In The Lancet Oncology, Joanna A Didkowska and colleagues from the Polish National Cancer Registry reported on the current and expected future burden of cancer care for Ukrainian refugees coming to Poland. They expect approximately 52 000 prevalent cases in Poland overall, and 3300 new cases of cancer per year.
The Central European Cooperative Oncology Group (CECOG) has surveyed health-care professionals in Ukraine's neighbouring countries Poland, Czech Republic, Slovakia, Hungary, and Romania. Our survey supports Didkowska and colleagues’ observations from Poland and highlights some of the challenges faced by countries hosting refugees from Ukraine. Of 53 respondents, 45 (85%) provided care for refugee patients with cancer. Of these health-care professionals, 19 (42%) had treated more than five refugees with cancer in the preceding 8 weeks. The challenges were related to language barriers and the obvious burden on health-care systems, in terms of time and resources. However, health-care professionals also reported encouraging facts. Most Ukrainian patients with cancer carried their relevant documentation, allowing for a rapid continuation of treatment with delays of less than 4 weeks in most cases. Most patients did not have more advanced disease than usually observed among local patients with cancer.
As Didkowska and colleagues also noted, it is important to consider that these refugees will remain in their host countries for months, if not years. The current situation in Ukraine is the early phase of an armed conflict. As the war reaches a stalemate, with protracted fighting and ever more destroyed local infrastructure, increasing numbers of patients with cancer will remain without proper treatment. It is assumed that people fleeing Ukraine at a later stage of the conflict or not at all will have received inadequate treatment, with possibly long time gaps between treatment sessions or no proper diagnosis and treatment at all. Importantly, the numbers of affected patients should be estimated, and their situation assessed, to ensure adequate logistical support and distribution of financial resources in the long term. WHO has called for better alignment among international bodies, such as the UN, national ministries of health, and other aid organisations, to identify priority cancers, adequate clinical pathways, and financial protection mechanisms. Organisations such as the CECOG with its international network of cancer specialists are uniquely suited to serve as early warning systems for emerging difficulties, but can also advocate for the needs of both patients and health-care professionals in situations such as the present refugee crisis. CECOG can also play a role in storing information on local experiences and expertise gained over time and subsequently advise international bodies.
CT honoraria from the Central European Cooperative Oncology Group. CCZ has received grants, consulting fees, and contracts from Athenex, MSD, AstraZeneca; is a patent holder with Imugene; and is a member of the leadership board for European Society for Medical Oncology, Central European Cooperative Oncology Group, and Immunotherapy of Cancer Conference.
References
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Didkowska JA
Barańska K
Wojciechowska U
Tyczyński JE
War in Ukraine creates challenges for the cancer care system in Poland.
Lancet Oncol. 2022; 23: 1239-1240
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Ilbawi A
Slama S
Cancer care for refugees: time to invest in people and systems.
Lancet Oncol. 2020; 21: 604-605
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