Colombia, evidence from matched administrative cohorts.

backgroundThe COVID-19 pandemic, declared by WHO in March 2020, has had a significant impact on global health systems, including cancer care in Colombia. This study examines the impact of the pandemic on service delivery, health outcomes, and risk management for breast, cervical, colorectal, stomach, prostate, and lung cancers.

methodsUsing administrative data, we applied propensity score matching for individual-level to compare pre- and post-pandemic cohorts from 2017 to 2021, alongside with a fixed effect model to state-level covering 2018 to 2021.

resultsOur findings reveal a consistent decline in cancer care services, except for a notable increase in the likelihood of receiving palliative care consultations and chemotherapy for breast, cervical, and colorectal cancers. When examining the intensive margin, measured by the frequency of use per patient, the results indicate an increase in both consultations and chemotherapy, reflecting higher spending on these services and a rise in average total expenditure per patient for most cancers studied. At the state level, similar trends were observed, with rising cancer prevalence and increased mortality rates for most cancers, except stomach cancer.

conclusionsThese findings highlight the urgent need for a resilient health system capable of mitigating the impact of future health crises on chronic disease management, and particularly in cancer.