The Impact of the COVID-19 Lockdown on Cancer Referrals in Primary Care in the UK: Two Years On
Keywords:
Referrals, Primary Care, Clinical Audit, Observational Study, CoronavirusAbstract
BACKGROUND: Cancer is common, with most cancer patients presenting initially to a general care practitioner. The COVID-19 pandemic led to changes in the delivery of primary care, which could have affected cancer referrals. This observational study looked at cancer referrals made before, during and after the first UK COVID-19 lockdown in 2020, at a GP practice in the Wirral, England. METHODS: A search was conducted to find the cancer referrals made between 23rd March 2020 - 1st July 2020, during the first lockdown. Using the same methodology, cancer referral data was collected for the corresponding time periods in 2019 and 2021. The number of cancer referrals, and their positive diagnostic yields, were then compared.
RESULTS: The number of cancer referrals decreased by 40.4% in 2020, compared to 2019. In 2021, the number of referrals then increased by 225%, compared to 2020. Overall, the number of cancer referrals increased between 2019-2021. The positive diagnostic yield for the 2020 cancer referrals increased by 251.4%, compared to that of 2019. The calculated yield for the 2021 data then decreased by 10.8% compared to 2020. Overall, the positive diagnostic yield increased between 2019-2021.
CONCLUSION: The numbers and outcomes of cancer referrals at this GP practice have changed considerably, following the first UK COVID-19 lockdown in 2020, and the influence of the pandemic was still affecting cancer referrals in 2021. A greater focus on early detection of cancer in primary care could help overcome the ways in which the pandemic has affected primary care delivery.
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