Abstract

WALKER, L; STOPFORTH, L; NAIDOO, L  and  FERRER, S. Access to oncology care in western KwaZulu-Natal Province before, during and after the COVID-19 pandemic. SAMJ, S. Afr. med. j. [online]. 2025, vol.115, n.7, pp.27-33. ISSN 2078-5135.  https://doi.org/10.7196/SAMJ.2025.v115i7.2665.

BACKGROUND. Timely access to oncological care is essential. International experience suggests that the COVID-19 pandemic negatively impacted this. Knowledge of the experience in South Africa is limited. OBJECTIVE. To assess the effect of COVID-19-associated lockdowns on access to cancer care for public sector patients in western KwaZulu-Natal Province (KZN). METHODS. A retrospective chart review was conducted in the Oncology Department of Grey's Hospital (GHOD), a tertiary hospital in KZN, to determine times between onset of symptoms, diagnosis, first consultation at GHOD and treatment. Patient demographics were included. Patients were stratified by both date of first GHOD appointment and of biopsy with respect to the various lockdown stages. RESULTS. A total of 360 patient files over four time periods (pre COVID-19, hard and soft lockdown and post-COVID-19) were reviewed. When stratified by first GHOD appointment, only waiting time from GHOD review to treatment decreased, with all other waiting times remaining stable. The average number of new patients seen per day decreased during soft lockdown, with the proportion of patients referred from primary care facilities most affected. CONCLUSION. Despite the challenges of a global pandemic, access to GHOD care was not compromised in terms of patient waiting times. The absolute number of patients seen decreased, however, particularly those referred from primary care facilities. This study reviewed the entire COVID-19 period and shows that the impact of COVID-19 on patients who accessed care was not necessarily negative. The need for research regarding diagnosis and referral at primary and secondary care levels during the pandemic is highlighted.

Keywords : cancer care; access to care; treatment delays; waiting times; COVID-19 pandemic.

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