- Patients with cancer not only are at increased risk for severe COVID-19, but also face cancer treatment delays and interruptions due to the pandemic, potentially worsening cancer outcomes.
- Nearly 10 million missed cancer screenings in 2020 could lead to diagnoses of advanced-stage cancers and increased cancer deaths in the coming years.
- Early-career investigators, especially women and underrepresented minorities, are uniquely vulnerable to the adverse impacts of the pandemic.
IMPACT OF COVID-19 ON PATIENTS WITH CANCERResearch indicates that patients with cancer are at an increased risk for COVID-19 infection and severe disease. In addition, the interruptions caused by the pandemic may contribute to worse cancer-related outcomes in the coming years. According to the report:
- Patients with hematologic cancers as well as patients receiving B cell-targeted therapeutics are not only are at higher risk for COVID-19, but also have shown poor responses to the available vaccines.
- The delays in cancer screening, diagnosis, and treatment caused by the pandemic have had and may continue to have negative effects on outcomes for patients.
- The pandemic resulted in nearly 10 million missed cancer screenings from January to July 2020.
- The pandemic impaired referrals for preliminary cancer diagnoses and led to an 11 percent increase in patients diagnosed with inoperable or metastatic cancer during March to December 2020, when compared to the same time frame in 2019.
- Patients and cancer centers reported delays in cancer treatments including chemotherapy, immunotherapy, radiotherapy, and surgery.
- The pandemic has had a considerable negative impact on the mental health of cancer patients, survivors, and caregivers arising from a range of issues such as social isolation, financial stress, food insecurity, concerns about timely access to cancer treatments, and disease recurrence.
- Racial and ethnic minorities and other medically underserved populations not only have shouldered a disproportionate burden of COVID-19, but also have been more affected by pandemic-related disruptions to the cancer care continuum.
IMPACT OF COVID-19 ON CANCER RESEARCHERSAs outlined in the AACR Report on the Impact of COVID-19 on Cancer Research and Patient Care, the pandemic has caused significant challenges for cancer researchers, leading to research laboratory closures and clinical trial interruptions. It has negatively impacted their career development opportunities as well, especially for women and minority early-stage investigators. According to a recent survey of 66 AACR grant recipients, the results of which are included in the report:
- Ninety-nine percent of respondents indicated that the pandemic negatively impacted their research, career, and/or patient care.
- Eighty-seven percent of respondents reported a drop in productivity.
- Sixty-one percent of respondents indicated that the pandemic has delayed their career advancement.
What’s more, as explained in the report, decades of research into mRNA vaccines for use as cancer immunotherapies paved the way for the development of COVID-19 vaccines at an unprecedented speed. In turn, the tremendous success of the COVID-19 vaccines has renewed enthusiasm for mRNA-based cancer immunotherapies, which have the potential to revolutionize cancer treatment.
“We have tackled cancer in a science-based manner, where we define the problem, understand the processes, and then develop treatments or ways to improve health,” said Antoni Ribas, MD, PhD, FAACR, chair of both the AACR Report on the Impact of COVID-19 on Cancer Research and Patient Care Steering Committee and the AACR COVID-19 and Cancer Task Force, and immediate Past President of AACR. “The same had to be done for COVID-19. The cancer research community has generated so many tools to study cancer — sequencing, developing antibodies, pioneering targeted therapies — that have also helped researchers address COVID-19. And the best example of all is the COVID-19 mRNA vaccines.”
LESSONS LEARNED FROM THE PANDEMICDespite the many adverse effects of the pandemic, some of the necessary adjustments to clinical research and practice over the past two years have the potential to improve care for patients with cancer in the future. As noted in the report:
- The use of telemedicine for health care needs was 38 times higher in July 2021 than before the pandemic, an expansion that was welcomed by most Americans.
- The pandemic also required changes to the conduct of clinical trials that made such studies more patient-centric, a shift that has the potential to increase and diversify clinical trial participation, shorten the timelines for some trials, and minimize the financial and logistical burdens on clinical trial participants.
A CALL TO ACTIONBuilding on these experiences, the AACR Report on the Impact of COVID-19 on Cancer Research and Patient Care includes a Call to Action with steps that Congress should take to rebuild U.S. public health infrastructure, enhance medical research, and modernize how patients receive care and enroll in clinical trials. Recommendations include:
- Offset pandemic-related research costs by providing at least $10 billion for the National Institutes of Health (NIH) and its grantees in emergency supplemental funding as proposed in the Research Investment to Spark the Economy (RISE) Act of 2021.
- Increase investments in cancer research and prevention by supporting robust, sustained, and predictable growth for NIH and NCI, including at least $3.5 billion and $1.1 billion, respectively, in fiscal year (FY) 2022, for a total funding level of $46.4 billion for NIH and $7.6 billion for NCI.
- Enact policies that broaden health care coverage and reduce inequities in access to health care, such as expanding Medicaid.
- Deliver a permanent extension of Centers for Medicare & Medicaid Services (CMS)-approved telehealth services and support greater access to telehealth by providing funding, including grants, to support high-speed broadband, reach underserved areas, and address the digital divide.
- Support the U.S. Food and Drug Administration’s regulatory science initiatives and advance the development of oncology products by providing an increase of at least $343 million in discretionary budget authority in FY 2022.
- Increase diversity in clinical trials and alleviate the financial burden on prospective trial participants by reimbursing patients for ancillary trial-related costs, such as transportation and lodging, as contained in the DIVERSE Act.
“The COVID-19 pandemic has highlighted the importance of basic science, cancer prevention, cancer screenings, and addressing cancer disparities,” said Margaret Foti, PhD, MD (hc), chief executive officer of AACR. “To restore the momentum against cancer, we urge Congress to continue its long-standing commitment to supporting cancer research. Robust, sustained, and predictable annual funding increases for NIH and NCI will propel future scientific advances, maximize returns from prior investments in cancer research, drive economic prosperity, and support new lifesaving cures for patients with cancer.”The AACR Report on the Impact of COVID-19 on Cancer Research and Patient Care builds on AACR’s commitment to advancing scientific understanding of SARS-CoV-2, COVID-19, and all aspects of how the pandemic affects cancer research and care. In coordination with its COVID-19 and Cancer Task Force, AACR has hosted two scientific conferences and published groundbreaking research on COVID-19 and cancer; engaged patient advocates to identify barriers and develop solutions to optimize cancer care during the pandemic; and remained a steadfast voice in support of policies that protect patients with cancer during this crisis.
Source: "AACR Releases Report Outlining Impact Of COVID-19 Pandemic On Cancer Research And Patient Care | AACR | News Releases". 2022. American Association For Cancer Research (AACR).