COVID Impact on Head and Neck Cancer

Hundreds more head and neck cancer sufferers may die due to COVID-19

A leading head and neck cancer charity is warning that hundreds of people are potentially at risk of dying unnecessarily over the next five years if the Government does not get a grip of how to treat people with other life-threatening illnesses alongside COVID-19.

New data, from DATA-CAN: The Health Data Research Hub for Cancer and collaborators on behalf of the Swallows Head and Neck Cancer Charity, has shown that progress in projected five-year survival from head and neck cancer could be set back significantly and have a devastating impact on patients.

Mark Jordan, lost his lifelong friend and work colleague, Roger, 60, a plumber from Blackpool, to mouth cancer, just before Christmas. He said: “In February 2020, Roger started feeling a dull pain towards the back of his mouth, so he booked a dentist appointment. He was seen and referred to Blackpool Victoria Hospital, where he had an x-ray mid-March, just before lockdown.

“Roger had a dental follow-up check cancelled during the first lockdown. He was still in pain and chased up the results but was told all non-essential consultations were on hold. The pain was getting worse, so he went to A & E twice. While x-rays were taken, he wasn’t seen as a priority and didn’t get answers.

“By August, he could feel a lump the size of a thumbnail in his mouth. At the start of September, he finally got an appointment with a plastic surgeon at the Royal Preston Hospital. Scans showed he had an aggressive tumour. In September Roger was diagnosed with advanced mouth cancer and told he had just six weeks to live. We will always wonder whether, if the pandemic hadn’t happened and Roger had received his treatment on time, he would still be here”.

Chris Curtis, Founder Swallows Head and Neck Cancer Charity said: “The impact of coronavirus on all head and neck cancer patients is alarming. In 2020, there was a drastic reduction in suspected head and neck cancer referrals compared to 2019 figures.

“If this continues, it could have a devastating effect on five-year survival rates and potentially lead to hundreds of extra deaths. We are also seeing additional deaths like Roger that might have had a different outcome if they received their treatment without delays and cancellations due to COVID-19.”

Over the course of the UK lockdown between March and May 2020, DATA-CAN and partners collected and analysed ‘real-time’ data from UK cancer centres. These data provided a valuable insight into the effects of the COVID-19 pandemic on all cancer patients and cancer services.

The research found:

• A 70% decline in urgent referrals for cancer during the initial lockdown
• A 40% decline in chemotherapy attendances during the initial lockdown
• For certain cancers, these declines had only partially recovered.

The researchers looked in detail at the impact on head and neck cancers and found that, at its worst, there was a drop of nearly 60% in urgent referrals during the first lockdown. Estimates suggest that this could have a devastating impact on five-year survival for people with head and neck cancer.

Pre-COVID, around 47% of people with head and neck cancer would be projected to survive for five years or more. This figure could now drop to 43% which could potentially lead to an additional 451 deaths per annum.

Professor Mark Lawler, DATA CAN’s scientific lead and Professor of Digital Health at Queen’s University Belfast, said: “Our research shows that there have been significant diagnostic and treatment delays as a result of the pandemic for people with all cancers. The data we show today for head and neck cancer is particularly worrying.

“While we have seen some positive recovery in urgent referrals and chemotherapy appointments, it may be that just getting back to pre-COVID-19 levels will not be enough. We may need to be operating at 130% of previous levels to address the backlog, the missing diagnoses, and the delayed treatments for people with cancer.”

“We’ve done so well to improve cancer outcomes in the UK in the last decade. Let us make sure that 10 years progress isn’t wiped out in 10 months.”

Consultant Oral Maxillofacial Surgeon and Mouth Cancer Foundation Ambassador, Mahesh Kumar, who works at Northwick Park Hospital, London added: “We saw a drop in cases during the lockdown months, and I now have patients who are presenting at a more advanced stage, (stage 4), of the disease, which is far more distressing for everyone.

“We will not know the full impact for a few years, but I imagine the statistics for head and neck cancer deaths will keep rising.”