Journal
BRITISH JOURNAL OF CANCER
Volume 126, Issue 6, Pages 948-956Publisher
SPRINGERNATURE
DOI: 10.1038/s41416-021-01666-6
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Funding
- University of Oxford Medical Sciences Division Urgent COVID-19 Fund
- Primary Care Research Trust
- Public Health England
- National institute for Health Research (NIHR) Oxford and Thames Valley Applied Research Collaboration
- Wellcome Trust [211182/Z/18/Z]
- NIHR Applied Research Collaboration (ARC) Oxford Thames Valley
- NIHR Oxford Biomedical Research Centre (BRC)
- NIHR Oxford Medtech and In-Vitro Diagnostics Co-operative (MIC)
- NIHR Oxford Biomedical Research Centre
- NIHR Thames Valley Applied Research Collaborative
- Wellcome Trust [211182/Z/18/Z] Funding Source: Wellcome Trust
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During the COVID-19 pandemic in 2020, consultations for cancer clinical features and urgent referrals decreased significantly, particularly in the 6-12 weeks following the first national lockdown. Overall, once patients consulted, GPs continued to urgently refer a similar or greater proportion of patients with suspected cancer compared to previous years.
Background It remains unclear to what extent reductions in urgent referrals for suspected cancer during the COVID-19 pandemic were the result of fewer patients attending primary care compared to GPs referring fewer patients. Methods Cohort study including electronic health records data from 8,192,069 patients from 663 English practices. Weekly consultation rates, cumulative consultations and referrals were calculated for 28 clinical features from the NICE suspected cancer guidelines. Clinical feature consultation rate ratios (CRR) and urgent referral rate ratios (RRR) compared time periods in 2020 with 2019. Findings Consultations for cancer clinical features decreased by 24.19% (95% CI: 24.04-24.34%) between 2019 and 2020, particularly in the 6-12 weeks following the first national lockdown. Urgent referrals for clinical features decreased by 10.47% (95% CI: 9.82-11.12%) between 2019 and 2020. Overall, once patients consulted with primary care, GPs urgently referred a similar or greater proportion of patients compared to previous years. Conclusion Due to the significant fall in patients consulting with clinical features of cancer there was a lower than expected number of urgent referrals in 2020. Sustained efforts should be made throughout the pandemic to encourage the public to consult their GP with cancer clinical features.
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