The Pandemic Gap and Bladder Cancer

Since March 2020, there has been a steady flow of news about the COVID-19 pandemic's impact on healthcare. Doctors, nurses, and people in need of all types of care were suddenly faced with stress and fear of the unknown.

Researchers are now starting to explore how the pandemic specifically affected cancer care, including diagnosis and treatment for bladder cancer. During the pandemic, many people were delayed in getting the care they needed. Researchers are referring to this delay in care as the pandemic gap.¹

What is the pandemic gap?

There are various treatments and support groups available for many people with cancer. But during the COVID-19 global pandemic, there was a lack of access to or delay in using these treatments and supports.¹

For most people, it was challenging to go to the hospital or see their doctors. The delay in seeing a doctor due to COVID-19 led to:²

• Fewer diagnoses of cancer
• Postponed treatment of bladder cancer
• Decreased referrals to specialists who treat bladder cancer

What led to the pandemic gap?

At the onset of the COVID-19 pandemic, very little was known about the virus. The uncertainly had a major impact on the healthcare system around the world. Many medical workers were sent to various locations to help support COVID-19 treatment units. This meant many surgeries, exams, and doctor's visits were limited or even canceled due to staff shortages.²

The fear of COVID-19 exposure also impacted how healthcare systems treated people with cancer and other conditions. Research published in 2020 found that people with cancer who contracted COVID-19 are more likely to have negative outcomes, such as being placed on a ventilator and being admitted into the intensive care unit (ICU). So, despite symptoms of cancer, many people avoided necessary exams and screenings.³

New research studies have explored how these gaps in medical care led to a delay in diagnosing and treating people with bladder cancer, as well as the stage of their cancer when they were finally diagnosed.

How were the studies done?

One study published in November 2020 used an extensive medical database to get statistics on older adults with different types of cancer from March through July 2019 and March through July 2020. The goal was to determine the changes in cancer care services to this population due to the pandemic gap. The researchers looked at the data to compare:¹

• Cancer screenings
• Doctor visits
• Therapies
• Surgeries

Another study published in April 2021 focused on the impact of the pandemic gap in people with bladder cancer, and its effect on tumor stage and grade. The study participants were diagnosed with and had surgery for bladder cancer between January 2019 and December 2020.²

During the study, the participants were split into two groups. The people in the first group received a new diagnosis of bladder cancer between January 2019 and December 2020. The people in the second group were diagnosed with recurrent bladder cancer during this timeframe.²

Treatments were not delayed in those who had:

• • New or recurrent high-risk bladder cancer;
  • Recurrent intermediate-risk bladder cancer and had been undergoing BCG mainentence for at least 1 year;
  • Recurrent high-risk bladder cancer and had been undergoing BCG mainentence for at least 3 years.

On the other hand, treatments were postponed until the end of lockdown for those with new or recurrent low- or intermediate-risk bladder cancer.²

What did the research show?

Research showed there was a considerable drop in cancer screenings and detections between 2019 and 2020. Screenings for many types of cancers decreased by up to 85 percent, including screenings for:¹

• • • Breast cancer
    • Colon cancer
    • Prostate cancer
    • Lung cancer

Researchers found that there were also fewer patient visits, therapy appointments, and surgeries during the pandemic. In turn, the delay in surgery led to an increased risk of advanced cancer. Advanced cancer needs quick diagnosis, staging, and treatment to ensure better results.²

Data also showed that people who received an initial diagnosis of bladder cancer during the pandemic had more high-grade and advanced tumors at the time of their diagnosis. However, tumor stage and grade were not affected in people who were diagnosed with recurrent bladder cancer during the pandemic.²

Bladder cancer and the pandemic gap

The pandemic gap affected access to healthcare, causing a decrease in treatment and finding of new cancers. On top of that, it increased the chance of worsening tumors in people who were newly diagnosed with bladder cancer.²

The full effect of the COVID-19 medical lockdown is still unknown. More research is needed to better understand how it impacted people with cancer. However, we will likely not have a full understanding for many years.⁴

Did the pandemic effect you and your bladder cancer journey? Let us know in the comments below, or share your story with the community.