Cancer diagnoses curtailed

The southern region had the largest drop in cancer diagnoses nationwide during Covid-19 Alert Level 4 and 3, but regional hospitals are bracing for a surge in patients soon.

Many more cancer patients are likely to present in the next three to six months as testing gets back to normal rates, the Southern District Health Board’s hospital advisory committee was warned yesterday.

Testing for most conditions was severely curtailed at the height of Covid-19, as patients were unable to travel and hospitals were closed to all but essential cases, surgery and radiology general manager Janine Cochrane said in a briefing on lessons learned in the region’s hospitals during the pandemic emergency.

The Cancer Control Agency charted rates of cancer diagnoses throughout New Zealand during the heightened alert levels.

Rates in the South dropped 22%; by comparison, rates fell just 4% in Canterbury, Dr Cochrane said.

"We are quite keen to have a look at that and see what factors were at work."

It was not all bad news for cancer treatment in the South during lockdown.

Surgical and non-surgical treatment for cancer and diagnostics for urgent conditions were maintained and the SDHB was one of the best-performed DHBs, Dr Cochrane said.

However, the testing drop, coupled with backlogs in CT and MRI scans and other diagnostic tests, meant southern hospitals could expect a surge in cancer patients soon.

Breast cancer and gastroenterology were the departments expected to be most affected.

"Breast cancer is not going to do any catch-up screenings but that will change workloads later on in the year in terms of diagnostics.

"Chemotherapy will also likely be impacted 3-6 months out," Dr Cochrane said.

"We have had many discussions around bowel cancer and the fact it is quite resource intensive ... diagnostics and chemotherapy will be greatly impacted by that."

Changes to hospital procedures during lockdown meant there were now 18 hours more time in acute operating theatres a week for serious patients.

Staff could reinstitute Covid-19 precautionary measures in hospitals within two days should another surge of cases happen in the South, Dr Cochrane said.

The SDHB knew some harm was caused to non-Covid-19 patients during the lockdown period due conditions not being diagnosed or treated.

The organisation should discuss whether it "over engineered" its processes and dropped too much of its general care work, Dr Cochrane said.

"We followed the Ministry of Health and college [of surgeons] guidelines during Covid, but what deferrable but urgent care might we have kept going while keeping staff, patients and whanau safe?"

A report to the SDHB said current radiation oncology wait times were within "reasonable parameters" — the waiting list was 70 patients, and the service usually had a forward waiting list of 50.

Specialist services executive director Patrick Ng said a request for $1.15million funding for radiation oncology services had been approved by the Ministry of Health.

The SDHB had also had additional funding approved to catch up on delayed CT and MRI scans.

mike.houlahan@odt.co.nz