Uneven Pediatric Cancer Care Delivered During the COVID-19 Pandemic

A recent study highlights multiple challenges that the COVID-19 pandemic created for childhood cancer care at all resource levels.

However, the overall mortality due to the COVID-19 pandemic has been reportedly low among children with cancer, reported a news study published by The Lancet.

In this study published on March 3, 2021, institutions reported using new technologies, improved practices around infection control, reprioritization of the psychosocial needs of families and staff, and care transition to outpatient settings to allow for continued care delivery despite the pandemic.

Overall, 2% (5 of 213) of centers were no longer evaluating new cases of suspected cancer, while 43% of the remaining centers described a decrease in newly diagnosed pediatric cancer cases. And 34% of centers reported increased treatment abandonment (i.e., failure to initiate cancer therapy or a delay in 4 weeks or longer) care. 

Changes to cancer care delivery included: reduced surgical care (72%), blood product shortages (60%), and chemotherapy modifications (57%).

However, the decreased number of new cancer diagnoses did not vary based on country income status.

Although the long-term effects of these challenges on childhood cancer outcomes are not yet apparent, these results emphasize the need for a continued assessment of resource requirements throughout the pandemic and the sharing of strategies that have mitigated the adverse effects of pediatric cancer care.

These findings are consistent with reports from high-income countries describing a similar reduction in newly diagnosed cancer patients from population-based cancer registries and suggest this delay might be contributing to critical or advanced presentations.

This study has several limitations. We did a cross-sectional survey of pediatric oncology providers, and our results reflect the knowledge and opinions of respondents at a one-time point during an evolving pandemic. Because the survey was distributed to different cadres of health-care professionals, unfamiliarity with some aspects of pediatric cancer care or the effect of the pandemic might have been captured by the responses.

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