COVID-19 and Its Impact on Casefinding, Caseloads, Diagnosis, Treatment and Follow Up
Since the beginning of the COVID-19 pandemic, cancer patients and physicians have been forced to make difficult decisions regarding cancer treatments. Some cancer patients have had treatment delayed or treatment plans altered because of the pandemic, as patients with cancer are among those at high risk of infection with COVID-19. For cancer registrars, they are beginning to see the impact is having on cancer patients and how they are treated. It’s critical to understand how the pandemic will affect casefinding, caseloads, diagnosis, treatment and follow up.
Because many of us have been confined to our homes because of the pandemic, there has been a decrease in cancer diagnosis as well as cancer treatments -- which means decreases in caseloads. There also will be fewer pathology reports and fewer cases in suspense in the coming months. Registrars are already starting to see delays in workups and treatments because of the pandemic restrictions.
Registrars are likely to see a decrease in colonoscopies, mammograms, PSA testing and lung CT scanning. Additionally, cancer programs may be canceling their screening and prevention activities. Some of our staff have already seen documentation about delays in treatment or treatment modifications when they are in the EMR abstracting cases.
At the onset of this pandemic, hospitals needed to conserve critical resources, such as hospital and ICU beds, ventilators, as well as personal protective equipment critical for protecting patients, care providers and staff. It was generally advised that hospitals discontinue elective surgeries, particularly with patients that have a high likelihood of the need to utilize the ICU postoperatively or patients who may require respiratory equipment. This resulted in canceled or postponed surgical procedures.
There have been non-surgical changes in care since the beginning of the pandemic. Hospitals reduced patient time to avoid infection in immunocompromised patients, managed staffing shortages and aided patients with transportation issues. Cancer patients opted out of visiting the hospital in fear of being exposed, and some had to stay at home or self-quarantine due to a spouse or family member testing positive for COVID-19. All of these factors have contributed to changes in the delivery of systemic care and physicians are modifying treatment plans. This can mean that IV chemotherapy may be changed to oral chemotherapy or immunotherapy. Hormone therapy may be started before surgery.
We are also seeing major delays in radiation therapy. What is the impact on data collection? Registrars may see an increase in the incidence of neoadjuvant therapy or an increase in active surveillance or patients with no treatment, which may affect the assignment of Class of Case. CTRs will need to utilize “Reason No” codes for “Reason No Surgery” and “Reason No Radiation.” Although the “Reason No Chemotherapy” and “Reason No Hormone Therapy” fields are no longer required, we recommend using those, particularly during this pandemic.
What is the impact on data collection? Registrars may see an increase in the incidence of neoadjuvant therapy or an increase in active surveillance or patients with no treatment, which may affect the assignment of Class of Case. CTRs will need to utilize “Reason No” codes for “Reason No Surgery” and “Reason No Radiation.” Although the “Reason No Chemotherapy” and “Reason No Hormone Therapy” fields are no longer required, we always recommend completing those fields, particularly during this pandemic.
The cancer registry should lead the way in capturing data on these treatment delays, treatment modifications and COVID-19 positivity and impacts on cancer care. Ask your cancer registrar to create additional fields to capture this information. At a minimum, everyone should collect COVID-19 positivity (yes or no) and Treatment Delayed due to COVID -19 (yes or no). This information will help inform hospitals and physicians on the true impact of COVID-19 on cancer.
To find out more about how the pandemic may affect cancer program activities as well as updates from The Annals of Internal Medicine, the American College of Surgeons and the Commission on Cancer, please visit our resources page to view our “2020 Pandemic and the Cancer Registry” webinar.
This article was featured in the Association of Cancer Executives' July 2020 newsletter.
CHAMPS Oncology will attend, exhibit and present at the National Cancer Registrar Association's (NCRA) 46th Annual Educational Conference that is taking place virtually Monday, Sept. 21 through Wednesday, Sept. 23.
CHAMPS Oncology Regional Manager Amanda Harvey-McKee, BA, CTR, will be presenting during the Registry Management Symposium portion of the conference. Her presentation, Transform Your Cancer Program with the Data You Collect, will take place during the conference. Check back for more details on her presentation as the conference date approaches!
Visit our booth to learn about our cancer registry careers and see if you have what it takes to join our team!
Learn more about the NCRA 46th Annual Educational Conference by visiting their website.
Where: ONLINE - VIRTUAL FORMAT
When: Sep 21, 2020 12:00 AM - 12:00 AM
ACCC 46th Annual Meeting & Cancer Center Business Summit
CHAMPS Oncology will attend and exhibit at the Association of Community Cancer Centers (ACCC) 45th Annual Meeting and Cancer Center Business Summit.
Follow the hashtag #AMCCBS to stay connected or visit their website here.
Where: Washington Hilton, DC
When: Mar 4, 2020 -
CHAMPS Oncology Annual Meeting: 2020 Cancer Program Insights
CHAMPS Oncology's Annual Meeting: 2020 Cancer Program Insights will be held Wednesday, Jan. 29 from 8 a.m. - 12 p.m. Register now to attend our free, in-person meeting.
What are the objectives?
Review NEW CoC Standards.
Receive NEW Compliance at a Glance Tool.
Ensure you're prepared for your first quarter cancer committee.
Who should attend?
Certified Tumor Registrars (CTRs)
Cancer Service Line Leaders
Cancer Committee Members
Follow #CHAMPSAnnualMeeting to stay connected.
Can't attend in person? Downloadable version and CEs will be available for purchase.
Interested in joining the CHAMPS Oncology team and learning about our rich history? Watch this video detailing our team's 40+ years of cancer registry experience and then apply here:https://bit.ly/3jiXfXF
Stay current with your cancer registry — let CHAMPS Oncology implement our concurrent abstracting for you. Our methods provide your organization with timely cancer registry data, so you can focus on saving lives. Find out more about our tested and proven approach that is making waves in the industry:https://bit.ly/3aJAjh7