TY - JOUR
T1 - Survey of the impact of COVID-19 on oncologists' decision making in cancer
AU - Ürün, Yüksel
AU - Hussain, Syed A.
AU - Bakouny, Ziad
AU - Castellano, Daniel
AU - Kılıçkap, Saadettin
AU - Morgan, Gilberto
AU - McKay, Rana R.
AU - Pels, Kevin
AU - Schmidt, Andrew
AU - Doroshow, Deborah B.
AU - Schütz, Fábio
AU - Albiges, Laurence
AU - Lopes, Gilberto
AU - Catto, James W.F.
AU - Peters, Solange
AU - Choueiri, Toni K.
N1 - Publisher Copyright:
© 2020 by American Society of Clinical Oncology
PY - 2020/1/1
Y1 - 2020/1/1
N2 - PURPOSE To understand readiness measures taken by oncologists to protect patients and health care workers from the novel coronavirus (COVID-19) and how their clinical decision making was influenced by the pandemic. METHODS An online survey was conducted between March 24 and April 29, 2020. RESULTS A total of 343 oncologists from 28 countries participated. The median age was 43 years (range, 29-68 years), and the majority were male (62%). At the time of the survey, nearly all participants self-reported an outbreak in their country (99.7%). Personal protective equipment was available to all participants, of which surgical mask was the most common (n = 308; 90%). Telemedicine, in the form of phone or video encounters, was common and implemented by 80% (n = 273). Testing patients with cancer for COVID-19 via reverse transcriptase polymerase chain reaction before systemic treatment was not routinely implemented: 58% reported no routine testing, 39% performed testing in selected patients, and 3% performed systematic testing in all patients. The most significant factors influencing an oncologist's decision making regarding choice of systemic therapy included patient age and comorbidities (81% and 92%, respectively). Although hormonal treatments and tyrosine kinase inhibitors were considered to be relatively safe, cytotoxic chemotherapy and immune therapies were perceived as being less safe or unsafe by participants. The vast majority of participants stated that during the pandemic they would use less chemotherapy, immune checkpoint inhibitors, and steroids. Although treatment in neoadjuvant, adjuvant, and first-line metastatic disease was less affected, most of the participants stated that they would be more hesitant to recommend second- or third-line therapies in metastatic disease. CONCLUSION Decision making by oncologists has been significantly influenced by the ongoing COVID-19 pandemic.
AB - PURPOSE To understand readiness measures taken by oncologists to protect patients and health care workers from the novel coronavirus (COVID-19) and how their clinical decision making was influenced by the pandemic. METHODS An online survey was conducted between March 24 and April 29, 2020. RESULTS A total of 343 oncologists from 28 countries participated. The median age was 43 years (range, 29-68 years), and the majority were male (62%). At the time of the survey, nearly all participants self-reported an outbreak in their country (99.7%). Personal protective equipment was available to all participants, of which surgical mask was the most common (n = 308; 90%). Telemedicine, in the form of phone or video encounters, was common and implemented by 80% (n = 273). Testing patients with cancer for COVID-19 via reverse transcriptase polymerase chain reaction before systemic treatment was not routinely implemented: 58% reported no routine testing, 39% performed testing in selected patients, and 3% performed systematic testing in all patients. The most significant factors influencing an oncologist's decision making regarding choice of systemic therapy included patient age and comorbidities (81% and 92%, respectively). Although hormonal treatments and tyrosine kinase inhibitors were considered to be relatively safe, cytotoxic chemotherapy and immune therapies were perceived as being less safe or unsafe by participants. The vast majority of participants stated that during the pandemic they would use less chemotherapy, immune checkpoint inhibitors, and steroids. Although treatment in neoadjuvant, adjuvant, and first-line metastatic disease was less affected, most of the participants stated that they would be more hesitant to recommend second- or third-line therapies in metastatic disease. CONCLUSION Decision making by oncologists has been significantly influenced by the ongoing COVID-19 pandemic.
UR - http://www.scopus.com/inward/record.url?scp=85089171153&partnerID=8YFLogxK
U2 - 10.1200/GO.20.00300
DO - 10.1200/GO.20.00300
M3 - Review article
C2 - 32755479
AN - SCOPUS:85089171153
SN - 2687-8941
SP - 1248
EP - 1257
JO - JCO Global Oncology
JF - JCO Global Oncology
IS - 6
ER -