The domino effect of the pandemic, by Judit Vall

When it seems that vaccines have saved us (at least for the moment) from suffering the next (would it already be the seventh?) wave of the covid-19 pandemic, some collateral effects and damage are beginning to be seen on health that will materialize in all its cruelty in the coming months and years.

Among those that will surely be more serious and more visible are those related to early diagnosis of cancer and with the mortality caused by that disease. At Cancer Global Modelling Consortium Several working groups have been created to investigate these effects and one of them focuses on the impact of covid-19 on breast cancer detection, treatment and mortality. The reason for focusing on this type of cancer is that it is the most diagnosed in the world, with a total of 2.3 million cases each year. Consequently, the impact on the population, as well as the costs for the health system derived from this disease, are enormous.

You have to know that, in order to detect breast cancer as soon as possible and obtain a diagnosis as early as possible & horbar; which translates into an increased probability of survival & horbar ;, many of the developed countries have screening programs of the population with certain risk factors for developing breast cancer. The truth is that some of the studies that evaluate the results of these early detection programs point to important positive effects, such as, for example, reduce 20% of the mortality of women that are subject to such screening programs.

The pandemic has increased the pressure on the health system to limits never before reached. The available resources, both in health personnel and in assistance capacity, have focused on covid patients and visits and operations for other pathologies had to be postponed during the first months of the pandemic. East effect “collapse & rdquor; it also had an impact on screening and early detection programs.

In a recent study led by some of the researchers from the Cancer Global Modelling Consortium A modeling exercise is presented to estimate in six developed countries the effect caused by the interruption of early detection programs for breast cancer. Specifically, we sought to know the effect on the probability of detecting said disease; also, the variation that had to be made towards a more aggressive treatment due to the delay in diagnosis; finally, The mortality associated with the interruption of the screening programs was estimated. Obviously, knowing what happens when these programs are not carried out is very important to gauge the effort that will be made to restore them.

The countries analyzed have been Canada, the Netherlands, Germany, Italy, the United Kingdom and Australia, where breast cancer screening programs came to a complete halt for a period of one to six months at the onset of the pandemic. Obviously, the effects of the interruption depend on the type of screening and the number of actions that were taking place in each country before the pandemic. However, there is a general and undeniable tendency for the results to be quite negative.

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The modeling exercise shows how, for example, in Italy, a three-month suspension of breast cancer screening programs will result in 10,000 fewer cases being diagnosed. If the suspension is maintained for six months, the missed diagnoses amount to 16,000. In the case of the United Kingdom, a three-month disruption in early detection programs it will imply an increase in mortality from this type of cancer of 6.3%, which will increase to 22.3% if the suspension lasts six months.

These numbers, even though they are estimates based on mathematical models, are chilling and compelling enough to highlight the importance of maintaining the reach of such programs. Detection efforts have surely multiplied after overcoming the initial phase of the pandemic, but The consequencesUnfortunately, they are going to be noticed, and a lot, in the coming months.

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