The COVID-19 pandemic has placed an unprecedented burden on the healthcare system. In particular, the intersection of COVID-19 and cancer has created a double burden on the healthcare system, presenting challenges in both the diagnosis and treatment of cancer. During the pandemic, overcrowding of hospitals and clinics, shortages of PPE and other medical supplies, and the impact of COVID-19 on healthcare workers have all made it more difficult to care for cancer patients. The challenges in cancer diagnosis and screening during the pandemic have included delays in cancer diagnoses, decreased access to cancer screenings, and a decrease in the number of cancer surgeries being performed. Changes in cancer treatment patterns and access to care during COVID-19 have also impacted the treatment outcomes for cancer patients, with a decrease in the number of cancer patients being treated and an increased risk of poor outcomes for those who are being treated. The impact of COVID-19 on healthcare workers and their ability to care for cancer patients has also been significant, with healthcare workers facing increased exposure to the virus, increased workloads, and increased stress and burnout. The double burden of COVID-19 and cancer on the healthcare system has implications for policy and practice, including the need for improved coordination between cancer and COVID-19 response efforts and the need for increased investment in healthcare infrastructure and resources. In conclusion, the COVID-19 pandemic has created a double burden on the healthcare system, with significant challenges in the diagnosis and treatment of cancer. The impact of COVID-19 on healthcare workers and the healthcare system more broadly highlights the need for improved coordination and increased investment in healthcare resources and infrastructure.
Ferlay J, Colombet M, Soerjomataram I, Parkin DM, Piñeros M, Znaor A, et al. Cancer statistics for the year 2020: An overview. Int J Cancer. 2021.
Eckerling A, Ricon-Becker I, Sorski L, Sandbank E, Ben-Eliyahu S. Stress and cancer: mechanisms, significance and future directions. Nature Reviews Cancer. 2021;21(12):767-85.
Lamers MM, Haagmans BL. SARS-CoV-2 pathogenesis. Nature Reviews Microbiology. 2022;20(5):270-84.
Hu B, Guo H, Zhou P, Shi Z-L. Characteristics of SARS-CoV-2 and COVID-19. Nature Reviews Microbiology. 2021;19(3):141-54.
Kumar A, Singh R, Kaur J, Pandey S, Sharma V, Thakur L, et al. Wuhan to World: The COVID-19 Pandemic. Frontiers in Cellular and Infection Microbiology. 2021;11.
Zong Z, Wei Y, Ren J, Zhang L, Zhou F. The intersection of COVID-19 and cancer: signaling pathways and treatment implications. Molecular Cancer. 2021;20(1):76.
Wang L, Sun Y, Yuan Y, Mei Q, Yuan X. Clinical challenges in cancer patients with COVID-19: Aging, immunosuppression, and comorbidities. Aging (Albany NY). 2020;12(23):24462-74.
The L. The COVID-19 pandemic in 2023: far from over. Lancet. 2023;401(10371):79.
Sharma A, Ahmad Farouk I, Lal SK. COVID-19: A Review on the Novel Coronavirus Disease Evolution, Transmission, Detection, Control and Prevention. Viruses. 2021;13(2).
Voigtländer S, Hakimhashemi A, Inwald EC, Ortmann O, Gerken M, Klug SJ, et al. The Impact of the COVID-19 Pandemic on Cancer Incidence and Treatment by Cancer Stage in Bavaria, Germany. Dtsch Arztebl Int. 2021;118(39):660-1.
Rahimmanesh I, Shariati L, Dana N, Esmaeili Y, Vaseghi G, Haghjooy Javanmard S. Cancer Occurrence as the Upcoming Complications of COVID-19. Front Mol Biosci. 2021;8:813175.
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209-49.
O’Brien K, Ried K, Binjemain T, Sali A. Integrative Approaches to the Treatment of Cancer. Cancers. 2022;14(23):5933.
Block KI, Gyllenhaal C, Lowe L, Amedei A, Amin ARMR, Amin A, et al. Designing a broad-spectrum integrative approach for cancer prevention and treatment. Seminars in Cancer Biology. 2015;35:S276-S304.
Farhood B, Geraily G, Alizadeh A. Incidence and Mortality of Various Cancers in Iran and Compare to Other Countries: A Review Article. Iran J Public Health. 2018;47(3):309-16.
Riera R, Bagattini Â M, Pacheco RL, Pachito DV, Roitberg F, Ilbawi A. Delays and Disruptions in Cancer Health Care Due to COVID-19 Pandemic: Systematic Review. JCO Glob Oncol. 2021;7:311-23.
Jidkova S, Hoeck S, Kellen E, le Cessie S, Goossens MC. Flemish population-based cancer screening programs: impact of COVID-19 related shutdown on short-term key performance indicators. BMC Cancer. 2022;22(1):183.
Cancino RS, Su Z, Mesa R, Tomlinson GE, Wang J. The Impact of COVID-19 on Cancer Screening: Challenges and Opportunities. JMIR Cancer. 2020;6(2):e21697.
Chen RC, Haynes K, Du S, Barron J, Katz AJ. Association of Cancer Screening Deficit in the United States With the COVID-19 Pandemic. JAMA Oncology. 2021;7(6):878-84.
Bakouny Z, Hawley JE, Choueiri TK, Peters S, Rini BI, Warner JL, et al. COVID-19 and Cancer: Current Challenges and Perspectives. Cancer Cell. 2020;38(5):629-46.
Richards M, Anderson M, Carter P, Ebert BL, Mossialos E. The impact of the COVID-19 pandemic on cancer care. Nature Cancer. 2020;1(6):565-7.
Nnaji CA, Moodley J. Impact of the COVID-19 pandemic on cancer diagnosis, treatment and research in African health systems: a review of current evidence and contextual perspectives. Ecancermedicalscience. 2021;15:1170.
Koca S, Koca E, Okten IN, Orengül FF, Oztürk A, Ozçelik M, et al. Psychological impacts of COVID-19 pandemic in cancer patients on active treatment. Heliyon. 2022;8(8):e10142.
Marino P, Touzani R, Pakradouni J, Ben Soussan P, Gravis G. The Psychological Distress of Cancer Patients following the COVID-19 Pandemic First Lockdown: Results from a Large French Survey. Cancers (Basel). 2022;14(7).
Parikh KD, Ramaiya NH, Kikano EG, Tirumani SH, Pandya H, Stovicek B, et al. COVID-19 Pandemic Impact on Decreased Imaging Utilization: A Single Institutional Experience. Acad Radiol. 2020;27(9):1204-13.
Alkatout I, Biebl M, Momenimovahed Z, Giovannucci E, Hadavandsiri F, Salehiniya H, et al. Has COVID-19 Affected Cancer Screening Programs? A Systematic Review. Front Oncol. 2021;11:675038.
Rucinska M, Nawrocki S. COVID-19 Pandemic: Impact on Cancer Patients. Int J Environ Res Public Health. 2022;19(19).
Angelini M, Teglia F, Astolfi L, Casolari G, Boffetta P. Decrease of cancer diagnosis during COVID-19 pandemic: a systematic review and meta-analysis. Eur J Epidemiol. 2023;38(1):31-8.
Patt D, Gordan L, Diaz M, Okon T, Grady L, Harmison M, et al. Impact of COVID-19 on Cancer Care: How the Pandemic Is Delaying Cancer Diagnosis and Treatment for American Seniors. JCO Clin Cancer Inform. 2020;4:1059-71.
Richards M, Anderson M, Carter P, Ebert BL, Mossialos E. The impact of the COVID-19 pandemic on cancer care. Nat Cancer. 2020;1(6):565-7.
Al-Quteimat OM, Amer AM. The Impact of the COVID-19 Pandemic on Cancer Patients. Am J Clin Oncol. 2020;43(6):452-5.
Gautret P, Lagier JC, Parola P, Hoang VT, Meddeb L, Mailhe M, et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. Int J Antimicrob Agents. 2020;56(1):105949.
Pausawasdi N, Manomaiwong E, Kaosombatwattana U, Karaketklang K, Charatcharoenwitthaya P. The Effects of COVID-19 on Clinical Outcomes of Non-COVID-19 Patients Hospitalized for Upper Gastrointestinal Bleeding during the Pandemic. J Clin Med. 2022;11(9).
Patt D, Gordan L, Diaz M, Okon T, Grady L, Harmison M, et al. Impact of COVID-19 on Cancer Care: How the Pandemic Is Delaying Cancer Diagnosis and Treatment for American Seniors. JCO Clinical Cancer Informatics. 2020(4):1059-71.
McGrowder DA, Miller FG, Vaz K, Anderson Cross M, Anderson-Jackson L, Bryan S, et al. The Utilization and Benefits of Telehealth Services by Health Care Professionals Managing Breast Cancer Patients during the COVID-19 Pandemic. Healthcare (Basel). 2021;9(10).
Ftouni R, AlJardali B, Hamdanieh M, Ftouni L, Salem N. Challenges of Telemedicine during the COVID-19 pandemic: a systematic review. BMC Med Inform Decis Mak. 2022;22(1):207.
Gupta K, Gandhi S, Mebane A, 3rd, Singh A, Vishnuvardhan N, Patel E. Cancer patients and COVID-19: Mortality, serious complications, biomarkers, and ways forward. Cancer Treat Res Commun. 2021;26:100285.
Yang L, Chai P, Yu J, Fan X. Effects of cancer on patients with COVID-19: a systematic review and meta-analysis of 63,019 participants. Cancer Biol Med. 2021;18(1):298-307.
Johannesen TB, Smeland S, Aaserud S, Buanes EA, Skog A, Ursin G, et al. COVID-19 in Cancer Patients, Risk Factors for Disease and Adverse Outcome, a Population-Based Study From Norway. Frontiers in Oncology. 2021;11.
Sahin E, Kefeli U, Cabuk D, Ozden E, Cakmak Y, Kaypak MA, et al. Perceptions and acceptance of telemedicine among medical oncologists before and during the COVID-19 pandemic in Turkey. Support Care Cancer. 2021;29(12):7497-503.
Alom S, Chiu CM, Jha A, Lai SHD, Yau THL, Harky A. The Effects of COVID-19 on Cancer Care Provision: A Systematic Review. Cancer Control. 2021;28:1073274821997425.
Paul C, Carey M, Anderson A, Mackenzie L, Sanson-Fisher R, Courtney R, et al. Cancer patients' concerns regarding access to cancer care: perceived impact of waiting times along the diagnosis and treatment journey. Eur J Cancer Care (Engl). 2012;21(3):321-9.
Sartini M, Carbone A, Demartini A, Giribone L, Oliva M, Spagnolo AM, et al. Overcrowding in Emergency Department: Causes, Consequences, and Solutions—A Narrative Review. Healthcare [Internet]. 2022; 10(9).
Gatellier L, Shankar A, Dewi LKM, Hussain QM, Dendup Wangdi T, Sukumaran DB, et al. The Impact of COVID-19 on Cancer Care in the Post Pandemic World: Five Major Lessons Learnt from Challenges and Countermeasures of Major Asian Cancer Centres. Asian Pac J Cancer Prev. 2021;22(3):681-90.
Cohen J, Rodgers YVM. Contributing factors to personal protective equipment shortages during the COVID-19 pandemic. Prev Med. 2020;141:106263.
Jain U. Risk of COVID-19 due to Shortage of Personal Protective Equipment. Cureus. 2020;12(6):e8837.
Shukar S, Zahoor F, Hayat K, Saeed A, Gillani AH, Omer S, et al. Drug Shortage: Causes, Impact, and Mitigation Strategies. Frontiers in Pharmacology. 2021;12.
Gupta N, Dhamija S, Patil J, Chaudhari B. Impact of COVID-19 pandemic on healthcare workers. Ind Psychiatry J. 2021;30(Suppl 1):S282-s4.
Nguyen LH, Drew DA, Joshi AD, Guo CG, Ma W, Mehta RS, et al. Risk of COVID-19 among frontline healthcare workers and the general community: a prospective cohort study. medRxiv. 2020.
Aden D, Zaheer S, Raj S. Challenges faced in the cancer diagnosis and management-COVID-19 pandemic and beyond-Lessons for future. Heliyon. 2022;8(12):e12091.