| Title: | Audit on the impact of the COVID 19 pandemic on the functioning, effectiveness and efficiency of the Rapid Access Lung Cancer (RALC) pathway |
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| Author(s): | C Farrell, A Scott, D McGrath, B Casserly, A O BrienC Farrell, A Scott, D McGrath, B Casserly, A O BrienC Farrell, A Scott, D McGrath, B Casserly, A O Brien |
| Institution: | St John's Hospital Limerick |
| Poster: | Click to view poster |
| Category: | Lung Cancer/CF/ILD/Surgery |
| Abstract: | Introduction The COVID 19 pandemic has dramatically altered healthcare delivery, worsened non-virus-related health outcomes with likely a significant effect on the functioning of the Rapid Access Lung Cancer (RALC). Cancer screening as a whole has been affected; this hasn’t been fully quantified in Ireland. On review of the literature, a study in the US evaluating how cancer screening has been affected by the pandemic showed a 62% reduction in lung cancer screening, 92% reduction in cervical cancer screening and 82% reduction in colorectal cancer screening. Methods This is a retrospective audit of all patients referred to University Hospital Limerick (UHL) RALC clinic in April and May 2019 and 2020. Total referrals and breakdown by referral source and month/year were calculated. The average time from referral to RALC clinic review was calculated for each year. Lung cancer diagnosis by stage was recorded for each of the months. Results Total referrals were 40% lower 128 in 2020, compared to 220 in 2019. Direct GP referrals were 67% lower, 34 in 2020 and 103 in 2019. The average time from referral to review was 15.6 days in 2019 compared to 14.1 days in 2020. Discussion The reduced number of direct GP referrals likely accounts for the lower number diagnosed with Stage 1 or 2 lung cancer. As a consequence, this results in a delay in lung cancer diagnosis for many, diagnosis occurring at a later stage, reduction in life expectancy. This results in greater cost and burden to the healthcare system. These findings are very relevant as likely cycles of increasing restrictions until appropriate treatment or affective vaccination becomes widely available in Europe. An add on to this study is looking at the time from referral to bronchoscopy and histological diagnosis to see has this been significantly affected during the pandemic.Introduction The COVID 19 pandemic has dramatically altered healthcare delivery, worsened non-virus-related health outcomes with likely a significant effect on the functioning of the Rapid Access Lung Cancer (RALC). Cancer screening as a whole has been affected; this hasn’t been fully quantified in Ireland. On review of the literature, a study in the US evaluating how cancer screening has been affected by the pandemic showed a 62% reduction in lung cancer screening, 92% reduction in cervical cancer screening and 82% reduction in colorectal cancer screening. Methods This is a retrospective audit of all patients referred to University Hospital Limerick (UHL) RALC clinic in April and May 2019 and 2020. Total referrals and breakdown by referral source and month/year were calculated. The average time from referral to RALC clinic review was calculated for each year. Lung cancer diagnosis by stage was recorded for each of the months. Results Total referrals were 40% lower 128 in 2020, compared to 220 in 2019. Direct GP referrals were 67% lower, 34 in 2020 and 103 in 2019. The average time from referral to review was 15.6 days in 2019 compared to 14.1 days in 2020. Discussion The reduced number of direct GP referrals likely accounts for the lower number diagnosed with Stage 1 or 2 lung cancer. As a consequence, this results in a delay in lung cancer diagnosis for many, diagnosis occurring at a later stage, reduction in life expectancy. This results in greater cost and burden to the healthcare system. These findings are very relevant as likely cycles of increasing restrictions until appropriate treatment or affective vaccination becomes widely available in Europe. An add on to this study is looking at the time from referral to bronchoscopy and histological diagnosis to see has this been significantly affected during the pandemic.Introduction The COVID 19 pandemic has dramatically altered healthcare delivery, worsened non-virus-related health outcomes with likely a significant effect on the functioning of the Rapid Access Lung Cancer (RALC). Cancer screening as a whole has been affected; this hasn’t been fully quantified in Ireland. On review of the literature, a study in the US evaluating how cancer screening has been affected by the pandemic showed a 62% reduction in lung cancer screening, 92% reduction in cervical cancer screening and 82% reduction in colorectal cancer screening. Methods This is a retrospective audit of all patients referred to University Hospital Limerick (UHL) RALC clinic in April and May 2019 and 2020. Total referrals and breakdown by referral source and month/year were calculated. The average time from referral to RALC clinic review was calculated for each year. Lung cancer diagnosis by stage was recorded for each of the months. Results Total referrals were 40% lower 128 in 2020, compared to 220 in 2019. Direct GP referrals were 67% lower, 34 in 2020 and 103 in 2019. The average time from referral to review was 15.6 days in 2019 compared to 14.1 days in 2020. Discussion The reduced number of direct GP referrals likely accounts for the lower number diagnosed with Stage 1 or 2 lung cancer. As a consequence, this results in a delay in lung cancer diagnosis for many, diagnosis occurring at a later stage, reduction in life expectancy. This results in greater cost and burden to the healthcare system. These findings are very relevant as likely cycles of increasing restrictions until appropriate treatment or affective vaccination becomes widely available in Europe. An add on to this study is looking at the time from referral to bronchoscopy and histological diagnosis to see has this been significantly affected during the pandemic. |
