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Cancer patients from the UK were 1.5 times more likely to die following a diagnosis with COVID-19 than cancer patients from European countries.

This is the finding of a study of over 1000 patients – 924 from European countries and 468 from the UK – during the first wave of the COVID-19 pandemic. The research team, led by Imperial College London, say the study highlights the need for UK cancer patients to be prioritised for vaccination.

We need to now prioritise cancer patients in the UK, as this study suggests they are extremely vulnerable – more so than in many other countries Dr David Pinato Study author

The study tracked data between 27 February to 10 September 2020, across 27 centres in six countries: Italy, Spain, France, Belgium, Germany and the UK.

The results, published in the European Journal of Cancer, showed that 30 days after a COVID-19 diagnosis, 40.38 per cent of UK cancer patients had died, versus 26.5 per cent of European patients.

Six months after a COVID-19 diagnosis, 47.64 per cent of UK cancer patients had died, compared to 33.33 per cent of European patients.

Dr David Pinato, lead author of the study from Imperial’s Department of Surgery and Cancer, said: “This is the first study showing UK cancer patients were more likely to die following a COVID-19 diagnosis compared to European patients. We knew the UK had one of the highest deaths rates from COVID-19. However, in addition to this, prior to COVID-19 the UK already lagged behind European nations in terms of cancer care, with the UK having lower survival rates from many cancers compared to many other EU nations. We need to now prioritise cancer patients in the UK, as this study suggests they are extremely vulnerable – more so than in many other countries.”

UK patients less likely to be receiving treatments

The study also found that UK patients were less likely to be receiving cancer treatment at the time of COVID-19 diagnosis, compared to European patients. This was most likely due to guidance from the UK National Institute for Health and Care Excellence, say the team, which recommended pausing cancer treatment during the first UK wave of COVID-19, due to concerns cancer treatment would increase risk of COVID-19.

However, the study found pausing cancer treatment did not affect risk of death following COVID-19 diagnosis.

UK cancer patients tended to be older than European patients, were more likely to be male, and have other conditions such as obesity or diabetes. Dr Alessio Cortellini Study author

The study also found equal proportions between the UK and EU of complicated COVID-19 cases, rates of intensive care admission and use of ventilation. In addition to this, UK cancer patients were less likely to receive anti-COVID-19 therapies including corticosteroids, anti-virals and interleukin-6 antagonists. There were also similar rates of admission to intensive care units.

The study team added that UK cancer patients tended to be more frail than European cancer patients, which may have led to the increased death rates following a COVID-19 diagnosis.

Dr Alessio Cortellini, co-author of the paper from the Department of Surgery and Cancer, added: “UK cancer patients tended to be older than European patients, were more likely to be male, and have other conditions such as obesity or diabetes. All of these may have contributed to the increased mortality rate, and show why cancer patients should be prioritised for COVID-19 vaccination.”

The study was supported by the National Institute for Health Research Imperial Biomedical Research Centre.

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‘Determinants of enhanced vulnerability to COVID-19 in UK cancer patients: a European Study’ is published in the European Journal of Cancer