The changing face of cancer surgery during multiple waves of COVID-19

COVID-19 has had a detrimental effect on the provision of cancer surgery, but its impact beyond the first 6 months of the pandemic remains unclear. We used data on 799,220 cancer surgeries performed in Ontario, Canada during 2018–2021 and segmented regression to address this knowledge gap. With the arrival of the first COVID-19 wave (March 2020), mean cancer surgical volume decreased by 57%. Surgical volume then rose by 2.5% weekly and reached pre-pandemic levels in 8 months. The surgical backlog after the first wave was 47,639 cases. At the beginning of the second COVID-19 wave (January 2021), mean cancer surgical volume dropped by 22%. Afterwards, surgical volume did not actively recover (2-sided p-value = 0.25), resulting in a cumulative backlog of 66,376 cases as of August 2021. These data urge the strengthening of the surgical system to quickly clear the backlog in anticipation of a tsunami of newly diagnosed cancer patients needing surgery.