{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T19:45:22Z","timestamp":1785527122951,"version":"3.56.0"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"vor","delay-in-days":63,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Colombian Ministry of Science and Technology","award":["Contract No. 637-2022"],"award-info":[{"award-number":["Contract No. 637-2022"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Public Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The COVID-19 pandemic, declared by WHO in March 2020, has had a significant impact on global health systems, including cancer care in Colombia. This study examines the impact of the pandemic on service delivery, health outcomes, and risk management for breast, cervical, colorectal, stomach, prostate, and lung cancers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using administrative data, we applied propensity score matching for individual-level to compare pre- and post-pandemic cohorts from 2017 to 2021, alongside with a fixed effect model to state-level covering 2018 to 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our findings reveal a consistent decline in cancer care services, except for a notable increase in the likelihood of receiving palliative care consultations and chemotherapy for breast, cervical, and colorectal cancers. When examining the intensive margin, measured by the frequency of use per patient, the results indicate an increase in both consultations and chemotherapy, reflecting higher spending on these services and a rise in average total expenditure per patient for most cancers studied. At the state level, similar trends were observed, with rising cancer prevalence and increased mortality rates for most cancers, except stomach cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings highlight the urgent need for a resilient health system capable of mitigating the impact of future health crises on chronic disease management, and particularly in cancer.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13690-026-01922-2","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T03:05:18Z","timestamp":1779937518000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cancer care under systemic shock: utilization declines and cost increases during the COVID-19 pandemic in Colombia, evidence from matched administrative cohorts"],"prefix":"10.1186","volume":"84","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-4958-1472","authenticated-orcid":false,"given":"Daniel","family":"Medina-Gaspar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Bejarano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Orozco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meisser","family":"Madera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Rodr\u00edguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Bruges","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Atehort\u00faa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giancarlo","family":"Romano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"key":"1922_CR1","unstructured":"World Health Organization. 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It is part of a larger research project, which has received the following approval:The project entitled \u201cAGORA: Alianza para la Generaci\u00f3n de evidencia sobre Covid-19, su respuesta y lecciones Aprendidas para la postpandemia y futuras epidemias\u201d, whose Principal Investigator is Dr. Zulma Milena Cucunuba from the Department of Clinical Epidemiology of the Pontificia Universidad Javeriana, was evaluated and approved by the Institutional Research and Ethics Committee of the Faculty of Medicine of the Pontificia Universidad Javeriana, in its ordinary session of July 14, 2022, considering the relevance of the research, the methodological rigor, its scientific quality, the coherence and rationality of the proposed budget and compliance with the national and international scientific, technical and ethical standards that govern this type of research.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"170"}}