Imaging and physician visits at cancer diagnosis: COVID-19 pandemic impact on cancer care

Background Little is known about the COVID-19 pandemic impact on the provision of diagnostic imaging and physician visits at cancer diagnosis. Methods We used administrative databases from Ontario, Canada, to identify MRI/CT/ultrasound scans and in-person/virtual physician visits conducted with cancer patients within 91 days around the date of diagnosis in 2016-2020. In separate segmented regression procedures, we assessed the trends in weekly volume of these services per thousand cancer patients in prepandemic (June 26, 2016 to March 14, 2020), the change in mean volume at the start of the pandemic, and the additional change in weekly volume during the pandemic (March 15, 2020, to September 26, 2020). Results Totally, 403,561 cancer patients were included. On March 15, 2020 (COVID-19 arrived), mean scan volume decreased by 12.3% (95% CI: 6.4%-17.9%) where ultrasound decreased the most by 31.8% (95% CI: 23.9%-37.0%). Afterward, the volume of all scans increased further by 1.6% per week (95% CI: 1.3%-2.0%), where ultrasound increased the fastest by 2.4% (95% CI: 1.8%-2.9%). Mean in-person visits dropped by 47.4% when COVID-19 started (95% CI: 41.6%-52.6%) while virtual visits rose by 55.15-fold (95% CI: 4927%-6173%). In the pandemic (until September 26, 2020), in-person visits increased each week by 2.6% (95% CI: 2.0%-3.2%), but no change was observed for virtual visits (p -value = 0.10). Conclusions Provision of diagnostic imaging and virtual visits at cancer diagnosis has been increasing since the start of COVID-19 and has exceeded prepandemic utilization levels. Future work should monitor the impact of these shifts on quality of delivered care.

Automated summary

Little is known about the impact of the COVID-19 pandemic on diagnostic imaging and physician visits at cancer diagnosis. This study from Ontario, Canada, found that the volume of scans decreased at the start of the pandemic but gradually increased afterwards, with ultrasound experiencing the highest decrease and fastest increase. In-person visits dropped significantly, but virtual visits rose dramatically. However, in-person visits increased over time while virtual visits remained stable.