The Impact of the COVID-19 Pandemic on Genitourinary Cancer Care: Re-envisioning the Future.
Identifieur interne : 000464 ( Main/Exploration ); précédent : 000463; suivant : 000465The Impact of the COVID-19 Pandemic on Genitourinary Cancer Care: Re-envisioning the Future.
Auteurs : Christopher J D. Wallis [États-Unis] ; James W F. Catto [Royaume-Uni] ; Antonio Finelli [Canada] ; Adam W. Glaser [Royaume-Uni] ; John L. Gore [États-Unis] ; Stacy Loeb [États-Unis] ; Todd M. Morgan [États-Unis] ; Alicia K. Morgans [États-Unis] ; Nicolas Mottet [France] ; Richard Neal [Royaume-Uni] ; Tim O'Brien [Royaume-Uni] ; Anobel Y. Odisho [États-Unis] ; Thomas Powles [Royaume-Uni] ; Ted A. Skolarus [États-Unis] ; Angela B. Smith [États-Unis] ; Bernadett Szabados [Royaume-Uni] ; Zachary Klaassen [États-Unis] ; Daniel E. Spratt [États-Unis]Source :
- European urology [ 1873-7560 ] ; 2020.
Abstract
CONTEXT
The coronavirus disease 2019 (COVID-19) pandemic necessitated rapid changes in medical practice. Many of these changes may add value to care, creating opportunities going forward.
OBJECTIVE
To provide an evidence-informed, expert-derived review of genitourinary cancer care moving forward following the initial COVID-19 pandemic.
EVIDENCE ACQUISITION
A collaborative narrative review was conducted using literature published through May 2020 (PubMed), which comprised three main topics: reduced in-person interactions arguing for increasing virtual and image-based care, optimisation of the delivery of care, and the effect of COVID-19 in health care facilities on decision-making by patients and their families.
EVIDENCE SYNTHESIS
Patterns of care will evolve following the COVID-19 pandemic. Telemedicine, virtual care, and telemonitoring will increase and could offer broader access to multidisciplinary expertise without increasing costs. Comprehensive and integrative telehealth solutions will be necessary, and should consider patients' mental health and access differences due to socioeconomic status. Investigations and treatments will need to maximise efficiency and minimise health care interactions. Solutions such as one stop clinics, day case surgery, hypofractionated radiotherapy, and oral or less frequent drug dosing will be preferred. The pandemic necessitated a triage of those patients whose treatment should be expedited, delayed, or avoided, and may persist with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in circulation. Patients whose demographic characteristics are at the highest risk of complications from COVID-19 may re-evaluate the benefit of intervention for less aggressive cancers. Clinical research will need to accommodate virtual care and trial participation. Research dissemination and medical education will increasingly utilise virtual platforms, limiting in-person professional engagement; ensure data dissemination; and aim to enhance patient engagement.
CONCLUSIONS
The COVID-19 pandemic will have lasting effects on the delivery of health care. These changes offer opportunities to improve access, delivery, and the value of care for patients with genitourinary cancers but raise concerns that physicians and health administrators must consider in order to ensure equitable access to care.
PATIENT SUMMARY
The coronavirus disease 2019 (COVID-19) pandemic has dramatically changed the care provided to many patients with genitourinary cancers. This has necessitated a transition to telemedicine, changes in threshold or delays in many treatments, and an opportunity to reimagine patient care to maintain safety and improve value moving forward.
DOI: 10.1016/j.eururo.2020.08.030
PubMed: 32893062
PubMed Central: PMC7471715
Affiliations:
- Canada, France, Royaume-Uni, États-Unis
- Angleterre, Californie, Caroline du Nord, Grand Londres, Géorgie (États-Unis), Illinois, Michigan, Ontario, Tennessee, Washington (État), Yorkshire-et-Humber, État de New York
- Leeds, Londres, Seattle, Toronto
- Université de Leeds, Université de Londres, Université de Toronto, Université de Washington
Links toward previous steps (curation, corpus...)
Le document en format XML
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Morgans</name><affiliation wicri:level="2"><nlm:affiliation>Department of Medical Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Medical Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL</wicri:regionArea><placeName><region type="state">Illinois</region></placeName></affiliation></author><author><name sortKey="Mottet, Nicolas" sort="Mottet, Nicolas" uniqKey="Mottet N" first="Nicolas" last="Mottet">Nicolas Mottet</name><affiliation wicri:level="1"><nlm:affiliation>Department of Urology, University Hospital Nord, St Etienne, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Urology, University Hospital Nord, St Etienne</wicri:regionArea><wicri:noRegion>St Etienne</wicri:noRegion><wicri:noRegion>St Etienne</wicri:noRegion></affiliation></author><author><name sortKey="Neal, Richard" sort="Neal, Richard" uniqKey="Neal R" first="Richard" last="Neal">Richard Neal</name><affiliation wicri:level="4"><nlm:affiliation>Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Leeds Institute of Health Sciences, University of Leeds, Leeds</wicri:regionArea><orgName type="university">Université de Leeds</orgName><placeName><settlement type="city">Leeds</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Yorkshire-et-Humber</region></placeName></affiliation></author><author><name sortKey="O Brien, Tim" sort="O Brien, Tim" uniqKey="O Brien T" first="Tim" last="O'Brien">Tim O'Brien</name><affiliation wicri:level="3"><nlm:affiliation>Department of Urology, Guy's and St Thomas Hospitals, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Urology, Guy's and St Thomas Hospitals, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Odisho, Anobel Y" sort="Odisho, Anobel Y" uniqKey="Odisho A" first="Anobel Y" last="Odisho">Anobel Y. 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Skolarus</name><affiliation wicri:level="2"><nlm:affiliation>Department of Urology, University of Michigan, Ann Arbor, MI, USA; Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Urology, University of Michigan, Ann Arbor, MI, USA; Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI</wicri:regionArea><placeName><region type="state">Michigan</region></placeName></affiliation></author><author><name sortKey="Smith, Angela B" sort="Smith, Angela B" uniqKey="Smith A" first="Angela B" last="Smith">Angela B. Smith</name><affiliation wicri:level="2"><nlm:affiliation>Department of Urology, University of North Carolina, Chapel Hill, NC, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Urology, University of North Carolina, Chapel Hill, NC</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation></author><author><name sortKey="Szabados, Bernadett" sort="Szabados, Bernadett" uniqKey="Szabados B" first="Bernadett" last="Szabados">Bernadett Szabados</name><affiliation wicri:level="4"><nlm:affiliation>Barts Cancer Center, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Barts Cancer Center, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName><orgName type="university">Université de Londres</orgName></affiliation></author><author><name sortKey="Klaassen, Zachary" sort="Klaassen, Zachary" uniqKey="Klaassen Z" first="Zachary" last="Klaassen">Zachary Klaassen</name><affiliation wicri:level="2"><nlm:affiliation>Department of Surgery, Division of Urology, Augusta University-Medical College of Georgia, Augusta, GA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Surgery, Division of Urology, Augusta University-Medical College of Georgia, Augusta, GA</wicri:regionArea><placeName><region type="state">Géorgie (États-Unis)</region></placeName></affiliation></author><author><name sortKey="Spratt, Daniel E" sort="Spratt, Daniel E" uniqKey="Spratt D" first="Daniel E" last="Spratt">Daniel E. Spratt</name><affiliation wicri:level="2"><nlm:affiliation>Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Radiation Oncology, University of Michigan, Ann Arbor, MI</wicri:regionArea><placeName><region type="state">Michigan</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32893062</idno><idno type="pmid">32893062</idno><idno type="doi">10.1016/j.eururo.2020.08.030</idno><idno type="pmc">PMC7471715</idno><idno type="wicri:Area/Main/Corpus">000209</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000209</idno><idno type="wicri:Area/Main/Curation">000209</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000209</idno><idno type="wicri:Area/Main/Exploration">000209</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">The Impact of the COVID-19 Pandemic on Genitourinary Cancer Care: Re-envisioning the Future.</title><author><name sortKey="Wallis, Christopher J D" sort="Wallis, Christopher J D" uniqKey="Wallis C" first="Christopher J D" last="Wallis">Christopher J D. Wallis</name><affiliation wicri:level="2"><nlm:affiliation>Department of Urology, Vanderbilt University Medical Center, Nashville, TN, USA. Electronic address: wallis.cjd@gmail.com.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Urology, Vanderbilt University Medical Center, Nashville, TN</wicri:regionArea><placeName><region type="state">Tennessee</region></placeName></affiliation></author><author><name sortKey="Catto, James W F" sort="Catto, James W F" uniqKey="Catto J" first="James W F" last="Catto">James W F. Catto</name><affiliation wicri:level="1"><nlm:affiliation>Academic Urology Unit, University of Sheffield, Sheffield, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Academic Urology Unit, University of Sheffield, Sheffield</wicri:regionArea><wicri:noRegion>Sheffield</wicri:noRegion></affiliation></author><author><name sortKey="Finelli, Antonio" sort="Finelli, Antonio" uniqKey="Finelli A" first="Antonio" last="Finelli">Antonio Finelli</name><affiliation wicri:level="4"><nlm:affiliation>Division of Urology, Princess Margaret Cancer Center, University of Toronto, Toronto, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Division of Urology, Princess Margaret Cancer Center, University of Toronto, Toronto, ON</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Glaser, Adam W" sort="Glaser, Adam W" uniqKey="Glaser A" first="Adam W" last="Glaser">Adam W. Glaser</name><affiliation wicri:level="4"><nlm:affiliation>Leeds Institute of Medical Research, University of Leeds, Leeds, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Leeds Institute of Medical Research, University of Leeds, Leeds</wicri:regionArea><orgName type="university">Université de Leeds</orgName><placeName><settlement type="city">Leeds</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Yorkshire-et-Humber</region></placeName></affiliation></author><author><name sortKey="Gore, John L" sort="Gore, John L" uniqKey="Gore J" first="John L" last="Gore">John L. Gore</name><affiliation wicri:level="4"><nlm:affiliation>Department of Urology, University of Washington, Seattle, WA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Urology, University of Washington, Seattle, WA</wicri:regionArea><placeName><region type="state">Washington (État)</region><settlement type="city">Seattle</settlement></placeName><orgName type="university">Université de Washington</orgName></affiliation></author><author><name sortKey="Loeb, Stacy" sort="Loeb, Stacy" uniqKey="Loeb S" first="Stacy" last="Loeb">Stacy Loeb</name><affiliation wicri:level="2"><nlm:affiliation>Department of Urology and Population Health, NYU Langone Health and Manhattan Veterans Affairs, New York, NY, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Urology and Population Health, NYU Langone Health and Manhattan Veterans Affairs, New York, NY</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Morgan, Todd M" sort="Morgan, Todd M" uniqKey="Morgan T" first="Todd M" last="Morgan">Todd M. Morgan</name><affiliation wicri:level="2"><nlm:affiliation>Department of Urology, University of Michigan, Ann Arbor, MI, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Urology, University of Michigan, Ann Arbor, MI</wicri:regionArea><placeName><region type="state">Michigan</region></placeName></affiliation></author><author><name sortKey="Morgans, Alicia K" sort="Morgans, Alicia K" uniqKey="Morgans A" first="Alicia K" last="Morgans">Alicia K. Morgans</name><affiliation wicri:level="2"><nlm:affiliation>Department of Medical Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Medical Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL</wicri:regionArea><placeName><region type="state">Illinois</region></placeName></affiliation></author><author><name sortKey="Mottet, Nicolas" sort="Mottet, Nicolas" uniqKey="Mottet N" first="Nicolas" last="Mottet">Nicolas Mottet</name><affiliation wicri:level="1"><nlm:affiliation>Department of Urology, University Hospital Nord, St Etienne, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Urology, University Hospital Nord, St Etienne</wicri:regionArea><wicri:noRegion>St Etienne</wicri:noRegion><wicri:noRegion>St Etienne</wicri:noRegion></affiliation></author><author><name sortKey="Neal, Richard" sort="Neal, Richard" uniqKey="Neal R" first="Richard" last="Neal">Richard Neal</name><affiliation wicri:level="4"><nlm:affiliation>Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Leeds Institute of Health Sciences, University of Leeds, Leeds</wicri:regionArea><orgName type="university">Université de Leeds</orgName><placeName><settlement type="city">Leeds</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Yorkshire-et-Humber</region></placeName></affiliation></author><author><name sortKey="O Brien, Tim" sort="O Brien, Tim" uniqKey="O Brien T" first="Tim" last="O'Brien">Tim O'Brien</name><affiliation wicri:level="3"><nlm:affiliation>Department of Urology, Guy's and St Thomas Hospitals, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Urology, Guy's and St Thomas Hospitals, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Odisho, Anobel Y" sort="Odisho, Anobel Y" uniqKey="Odisho A" first="Anobel Y" last="Odisho">Anobel Y. Odisho</name><affiliation wicri:level="2"><nlm:affiliation>Department of Urology and Center for Digital Health Innovation, University of California San Francisco, San Francisco, CA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Urology and Center for Digital Health Innovation, University of California San Francisco, San Francisco, CA</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Powles, Thomas" sort="Powles, Thomas" uniqKey="Powles T" first="Thomas" last="Powles">Thomas Powles</name><affiliation wicri:level="4"><nlm:affiliation>Barts Cancer Center, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Barts Cancer Center, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName><orgName type="university">Université de Londres</orgName></affiliation></author><author><name sortKey="Skolarus, Ted A" sort="Skolarus, Ted A" uniqKey="Skolarus T" first="Ted A" last="Skolarus">Ted A. Skolarus</name><affiliation wicri:level="2"><nlm:affiliation>Department of Urology, University of Michigan, Ann Arbor, MI, USA; Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Urology, University of Michigan, Ann Arbor, MI, USA; Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI</wicri:regionArea><placeName><region type="state">Michigan</region></placeName></affiliation></author><author><name sortKey="Smith, Angela B" sort="Smith, Angela B" uniqKey="Smith A" first="Angela B" last="Smith">Angela B. Smith</name><affiliation wicri:level="2"><nlm:affiliation>Department of Urology, University of North Carolina, Chapel Hill, NC, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Urology, University of North Carolina, Chapel Hill, NC</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation></author><author><name sortKey="Szabados, Bernadett" sort="Szabados, Bernadett" uniqKey="Szabados B" first="Bernadett" last="Szabados">Bernadett Szabados</name><affiliation wicri:level="4"><nlm:affiliation>Barts Cancer Center, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Barts Cancer Center, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName><orgName type="university">Université de Londres</orgName></affiliation></author><author><name sortKey="Klaassen, Zachary" sort="Klaassen, Zachary" uniqKey="Klaassen Z" first="Zachary" last="Klaassen">Zachary Klaassen</name><affiliation wicri:level="2"><nlm:affiliation>Department of Surgery, Division of Urology, Augusta University-Medical College of Georgia, Augusta, GA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Surgery, Division of Urology, Augusta University-Medical College of Georgia, Augusta, GA</wicri:regionArea><placeName><region type="state">Géorgie (États-Unis)</region></placeName></affiliation></author><author><name sortKey="Spratt, Daniel E" sort="Spratt, Daniel E" uniqKey="Spratt D" first="Daniel E" last="Spratt">Daniel E. Spratt</name><affiliation wicri:level="2"><nlm:affiliation>Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Radiation Oncology, University of Michigan, Ann Arbor, MI</wicri:regionArea><placeName><region type="state">Michigan</region></placeName></affiliation></author></analytic><series><title level="j">European urology</title><idno type="eISSN">1873-7560</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>CONTEXT</b></p><p>The coronavirus disease 2019 (COVID-19) pandemic necessitated rapid changes in medical practice. Many of these changes may add value to care, creating opportunities going forward.</p></div><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b></p><p>To provide an evidence-informed, expert-derived review of genitourinary cancer care moving forward following the initial COVID-19 pandemic.</p></div><div type="abstract" xml:lang="en"><p><b>EVIDENCE ACQUISITION</b></p><p>A collaborative narrative review was conducted using literature published through May 2020 (PubMed), which comprised three main topics: reduced in-person interactions arguing for increasing virtual and image-based care, optimisation of the delivery of care, and the effect of COVID-19 in health care facilities on decision-making by patients and their families.</p></div><div type="abstract" xml:lang="en"><p><b>EVIDENCE SYNTHESIS</b></p><p>Patterns of care will evolve following the COVID-19 pandemic. Telemedicine, virtual care, and telemonitoring will increase and could offer broader access to multidisciplinary expertise without increasing costs. Comprehensive and integrative telehealth solutions will be necessary, and should consider patients' mental health and access differences due to socioeconomic status. Investigations and treatments will need to maximise efficiency and minimise health care interactions. Solutions such as one stop clinics, day case surgery, hypofractionated radiotherapy, and oral or less frequent drug dosing will be preferred. The pandemic necessitated a triage of those patients whose treatment should be expedited, delayed, or avoided, and may persist with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in circulation. Patients whose demographic characteristics are at the highest risk of complications from COVID-19 may re-evaluate the benefit of intervention for less aggressive cancers. Clinical research will need to accommodate virtual care and trial participation. Research dissemination and medical education will increasingly utilise virtual platforms, limiting in-person professional engagement; ensure data dissemination; and aim to enhance patient engagement.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>The COVID-19 pandemic will have lasting effects on the delivery of health care. These changes offer opportunities to improve access, delivery, and the value of care for patients with genitourinary cancers but raise concerns that physicians and health administrators must consider in order to ensure equitable access to care.</p></div><div type="abstract" xml:lang="en"><p><b>PATIENT SUMMARY</b></p><p>The coronavirus disease 2019 (COVID-19) pandemic has dramatically changed the care provided to many patients with genitourinary cancers. This has necessitated a transition to telemedicine, changes in threshold or delays in many treatments, and an opportunity to reimagine patient care to maintain safety and improve value moving forward.</p></div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">32893062</PMID><DateRevised><Year>2020</Year><Month>09</Month><Day>09</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1873-7560</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>Sep</Month><Day>03</Day></PubDate></JournalIssue><Title>European urology</Title><ISOAbbreviation>Eur. Urol.</ISOAbbreviation></Journal><ArticleTitle>The Impact of the COVID-19 Pandemic on Genitourinary Cancer Care: Re-envisioning the Future.</ArticleTitle><ELocationID EIdType="pii" ValidYN="Y">S0302-2838(20)30676-X</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.eururo.2020.08.030</ELocationID><Abstract><AbstractText Label="CONTEXT" NlmCategory="BACKGROUND">The coronavirus disease 2019 (COVID-19) pandemic necessitated rapid changes in medical practice. Many of these changes may add value to care, creating opportunities going forward.</AbstractText><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">To provide an evidence-informed, expert-derived review of genitourinary cancer care moving forward following the initial COVID-19 pandemic.</AbstractText><AbstractText Label="EVIDENCE ACQUISITION" NlmCategory="METHODS">A collaborative narrative review was conducted using literature published through May 2020 (PubMed), which comprised three main topics: reduced in-person interactions arguing for increasing virtual and image-based care, optimisation of the delivery of care, and the effect of COVID-19 in health care facilities on decision-making by patients and their families.</AbstractText><AbstractText Label="EVIDENCE SYNTHESIS" NlmCategory="RESULTS">Patterns of care will evolve following the COVID-19 pandemic. Telemedicine, virtual care, and telemonitoring will increase and could offer broader access to multidisciplinary expertise without increasing costs. Comprehensive and integrative telehealth solutions will be necessary, and should consider patients' mental health and access differences due to socioeconomic status. Investigations and treatments will need to maximise efficiency and minimise health care interactions. Solutions such as one stop clinics, day case surgery, hypofractionated radiotherapy, and oral or less frequent drug dosing will be preferred. The pandemic necessitated a triage of those patients whose treatment should be expedited, delayed, or avoided, and may persist with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in circulation. Patients whose demographic characteristics are at the highest risk of complications from COVID-19 may re-evaluate the benefit of intervention for less aggressive cancers. Clinical research will need to accommodate virtual care and trial participation. Research dissemination and medical education will increasingly utilise virtual platforms, limiting in-person professional engagement; ensure data dissemination; and aim to enhance patient engagement.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">The COVID-19 pandemic will have lasting effects on the delivery of health care. These changes offer opportunities to improve access, delivery, and the value of care for patients with genitourinary cancers but raise concerns that physicians and health administrators must consider in order to ensure equitable access to care.</AbstractText><AbstractText Label="PATIENT SUMMARY" NlmCategory="UNASSIGNED">The coronavirus disease 2019 (COVID-19) pandemic has dramatically changed the care provided to many patients with genitourinary cancers. This has necessitated a transition to telemedicine, changes in threshold or delays in many treatments, and an opportunity to reimagine patient care to maintain safety and improve value moving forward.</AbstractText><CopyrightInformation>Copyright © 2020 European Association of Urology. Published by Elsevier B.V. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Wallis</LastName><ForeName>Christopher J D</ForeName><Initials>CJD</Initials><AffiliationInfo><Affiliation>Department of Urology, Vanderbilt University Medical Center, Nashville, TN, USA. Electronic address: wallis.cjd@gmail.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Catto</LastName><ForeName>James W F</ForeName><Initials>JWF</Initials><AffiliationInfo><Affiliation>Academic Urology Unit, University of Sheffield, Sheffield, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Finelli</LastName><ForeName>Antonio</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Division of Urology, Princess Margaret Cancer Center, University of Toronto, Toronto, ON, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Glaser</LastName><ForeName>Adam W</ForeName><Initials>AW</Initials><AffiliationInfo><Affiliation>Leeds Institute of Medical Research, University of Leeds, Leeds, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gore</LastName><ForeName>John L</ForeName><Initials>JL</Initials><AffiliationInfo><Affiliation>Department of Urology, University of Washington, Seattle, WA, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Loeb</LastName><ForeName>Stacy</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Urology and Population Health, NYU Langone Health and Manhattan Veterans Affairs, New York, NY, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Morgan</LastName><ForeName>Todd M</ForeName><Initials>TM</Initials><AffiliationInfo><Affiliation>Department of Urology, University of Michigan, Ann Arbor, MI, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Morgans</LastName><ForeName>Alicia K</ForeName><Initials>AK</Initials><AffiliationInfo><Affiliation>Department of Medical Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mottet</LastName><ForeName>Nicolas</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Department of Urology, University Hospital Nord, St Etienne, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Neal</LastName><ForeName>Richard</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>O'Brien</LastName><ForeName>Tim</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Department of Urology, Guy's and St Thomas Hospitals, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Odisho</LastName><ForeName>Anobel Y</ForeName><Initials>AY</Initials><AffiliationInfo><Affiliation>Department of Urology and Center for Digital Health Innovation, University of California San Francisco, San Francisco, CA, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Powles</LastName><ForeName>Thomas</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Barts Cancer Center, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Skolarus</LastName><ForeName>Ted A</ForeName><Initials>TA</Initials><AffiliationInfo><Affiliation>Department of Urology, University of Michigan, Ann Arbor, MI, USA; Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Smith</LastName><ForeName>Angela B</ForeName><Initials>AB</Initials><AffiliationInfo><Affiliation>Department of Urology, University of North Carolina, Chapel Hill, NC, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Szabados</LastName><ForeName>Bernadett</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Barts Cancer Center, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Klaassen</LastName><ForeName>Zachary</ForeName><Initials>Z</Initials><AffiliationInfo><Affiliation>Department of Surgery, Division of Urology, Augusta University-Medical College of Georgia, Augusta, GA, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Spratt</LastName><ForeName>Daniel E</ForeName><Initials>DE</Initials><AffiliationInfo><Affiliation>Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>09</Month><Day>03</Day></ArticleDate></Article><MedlineJournalInfo><Country>Switzerland</Country><MedlineTA>Eur 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Wallis</name></region><name sortKey="Gore, John L" sort="Gore, John L" uniqKey="Gore J" first="John L" last="Gore">John L. Gore</name><name sortKey="Klaassen, Zachary" sort="Klaassen, Zachary" uniqKey="Klaassen Z" first="Zachary" last="Klaassen">Zachary Klaassen</name><name sortKey="Loeb, Stacy" sort="Loeb, Stacy" uniqKey="Loeb S" first="Stacy" last="Loeb">Stacy Loeb</name><name sortKey="Morgan, Todd M" sort="Morgan, Todd M" uniqKey="Morgan T" first="Todd M" last="Morgan">Todd M. Morgan</name><name sortKey="Morgans, Alicia K" sort="Morgans, Alicia K" uniqKey="Morgans A" first="Alicia K" last="Morgans">Alicia K. Morgans</name><name sortKey="Odisho, Anobel Y" sort="Odisho, Anobel Y" uniqKey="Odisho A" first="Anobel Y" last="Odisho">Anobel Y. Odisho</name><name sortKey="Skolarus, Ted A" sort="Skolarus, Ted A" uniqKey="Skolarus T" first="Ted A" last="Skolarus">Ted A. Skolarus</name><name sortKey="Smith, Angela B" sort="Smith, Angela B" uniqKey="Smith A" first="Angela B" last="Smith">Angela B. Smith</name><name sortKey="Spratt, Daniel E" sort="Spratt, Daniel E" uniqKey="Spratt D" first="Daniel E" last="Spratt">Daniel E. Spratt</name></country><country name="Royaume-Uni"><noRegion><name sortKey="Catto, James W F" sort="Catto, James W F" uniqKey="Catto J" first="James W F" last="Catto">James W F. Catto</name></noRegion><name sortKey="Glaser, Adam W" sort="Glaser, Adam W" uniqKey="Glaser A" first="Adam W" last="Glaser">Adam W. 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