Impact of the COVID-19 pandemic on cancer care and outcomes in children and adolescents

Cancer is a leading cause of death in children and adolescents in Canada. The COVID-19 pandemic is causing major disruptions to health care systems, and is likely to have negative impacts on cancer care in children and adolescents. Staffing shortages may occur due to reallocation of health care personnel to different services, or leaves of absence due to COVID-19 exposure. Many childhood cancers are diagnosed incidentally through routine health checks or for symptoms not initially thought to be cancer-related. Parents may be less likely to engage with the health care system for symptoms in their children in response to public health directives to stay at home, and fear of being infected with SARS-CoV-2 in healthcare settings. The pandemic is also likely to have created new psychological, social, and financial burdens for cancer patients and their families. Our research aims to study the long-term impact of the COVID-19 pandemic on cancer care and survival in children and adolescents. We will use health insurance medical claims, hospital records, and death registry data from Quebec to assess temporal changes in childhood and adolescent cancer diagnoses, survival, and treatment patterns attributable to the pandemic. We will also be performing a literature review of the psychological, social, and financial impacts of the pandemic on child and adolescent cancer patients and their families. While cancer is a rare disease in children and adolescents, it constitutes a leading cause of mortality in these age groups, and leads to a significant psychosocial impact on both patients and their families. As these cancers are rare, the analysis of data from large administrative databases is one of the best ways to assess the impact of the pandemic on child and adolescent cancer patients. Our results will be able to provide direct confirmation of whether public health directives to protect cancer services were successful in preventing negative outcomes in children and adolescents.