It may be cases of Covid that have been avoided but it will be additional cancer deaths. According to a prospective study carried out at the Gustave Roussy Institute, the leading European cancer center, on the basis of the 13,000 patients who attended the establishment between the start of the first confinement and the end of October 2020, we should record an excess mortality from cancer of around 6-7% on average over the next five years.
This in a scenario providing for a return to normal in March 2021, “which is, in reality, still not the case”, explains Aurélie Bardet, of the Biostatistics and Epidemiology department of the Gustave Roussy Institute, which carried out the ‘study.
Delay of support
This excess mortality will result from the delay in the management which is estimated, for 6 to 8% of patients, to be more than two months. This predicted increase in mortality naturally differs between types of cancer, ranging from over 20% in patients with uterine cancer to 2.1% in people with melanoma (skin cancer).
Regarding, for example, breast cancer, which constitutes the largest number of consultants in Gustave Roussy, the study estimates that the 740 patients who would have died within five years in normal times out of the 4,000 to be consulted, it is advisable to ‘add 40 – not a negligible figure – resulting in delays.
10% fewer mammograms
The main bottlenecks identified in the patient journey are the operating theater, chemotherapy infusions but also screening. According to figures, this time from the National Cancer Institute covering all French anti-cancer centers in 2020, there has been a decrease of 10% in mammograms, 20% in colonoscopies, more than 8% in biopsies. prostate cancer and 7% of surgical operations.
These delays which, according to the study by Gustave Roussy, will not be absorbed before the third quarter of 2021, “are not only linked to hospital activity, they also result from the disturbances caused by the Covid in city medicine (medical , radiology, analysis laboratories, etc.), explains Aurélie Bardet.
When it is not the patients themselves who have chosen to defer care. A survey by the Pacte social science laboratory of the CNRS, the University of Grenoble-Alpes, and the Assurance Maladie, covering all types of patients shows that the desire not to overburden health professionals and the apprehension of the contamination were frequent reasons for delays in consultations.
Individual benefit risk ratio
However, with regard to cancer, “if it is true that patients have an increased risk of catching Covid and of having complications, recognizes Aurélie Bardet, this risk must be weighed against the deleterious effects of a delayed management of their cancer. This benefit-risk ratio must be estimated, on a case-by-case basis, by the town doctor and not left to the sole discretion of the patient, ”recalls the epidemiologist.
It is certain that the invasion of the media sphere by Covid to the point of eliminating any other public health concern may have led some people to overestimate the threat of the virus with regard to other pathologies.