key: cord-0827936-w0fzyh9p
authors: Obispo, B.; Rogado, J.; Lara Alvarez, M.A.
title: The other cost of the pandemic
date: 2021-05-15
journal: Clin Breast Cancer
DOI: 10.1016/j.clbc.2021.05.001
sha: d7387838a1b23f7bac04d58daf9ea3982d16b4b9
doc_id: 827936
cord_uid: w0fzyh9p

nan

Since the beginning of the Covid-19 pandemic, we are immersed in an health crisis with more than 3291000 affected in Spain and more than 75541 deaths until April 2021, being our country one of the most affected in Europe (1).

The strong impact of the pandemic on our healthcare system has brought other problems such as delays in consultations, suspension of surgeries and delays in diagnostic tests (including screening programmes). The immediate consequence has been the delay in the diagnosis of diseases such as cancer.

Cancer is an ever-growing epidemic disease with an estimated incidence of 18.1 million new cases in 2018. Breast cancer is the most common tumour (2.1 million) and the leading cause of cancer deaths in women (2) . In Spain, 32825 new cases were diagnosed in 2018, with 6519 deaths and a 5-year survival rate of over 85% (3).

In western countries, breast cancer is diagnosed with metastatic disease in 5-6% of all cases (4) . Within Spain, in Madrid, a total of 32977 cases of cancer were diagnosed in 2019, of which 13.3% (4395 cases) corresponded to breast cancer. Of these patients 5.89% (259 cases) were diagnosed with metastatic disease (5).

In our centre, between March and December 2019, a total of 140 new cases of breast cancer were diagnosed, of which 5% (7/140) had metastatic disease at debut. However, when comparing the similar time period in 2020, after the start of the pandemic, there was a decrease in the number of new diagnostics, 113 cases, with an increase of patients with metastatic disease to 9.7% (11/113), doubling the previous year's figures.

And the cost is not just in lives. Diagnostic delays have a negative impact on our economy. The average cost of a patient with localised breast cancer in Spain is estimated at around 58,832 euros. However, in metastatic breast cancer, the average cost is up to four times higher, rising to 210,142 euros, being the solid tumour with the highest average cost. (6) .

When the possible end of the pandemic is in sight, multiple questions arise such as: What is the other cost of this health crisis? What will be the real impact on the diagnostic delays of cancer patients on increased morbidity and mortality? The first step should be to provide the necessary human and material resources to intensify early diagnosis programmes. If not, the cost will be enormous in lives and money.

Informe de actualización nº 344

Global cancerstatistics 2018: GLOBOCAN estimates of incidence and mortalityworldwidefor 36 cancers in 185 countries

Cancer treatment and survivorship statistics

Año 2019. Oficina Regional de Coordinación Oncológica

El impacto económico y social del cáncer en España

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.