Delayed diagnosis and treatment of children with cancer during the COVID-19 pandemic

Michal Dvori, Sarah Elitzur, Assaf Barg, Shlomit Barzilai-Birenboim, Gil Gilad, Shirah Amar, Helen Toledano, Amos Toren, Sigal Weinreb, Gal Goldstein, Adi Shapira, Shifra Ash, Shai Izraeli, Oded Gilad*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: COVID-19, the novel coronavirus has caused a global pandemic affecting millions of people around the world. Although children, including children with cancer, have been found to be affected less commonly and less severely than adults, indirect effects of the pandemic on the diagnosis and treatment of children with cancer have been less described. Methods: A survey was performed in the four largest tertiary pediatric hematology-oncology medical centers in Israel. Clinical and laboratory data were collected from the medical files of patients diagnosed or treated with cancer during April–October 2020. Results: Seventeen patients are described, who had a significant delay in diagnosis or treatment of cancer. These represent approximately 10% of all pediatric cancer diagnosed during the study period in these centers. A main cause of delay was fear of exposure to COVID-19 (fears felt by the patient, parent, physician, or decision-makers at the institution; or the implementation of national guidelines). Delays also resulted from co-infection with COVID-19 and the attribution of the oncologic symptoms to the infection. In addition, treatment was delayed of patients already diagnosed with cancer, due to COVID-19 infection detected in the patient, a family member, or a bone marrow donor. Conclusion: Fear from the COVID-19 pandemic may result in delayed diagnosis and treatment of children with cancer, which may carry a risk to dismal prognosis. It is crucial that pediatricians and patients alike remember that other diseases still prevail and must be thought of and treated in a timely fashion.

Original languageEnglish
Pages (from-to)1569-1574
Number of pages6
JournalInternational Journal of Clinical Oncology
Issue number8
StatePublished - Aug 2021


  • COVID-19
  • Delayed diagnosis
  • Delayed treatment
  • Pediatric cancer


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