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Lugnier C, Förster S, Sommerlatte S, Schoffer O, Christmann J, Kraeft AL, Terzer T, Kourti E, Overheu O, Schlageter E, Ekmekciu I, Uhl W, Biermann C, Müller L, Sinn M, Kasper-Virchow S, Modest D, Heinemann V, Schmitt J, Schildmann J, Tannapfel A, Reinacher-Schick A. Significant Alterations of Colorectal Cancer Care in the COVID-19 Pandemic With High Adherence to Quality Criteria in German Cancer Centers (CC) ‒ Data From the AIO CancerCOVID Consortium (AIO-YMO/KRK 520/ass). Clin Colorectal Cancer 2025:S1533-0028(25)00001-5. [PMID: 39966037 DOI: 10.1016/j.clcc.2025.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2024] [Revised: 12/31/2024] [Accepted: 01/05/2025] [Indexed: 02/20/2025]
Abstract
BACKGROUND Colorectal cancer (CRC) remains a leading cause of death despite notable advancements through guideline-based management. We present data on changes of CRC care during the COVID-19 pandemic in Germany. METHODS Retrospective data from 22 AIO CCs and an academic Institute of Pathology compared the first (fw, 03-05.2020) and second wave (sw, 11-12.2020) of the pandemic with corresponding 2019 periods. Parameters were: number of cases diagnosed, age, sex, tumor stage, surgical procedures, quality criteria of CRC care (presentation in multidisciplinary tumor boards (MTB), psychological or social consultation), number of precancerous and malignant colorectal lesions (CRL). Data points were compared as mean values with confidence intervals estimated according to Clopper and Pearson (1934). Hypothesis tests were conducted using Poisson regression models that included interaction terms (year*sex or year*age over70). Statistical significance was considered at P < .05. RESULTS A total of 4316 cases diagnosed (AIO CC) revealed a substantial reduction (fw -20.58%; sw -23.48%). Hypothesis test showed a significant decline in incidence due to the fw and sw of the pandemic. Quality criteria of cancer care remained stable except for trial participation. Analysis from 60,695 CRL detected a decrease in precancerous (fw: -16 %/sw: -4 %) and malignant (fw: -18 %) lesions while malignant CRL increased in the sw (+8 %). Hypothesis test revealed a significant decline only for the fw 2020 and detected age > 70 as independent risk factor in both waves. CONCLUSION We detected substantial alterations in cancer care during the pandemic, including detected precancerous CRL. CCs showed high resilience in quality criteria for CRC care.
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Affiliation(s)
- Céline Lugnier
- Dept. of Hematology and Oncology with Palliative Care, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany.
| | - Sarah Förster
- Institute of Pathology, Georgius Agricola Stiftung Ruhr, Ruhr-University Bochum, Bochum, Germany
| | - Sabine Sommerlatte
- Institute for History and Ethics of Medicine, Interdisciplinary Centre for Health Sciences, Medical Faculty of Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Olaf Schoffer
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Jens Christmann
- Institute of Pathology, Georgius Agricola Stiftung Ruhr, Ruhr-University Bochum, Bochum, Germany
| | - Anna-Lena Kraeft
- Dept. of Hematology and Oncology with Palliative Care, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Tobias Terzer
- Dept. of Hematology and Oncology with Palliative Care, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Eleni Kourti
- Dept. of Hematology and Oncology with Palliative Care, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Oliver Overheu
- Dept. of Hematology and Oncology with Palliative Care, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Elena Schlageter
- Dept. of Hematology and Oncology with Palliative Care, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Ira Ekmekciu
- Dept. of Hematology and Oncology with Palliative Care, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Waldemar Uhl
- Department of Surgery, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany
| | | | - Lothar Müller
- Practice for Oncology and Hematology, Study Centrum Unter Ems, Leer, Germany
| | - Marianne Sinn
- Department of Internal Medicine II, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan Kasper-Virchow
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Dominik Modest
- Department of Medical Oncology and Hematology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Volker Heinemann
- Department of Internal Medicine III and Comprehensive Cancer Center, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Jochen Schmitt
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Jan Schildmann
- Institute for History and Ethics of Medicine, Interdisciplinary Centre for Health Sciences, Medical Faculty of Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Andrea Tannapfel
- Institute of Pathology, Georgius Agricola Stiftung Ruhr, Ruhr-University Bochum, Bochum, Germany
| | - Anke Reinacher-Schick
- Dept. of Hematology and Oncology with Palliative Care, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany
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Naseem Z, Butt QM, Shaukat A, Grenfell-Dexter R, Zhu J, D'Souza B, Strugnell N. Clinical Outcomes and Resource Efficiency of a Telehealth Model for New Lower Gastrointestinal Bleeding Referrals: A Tertiary Colorectal Outpatient Service Audit. Int J Telemed Appl 2025; 2025:9945160. [PMID: 39822331 PMCID: PMC11737902 DOI: 10.1155/ijta/9945160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 08/31/2024] [Accepted: 12/05/2024] [Indexed: 01/19/2025] Open
Abstract
Introduction: Amidst the COVID-19 pandemic, telehealth (TH) has gained increasing relevance in colorectal patient care, prompting an audit of the TH clinic at a tertiary colorectal unit. This study evaluated telephone-based consultations' clinical efficacy and diagnostic thresholds for new lower gastrointestinal (LGI) bleeding referrals. Methods: We conducted a quality assurance audit of the per rectal (PR) bleeding TH clinic at Northern Hospital Victoria, evaluating new LGI bleeding referrals. Data from July 2021 to June 2023 were extracted from the Referral Management System (RMS) and analyzed. The study focused on newly referred patients, excluding those previously seen or awaiting procedures. Clinical efficacy was determined through sensitivity, specificity, and predictive values, with a receiver operating characteristic (ROC) curve assessing the TH method's discrimination threshold. Results: Of the 239 patients, 131 met the inclusion criteria, with a compliance rate of 96%. The TH clinic demonstrated a sensitivity of 75.76% and specificity of 52.46% in distinguishing between colorectal and anal pathologies. The average time from referral to a diagnostic procedure was 9.75 weeks, with a reduction in median wait time for first appointments from 19 weeks prepandemic to 3.6 weeks. A cost-benefit analysis highlighted TH clinics' ability to reduce overhead costs and maintain a revenue stream despite reduced face-to-face consultations. Conclusion: Our study concludes that the telecare service model serves as an effective complementary approach for managing new LGI bleeding referrals. Further research on long-term outcomes and cost-effectiveness is necessary to fully assess telecare as a potentially sustainable hybrid model.
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Affiliation(s)
- Zainab Naseem
- Department of Medicine and Health, University of Sydney, Sydney, Australia
- Department of Colorectal Surgery, Northern Hospital Epping, Epping, Australia
| | - Qamar M. Butt
- Department of Colorectal Surgery, Northern Hospital Epping, Epping, Australia
| | - Amina Shaukat
- Department of Colorectal Surgery, Northern Hospital Epping, Epping, Australia
| | | | - Junzhe Zhu
- Department of Surgery, University of Melbourne, Melbourne, Australia
| | - Basil D'Souza
- Department of Colorectal Surgery, Northern Hospital Epping, Epping, Australia
- Department of Surgery, University of Melbourne, Melbourne, Australia
| | - Neil Strugnell
- Department of Colorectal Surgery, Northern Hospital Epping, Epping, Australia
- Department of Surgery, University of Melbourne, Melbourne, Australia
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Kanno DT, Mattos RLMD, Siqueira RM, Pereira JA, Campos FG, Martinez CAR. IMPACT OF THE COVID-19 PANDEMIC ON THE EMERGENCY SURGICAL TREATMENT OF COLORECTAL CANCER. ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA : ABCD = BRAZILIAN ARCHIVES OF DIGESTIVE SURGERY 2024; 36:e1793. [PMID: 38324854 PMCID: PMC10841527 DOI: 10.1590/0102-672020230075e1793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 10/10/2023] [Indexed: 02/09/2024]
Abstract
BACKGROUND Colorectal cancer (CRC) is the most common malignancy of the gastrointestinal tract and the third most common type of cancer worldwide. The COVID-19 pandemic, during the years 2020 and 2022, increased the difficulties in offering adequate early diagnosis and treatment to CRC patients worldwide. During this period, it was only possible to treat patients who evolved with complications, mainly intestinal obstruction and perforation. AIMS To assess the impact of the COVID-19 pandemic on the treatment of patients with CRC. METHODS A review of data from a total of 112 patients undergoing emergency surgical treatment due to complications of CRC was carried out. Of these, 78 patients underwent emergency surgery during the COVID-19 pandemic (2020/2021), and 34 were treated before the pandemic (2018/2019). Ethnic aspects, clinical symptoms, laboratory tests, histopathological variables, intra and postoperative complications, and 90-day postoperative follow-up were compared between the two groups. RESULTS Between the years 2018 and 2019, 79.4% (27/34) of patients had intestinal obstruction, while 20.6% (7/34) had intestinal perforation. During the period of the COVID-19 pandemic (2020/2021), 1.3% (1/78) of patients underwent surgery due to gastrointestinal bleeding, 6.4% (5/78) due to intestinal perforation, and 92.3% (72/78) due to intestinal obstruction. No statistically significant differences were recorded between the two groups in ethnic aspects, laboratory tests, type of complications, number of lymph nodes resected, compromised lymph nodes, TNM staging, pre or intraoperative complications, length of stay, readmission, or mortality rate. When considering postoperative tumor staging, among patients operated on in 2018/2019, 44.1% were classified as stage III and 38.2% as stage IV, while during the pandemic period, 28.2% presented stage III and 51.3% stage IV, also without a statistically significant difference between the two periods. Patients operated on during the pandemic had higher rates of vascular, lymphatic and perineural invasion. CONCLUSIONS The COVID-19 pandemic increased the rate of complications related to CRC when comparing patients treated before and during the pandemic. Furthermore, it had a negative impact on histopathological variables, causing worse oncological prognoses in patients undergoing emergency surgery.
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Affiliation(s)
- Danilo Toshio Kanno
- Universidade São Francisco, Postgraduate Program in Health Sciences - Bragança Paulista (SP), Brazil
| | | | - Rayama Moreira Siqueira
- Universidade Estadual de Campinas, Department of Surgery, Postgraduate Program in Surgical Sciences - Campinas (SP), Brazil
| | - José Aires Pereira
- Universidade São Francisco, Postgraduate Program in Health Sciences - Bragança Paulista (SP), Brazil
| | | | - Carlos Augusto Real Martinez
- Universidade São Francisco, Postgraduate Program in Health Sciences - Bragança Paulista (SP), Brazil
- Universidade Estadual de Campinas, Department of Surgery - Campinas (SP), Brazil
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Omidifar N, Pazoki N, Shokripour M, Fattahi MR, Safarpour AR, Fallahzadeh Abarghooee E, Nikmanesh N, Shamsdin SA, Akrami H, Saghi SA, Nikmanesh Y. The Effect of Coronavirus Disease 2019 on the Quality of Associated Care in Patients with Gastric Cancer. Middle East J Dig Dis 2024; 16:12-22. [PMID: 39050096 PMCID: PMC11264831 DOI: 10.34172/mejdd.2024.363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 12/09/2023] [Indexed: 07/27/2024] Open
Abstract
Coronavirus is a new virus that has affected human life on a large scale; it has infected millions of people and killed hundreds of thousands of people. In contrast, among cancers, stomach neoplasia is the most common cancer of the upper gastrointestinal (UGI) tract. COVID-19 disease has disrupted the optimal management of patients with cancer. Metastasis, deterioration of the patient's nutritional status, UGI bleeding, and increased surgical complications are all consequences of delayed treatment of patients with gastric cancer. However, there is still insufficient evidence on the immunogenicity of the vaccine and the protection provided by coronavirus vaccines in patients with cancer, especially those with immunodeficiency or those who are treated for certain types of cancers. Also, as part of the prevention and control of COVID-19 disease, nutritional support for patients with gastrointestinal cancer is particularly important, and the psychological and physiological limitations caused by the disease duration are hurting the well-being of patients. Therefore, the assessment of the impact of the coronavirus on cancer should be treated as an important issue, and healthcare professionals should be prepared to deal with the long-term effects of the coronavirus disease.
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Affiliation(s)
- Navid Omidifar
- Biotechnology Research Center and Department of Pathology, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nasrin Pazoki
- Department of Genetics, Faculty of Biological Sciences, North Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Mansoureh Shokripour
- Department of Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Reza Fattahi
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Reza Safarpour
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Nika Nikmanesh
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyedeh Azra Shamsdin
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hassan Akrami
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyyed Amirreza Saghi
- Cellular and Molecular Biology Research Center, Larestan University of Medical Sciences, Larestan, Iran
- Student Research Committee, Larestan University of Medical Sciences, Larestan, Iran
| | - Yousef Nikmanesh
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Hijos-Mallada G, Alfaro E, Navarro M, Cañamares P, Ariño I, Charro M, Bruno C, Solano M, Pardillos A, Jimeno C, Carrera-Lasfuentes P, Lanas A, Domper-Arnal MJ. Impact of the COVID-19 pandemic in colorectal cancer diagnosis and presentation. GASTROENTEROLOGIA Y HEPATOLOGIA 2023; 46:702-709. [PMID: 36716926 PMCID: PMC9882881 DOI: 10.1016/j.gastrohep.2023.01.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 10/26/2022] [Accepted: 01/17/2023] [Indexed: 01/29/2023]
Abstract
BACKGROUND AND OBJECTIVE The COVID-19 pandemic has been associated with a decrease in the colorectal cancer (CRC) incidence, due to the disruption of screening programmes and a downscaling of endoscopic activity. The endpoint of this study is to evaluate if the pandemic has led to a change in CRC diagnostic rate and presentation in our population. METHODS Multicenter retrospective study of all public hospitals of the Aragon region, attending a population of 1,329,391 inhabitants. We have analyzed all CRC cases detected and endoscopic units workload the year before the pandemic onset (1 March 2019-14 March 2020) and the first year of the COVID-19 pandemic (15 March 2020-28 February 2021). RESULTS The diagnosis of CRC cases dropped a 38.9% (888 pre-pandemic vs 542 pandemic cases). Also, there were 30.3% less colonoscopies performed (24,860 vs 17,337). During the pandemic, CRC cases were diagnosed in older patients (72.4±12.2 vs 71.2±12.1 years, p=0.021), and had more frequently severe complications at diagnosis (14.6% vs 10.4%, p=0.019). Moreover, most CRC cases were diagnosed in symptomatic patients (81.4%). No significant difference was found in CRC stage at diagnosis, although stage IV was more frequent (20.1% vs 16.1%). Most hospitals reported a lower workload of endoscopic activity. CONCLUSION CRC diagnostic rate was lower after the onset of the pandemic. CRC was diagnosed in older patients and was more frequently associated with complications. After the onset of the pandemic, the endoscopic units did not reach the workload performed previously.
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Affiliation(s)
- Gonzalo Hijos-Mallada
- Lozano Blesa University Clinic Hospital, Zaragoza, Spain; Aragon Health Research Institute (IIS Aragón), Zaragoza, Spain.
| | - Enrique Alfaro
- Lozano Blesa University Clinic Hospital, Zaragoza, Spain; Aragon Health Research Institute (IIS Aragón), Zaragoza, Spain.
| | | | | | | | | | | | | | | | | | - Patricia Carrera-Lasfuentes
- Aragon Health Research Institute (IIS Aragón), Zaragoza, Spain; Biomedical Research Networking Center in Hepatic and Digestive Diseases (CIBERehd), Spain; Universidad San Jorge, Villanueva de Gállego, Zaragoza, Spain
| | - Angel Lanas
- Lozano Blesa University Clinic Hospital, Zaragoza, Spain; Aragon Health Research Institute (IIS Aragón), Zaragoza, Spain; Biomedical Research Networking Center in Hepatic and Digestive Diseases (CIBERehd), Spain; University of Zaragoza, Zaragoza, Spain
| | - Maria Jose Domper-Arnal
- Lozano Blesa University Clinic Hospital, Zaragoza, Spain; Aragon Health Research Institute (IIS Aragón), Zaragoza, Spain; University of Zaragoza, Zaragoza, Spain
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Feier CVI, Santoro RR, Faur AM, Muntean C, Olariu S. Assessing Changes in Colon Cancer Care during the COVID-19 Pandemic: A Four-Year Analysis at a Romanian University Hospital. J Clin Med 2023; 12:6558. [PMID: 37892695 PMCID: PMC10607165 DOI: 10.3390/jcm12206558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/08/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
This retrospective study investigates the impact of the COVID-19 pandemic on the surgical management of patients with colon cancer in a tertiary University Hospital in Timisoara, Romania. Data from 867 patients who underwent surgical interventions for this condition between 26 February 2019 and 25 February 2023 were meticulously analyzed to evaluate substantial shifts in the management and outcomes of these patients in comparison to the pre-pandemic era. The results reveal a substantial decrease in elective surgical procedures (p < 0.001) and a significant increase in emergency interventions (p < 0.001). However, postoperative mortality did not show significant variations. Of concern is the diagnosis of patients at more advanced stages of colon cancer, with a significant increase in Stage IV cases in the second year of the pandemic (p = 0.045). Average hospitalization durations recorded a significant decrease (p < 0.001) during the pandemic, and an inverse correlation between patient age and surgery duration was reported (p = 0.01, r = -0.088). This analysis provides a comprehensive perspective on how the pandemic has influenced the management of colon cancer, highlighting significant implications for the management and outcomes of these patients.
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Affiliation(s)
- Catalin Vladut Ionut Feier
- First Discipline of Surgery, Department X-Surgery, “Victor Babes” University of Medicine and Pharmacy, 2 E. Murgu Sq., 300041 Timisoara, Romania; (C.V.I.F.); (S.O.)
- First Surgery Clinic, “Pius Brinzeu” Clinical Emergency Hospital, 300723 Timisoara, Romania
| | - Rebecca Rosa Santoro
- Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Alaviana Monique Faur
- Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Calin Muntean
- Medical Informatics and Biostatistics, Department III-Functional Sciences, “Victor Babes” University of Medicine and Pharmacy, 2 E. Murgu Sq., 300041 Timisoara, Romania
| | - Sorin Olariu
- First Discipline of Surgery, Department X-Surgery, “Victor Babes” University of Medicine and Pharmacy, 2 E. Murgu Sq., 300041 Timisoara, Romania; (C.V.I.F.); (S.O.)
- First Surgery Clinic, “Pius Brinzeu” Clinical Emergency Hospital, 300723 Timisoara, Romania
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Yano T, Nakano K, Yoshimitsu M, Idani H, Okajima M. Successful resection of rectal cancer and perirectal abscess following systemic chemotherapy and chemoradiotherapy: A case report. Int J Surg Case Rep 2023; 108:108403. [PMID: 37329610 PMCID: PMC10382744 DOI: 10.1016/j.ijscr.2023.108403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 06/12/2023] [Accepted: 06/12/2023] [Indexed: 06/19/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Perirectal abscesses are uncommon in colorectal cancer. Although abscess infection should be controlled before colorectal cancer treatment, abscess formation makes surgical resection and preoperative treatment difficult. There is currently no established treatment for colorectal cancer with perirectal abscesses. Here, we present a case of rectal cancer with a perirectal abscess that was resected after systemic chemotherapy followed by chemoradiotherapy. CASE PRESENTATION A 73-year-old man presented to the outpatient clinic with complaints of weight loss and general malaise. Colonoscopy revealed a circumferential tumor 3 cm from the anal verge, and examination of the endoscopic biopsy specimen indicated a well-differentiated tubular adenocarcinoma. Pelvic magnetic resonance imaging revealed a perirectal abscess on the ventral aspect of the rectum. After sigmoid colostomy was performed to control the infection, 4 cycles of panitumumab and modified fluorouracil, leucovorin, and oxaliplatin were administered. After the perirectal abscess disappeared, chemoradiotherapy to the whole pelvis (radiotherapy 45Gy/25 fractions plus tegafur-gimeracil-oteracil) was administered. Total pelvic exenteration with an ileal conduit was performed via open surgery. The pathological diagnosis was well-differentiated tubular adenocarcinoma with complete resection and negative resection margins. No recurrence of cancer has been observed 26 months after surgery. CLINICAL DISCUSSION Treatment of colorectal cancer with perirectal abscess is difficult to define the extent of resection due to the spread of inflammation. We believe that treatment should address high risk of local recurrence. CONCLUSION After sigmoid colostomy, complete resection of colorectal cancer with perirectal abscess could be achieved by systemic chemotherapy followed by chemoradiotherapy.
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Affiliation(s)
- Takuya Yano
- Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-ku, Hiroshima 730-8518, Japan.
| | - Kanyu Nakano
- Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-ku, Hiroshima 730-8518, Japan
| | - Masanori Yoshimitsu
- Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-ku, Hiroshima 730-8518, Japan
| | - Hitoshi Idani
- Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-ku, Hiroshima 730-8518, Japan
| | - Masazumi Okajima
- Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-ku, Hiroshima 730-8518, Japan; Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
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Fujita M, Yamaguchi K, Nagashima K, Suzuki K, Kasai T, Hashimoto H, Onouchi Y, Sato D, Fujisawa T, Hata A. Changes in colorectal cancer treatment during the COVID-19 pandemic in Japan: Interrupted time-series analysis using the National Database of Japan. Cancer Epidemiol 2023; 85:102391. [PMID: 37207375 PMCID: PMC10191809 DOI: 10.1016/j.canep.2023.102391] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 05/10/2023] [Accepted: 05/12/2023] [Indexed: 05/21/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic forced us to accept changes in our usual diagnostic procedures and treatments for colorectal cancer. This study aimed to determine the impact of the pandemic on colorectal cancer treatment in Japan. METHODS The number of colorectal surgeries, stoma constructions, stent placements or long tube insertions, and neoadjuvant chemoradiotherapies were determined each month using sampling datasets from the National Database of Health Insurance Claims and Specific Health Checkups of Japan. The observation periods before and during the pandemic were January 2015 to January 2020 and April 2020 to January 2021, respectively. An interrupted time-series analysis was used to estimate the changes in the number of procedures during the pandemic. RESULTS The number of endoscopic surgeries for colon cancer significantly decreased in April and July 2020 and for rectal cancer in April 2020. Additionally, the number of laparoscopic and open surgeries for colon cancer significantly decreased in July 2020 and October 2020, respectively. The number of stoma constructions and stent placements or long tube insertions did not increase during the observation period. Neoadjuvant chemoradiotherapy for rectal cancer significantly increased in April 2020 but levels returned shortly thereafter. These results suggest that the recommendations to overcome the pandemic proposed by expert committees, including the replacement of laparoscopic surgery with open surgery, stoma construction to avoid anastomotic leak, and replacement of surgery on the ileus with stent placement, were not widely implemented in Japan. However, as an exception, neoadjuvant chemoradiotherapy for rectal cancer was performed as an alternative treatment to delay surgery in small quantities. CONCLUSION A declining number of surgeries raises concerns about cancer stage progression; however, we found no evidence to suggest cancer progression from the trajectory of the number of stoma constructions and stent placements. In Japan, even during the pandemic, conventional treatments were performed.
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Affiliation(s)
- Misuzu Fujita
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, 32-14 Shin-Minato, Mihama-ku, Chiba 261-0002, Japan; Department of Public Health, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.
| | - Kazuya Yamaguchi
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, 32-14 Shin-Minato, Mihama-ku, Chiba 261-0002, Japan
| | - Kengo Nagashima
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Kiminori Suzuki
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, 32-14 Shin-Minato, Mihama-ku, Chiba 261-0002, Japan
| | - Tokuzo Kasai
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, 32-14 Shin-Minato, Mihama-ku, Chiba 261-0002, Japan
| | - Hideyuki Hashimoto
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, 32-14 Shin-Minato, Mihama-ku, Chiba 261-0002, Japan
| | - Yoshihiro Onouchi
- Department of Public Health, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
| | - Daisuke Sato
- Center for Next Generation of Community Health, Chiba University Hospital, 1-8-15 Inohana, Chuo-ku, Chiba 260-0856, Japan
| | - Takehiko Fujisawa
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, 32-14 Shin-Minato, Mihama-ku, Chiba 261-0002, Japan
| | - Akira Hata
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, 32-14 Shin-Minato, Mihama-ku, Chiba 261-0002, Japan
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Mazidimoradi A, Hadavandsiri F, Momenimovahed Z, Salehiniya H. Impact of the COVID-19 Pandemic on Colorectal Cancer Diagnosis and Treatment: a Systematic Review. J Gastrointest Cancer 2023; 54:171-187. [PMID: 34843058 PMCID: PMC8628028 DOI: 10.1007/s12029-021-00752-5] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Following the official announcement of the COVID-19 pandemic by the World Health Organization (WHO) in March 2020 and decreased activity of healthcare systems, relocation of resources, and the possible reluctance of patients to seek medical help, colorectal cancer patients were exposed to significant risks. Given that colon cancer is the third most common cancer and the second deadliest cancer in the world, its timely diagnosis and treatment are necessary to reduce costs and improve quality of life and patient survival. The aim of this study was to investigate the effects of COVID-19 pandemic on the diagnosis and treatment of colorectal cancer. METHODS AND MATERIALS A comprehensive search performed on June 2021 in various databases, including Medline, Web of Science, and Scopus. Keywords such as "diagnosis," "treatment," "coronavirus disease-19," "COVID-19," "coronavirus disease," "SARS-CoV-2 infection," "SARS-CoV-2," "2019-nCoV," "coronavirus, 2019 novel," "SARS-CoV-2 virus," severe acute respiratory syndrome coronavirus 2," "COVID-19," "COVID-19, coronavirus disease 19," "SARS coronavirus 2," "colorectal neoplasm," and "colorectal cancer " was used individually or a combination of these words. All retrieved articles were entered into a database on EndNote X7. Then, studies were first selected by title and then by abstract, and at the end, full texts were investigated. RESULTS Of the 850 studies, 43 were identified as eligible. According to studies, the diagnosis of colorectal cancer and the number of diagnostic procedures have decreased. Emergency visits due to obstruction or perforation of the large intestine or in advanced stages of cancer have increased, and a delay in the diagnosis of colorectal cancer has reported from 5.4 to 26%. Treatment of colorectal cancer has also decreased significantly or has been delayed, interrupted, or stopped. This reduction and delay have been observed in all treatments, including surgery, chemotherapy, and long-term radiation therapy; only cases of emergency surgery and short-term radiotherapy has increased. The waiting time for hospitalization and the length of hospital stay after surgery has been reported to be higher. Changes in patients' treatment plans and complete to partial cessation of hospitals activities-that provided treatment services-were reported. CONCLUSION According to the reduction in the diagnosis and treatment of colorectal cancer due to the COVID-19 pandemic, compensating for the reduction and preventing the continuation of this declining trend, requires serious and effective interventions to prevent its subsequent consequences, including referrals of people with advanced stages and emergency conditions, increasing treatment costs and reducing the quality of life and patients survival.
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Affiliation(s)
| | - Fatemeh Hadavandsiri
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Hamid Salehiniya
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran.
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10
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Cano-Valderrama O, Sánchez-Santos R, Vigorita V, Paniagua M, Flores E, Garrido L, Facal C, Ruano A, San-Ildefonso A, Moncada E. Has the COVID-19 pandemic changed the clinical picture and tumour stage at the time of presentation of patients with colorectal cancer? A retrospective cohort study. Cir Esp 2023; 101:90-96. [PMID: 35169328 PMCID: PMC8831139 DOI: 10.1016/j.ciresp.2022.02.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/06/2022] [Indexed: 02/04/2023]
Abstract
Introduction Treatment of patients with Coronavirus Disease 2019 (COVID-19) has affected the management of patients with colorectal cancer (CRC). The aim of this study was to compare the diagnosis delay, symptoms, and stage of patients with CRC during the pandemic with a control cohort. Material and methods Patients referred to the CRC multidisciplinary team between September 2019 and January 2020 (cohort 1, control group) were compared with those who presented between September 2020 and March 2021 (cohort 2, pandemic group). Results 389 patients were included, 169 in cohort 1 and 220 in cohort 2. No differences were observed in the main characteristics of the patients. CRC screening and anaemia were the most common causes leading to the diagnosis of the tumour in cohort 1 and 2, respectively (p < 0.001). Diagnostic and therapeutic delay was longer in cohort 2 [6.4 (95% CI 5.8-6.9) vs. 4.8 (95% CI 4.3-5.3) months, p < 0.001]. More patients required non-elective treatment in the pandemic cohort (15.5% vs. 9.5%, p = 0.080). The tumour stage was more advanced in patients in cohort 2 [positive nodes in 52.3% vs. 36.7% (p = 0.002), and metastatic disease in 23.6% vs. 16.6% (p = 0.087)]. Conclusion CRC patients in the pandemic cohort had a longer diagnostic and therapeutic delay and less patients were diagnosed because of CRC screening. In addition, patients with CRC during the pandemic needed non-elective treatment more frequently than patients in the control cohort, and their tumour stage tended to be more advanced.
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Affiliation(s)
- Oscar Cano-Valderrama
- Department of Surgery, Complejo Hospitalario Universitario de Vigo, Vigo, Spain
- Instituto de Investigaciones Sanitarias Galicia Sur, Vigo, Spain
| | - Raquel Sánchez-Santos
- Department of Surgery, Complejo Hospitalario Universitario de Vigo, Vigo, Spain
- Instituto de Investigaciones Sanitarias Galicia Sur, Vigo, Spain
| | - Vincenzo Vigorita
- Department of Surgery, Complejo Hospitalario Universitario de Vigo, Vigo, Spain
- Instituto de Investigaciones Sanitarias Galicia Sur, Vigo, Spain
| | - Marta Paniagua
- Department of Surgery, Complejo Hospitalario Universitario de Vigo, Vigo, Spain
- Instituto de Investigaciones Sanitarias Galicia Sur, Vigo, Spain
| | - Erene Flores
- Department of Surgery, Complejo Hospitalario Universitario de Vigo, Vigo, Spain
- Instituto de Investigaciones Sanitarias Galicia Sur, Vigo, Spain
| | - Lucia Garrido
- Department of Surgery, Complejo Hospitalario Universitario de Vigo, Vigo, Spain
- Instituto de Investigaciones Sanitarias Galicia Sur, Vigo, Spain
| | - Cristina Facal
- Department of Surgery, Complejo Hospitalario Universitario de Vigo, Vigo, Spain
- Instituto de Investigaciones Sanitarias Galicia Sur, Vigo, Spain
| | - Alejandro Ruano
- Department of Surgery, Complejo Hospitalario Universitario de Vigo, Vigo, Spain
- Instituto de Investigaciones Sanitarias Galicia Sur, Vigo, Spain
| | - Alberto San-Ildefonso
- Department of Surgery, Complejo Hospitalario Universitario de Vigo, Vigo, Spain
- Instituto de Investigaciones Sanitarias Galicia Sur, Vigo, Spain
| | - Enrique Moncada
- Department of Surgery, Complejo Hospitalario Universitario de Vigo, Vigo, Spain
- Instituto de Investigaciones Sanitarias Galicia Sur, Vigo, Spain
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Cano-Valderrama O, Sánchez-Santos R, Vigorita V, Paniagua M, Flores E, Garrido L, Facal C, Ruano A, San-Ildefonso A, Moncada E. Has the COVID-19 pandemic changed the clinical picture and tumour stage at the time of presentation of patients with colorectal cancer? A retrospective cohort study. Cir Esp 2023; 101:90-96. [PMID: 36774002 PMCID: PMC9909381 DOI: 10.1016/j.cireng.2022.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/06/2022] [Indexed: 02/11/2023]
Abstract
INTRODUCTION Treatment of patients with Coronavirus Disease 2019 (COVID-19) has affected the management of patients with colorectal cancer (CRC). The aim of this study was to compare the diagnosis delay, symptoms, and stage of patients with CRC during the pandemic with a control cohort. MATERIAL AND METHODS Patients referred to the CRC multidisciplinary team between September 2019 and January 2020 (cohort 1, control group) were compared with those who presented between September 2020 and March 2021 (cohort 2, pandemic group). RESULTS 389 patients were included, 169 in cohort 1 and 220 in cohort 2. No differences were observed in the main characteristics of the patients. CRC screening and anaemia were the most common causes leading to the diagnosis of the tumour in cohort 1 and 2, respectively (p<0.001). Diagnostic and therapeutic delay was longer in cohort 2 [6.4 (95% CI 5.8-6.9) vs. 4.8 (95% CI 4.3-5.3) months, p<0.001]. More patients required non-elective treatment in the pandemic cohort (15.5% vs. 9.5%, p=0.080). The tumour stage was more advanced in patients in cohort 2 [positive nodes in 52.3% vs. 36.7% (p=0.002), and metastatic disease in 23.6% vs. 16.6% (p=0.087)]. CONCLUSION CRC patients in the pandemic cohort had a longer diagnostic and therapeutic delay and less patients were diagnosed because of CRC screening. In addition, patients with CRC during the pandemic needed non-elective treatment more frequently than patients in the control cohort, and their tumour stage tended to be more advanced.
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Affiliation(s)
- Oscar Cano-Valderrama
- Department of Surgery, Complejo Hospitalario Universitario de Vigo, Vigo, Spain; Instituto de Investigaciones Sanitarias Galicia Sur, Vigo, Spain.
| | - Raquel Sánchez-Santos
- Department of Surgery, Complejo Hospitalario Universitario de Vigo, Vigo, Spain; Instituto de Investigaciones Sanitarias Galicia Sur, Vigo, Spain
| | - Vincenzo Vigorita
- Department of Surgery, Complejo Hospitalario Universitario de Vigo, Vigo, Spain; Instituto de Investigaciones Sanitarias Galicia Sur, Vigo, Spain
| | - Marta Paniagua
- Department of Surgery, Complejo Hospitalario Universitario de Vigo, Vigo, Spain; Instituto de Investigaciones Sanitarias Galicia Sur, Vigo, Spain
| | - Erene Flores
- Department of Surgery, Complejo Hospitalario Universitario de Vigo, Vigo, Spain; Instituto de Investigaciones Sanitarias Galicia Sur, Vigo, Spain
| | - Lucia Garrido
- Department of Surgery, Complejo Hospitalario Universitario de Vigo, Vigo, Spain; Instituto de Investigaciones Sanitarias Galicia Sur, Vigo, Spain
| | - Cristina Facal
- Department of Surgery, Complejo Hospitalario Universitario de Vigo, Vigo, Spain; Instituto de Investigaciones Sanitarias Galicia Sur, Vigo, Spain
| | - Alejandro Ruano
- Department of Surgery, Complejo Hospitalario Universitario de Vigo, Vigo, Spain; Instituto de Investigaciones Sanitarias Galicia Sur, Vigo, Spain
| | - Alberto San-Ildefonso
- Department of Surgery, Complejo Hospitalario Universitario de Vigo, Vigo, Spain; Instituto de Investigaciones Sanitarias Galicia Sur, Vigo, Spain
| | - Enrique Moncada
- Department of Surgery, Complejo Hospitalario Universitario de Vigo, Vigo, Spain; Instituto de Investigaciones Sanitarias Galicia Sur, Vigo, Spain
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Fujita M, Nagashima K, Suzuki K, Kasai T, Hashimoto H, Yamaguchi K, Onouchi Y, Sato D, Fujisawa T, Hata A. Changes in the number of cancer diagnosis practices due to the COVID-19 pandemic: interrupted time-series analysis using the National Database of Japan. J Cancer Res Clin Oncol 2023:10.1007/s00432-022-04557-2. [PMID: 36627499 PMCID: PMC9838522 DOI: 10.1007/s00432-022-04557-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/23/2022] [Indexed: 01/12/2023]
Abstract
PURPOSE This study aimed to reveal the impact of coronavirus disease 2019 on the number of practices commonly used for cancer diagnosis in Japan. METHODS The sampling dataset of the National Database of Japan from January 2015 to January 2021 was used to generate 25-point time-series data for the number of practices (21 points before and 4 points during the pandemic outbreak). The decreased number was estimated by interrupted time-series analysis using a seasonal autoregressive integrated moving average model. Using the pre-pandemic data, expected counterfactual numbers during the pandemic were predicted, and decreased rate was calculated. RESULTS In most practices, the number dramatically decreased in the early stage of the pandemic and recovered rapidly thereafter. As of April 2020, gastric endoscopy decreased at the top of the practices (- 42.1%, with 95% confidence intervals of - 50.5% and - 33.7%), followed by gastric biopsy (- 38.6%, with 95% confidence intervals of - 46.7% and - 30.6%). The period of declined practices for lung cancer was relatively prolonged. The number of sentinel lymph node biopsies for breast cancer and colposcopies and biopsies for cervical cancer did not decrease in April 2020, but significantly decreased later in July 2020, which is assumed to be the time lapse after the primary testing before surgical treatment or intense scrutiny. CONCLUSION In general, the number of practices for cancer diagnosis in Japan showed only a temporary decline, which was concordant with reports from several other countries.
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Affiliation(s)
- Misuzu Fujita
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, 32-14 Shin-Minato, Mihama-Ku, Chiba, 261-0002 Japan ,Department of Public Health, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Kengo Nagashima
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan ,Research Center for Medical and Health Data Science, The Institute of Statistical Mathematics, Tachikawa, Japan
| | - Kiminori Suzuki
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, 32-14 Shin-Minato, Mihama-Ku, Chiba, 261-0002 Japan
| | - Tokuzo Kasai
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, 32-14 Shin-Minato, Mihama-Ku, Chiba, 261-0002 Japan
| | - Hideyuki Hashimoto
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, 32-14 Shin-Minato, Mihama-Ku, Chiba, 261-0002 Japan
| | - Kazuya Yamaguchi
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, 32-14 Shin-Minato, Mihama-Ku, Chiba, 261-0002 Japan
| | - Yoshihiro Onouchi
- Department of Public Health, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Daisuke Sato
- Center for Next Generation of Community Health, Chiba University Hospital, Chiba, Japan
| | - Takehiko Fujisawa
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, 32-14 Shin-Minato, Mihama-Ku, Chiba, 261-0002 Japan
| | - Akira Hata
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, 32-14 Shin-Minato, Mihama-Ku, Chiba, 261-0002 Japan
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Akbulut S, Hargura AS, Garzali IU, Aloun A, Colak C. Clinical presentation, management, screening and surveillance for colorectal cancer during the COVID-19 pandemic. World J Clin Cases 2022; 10:9228-9240. [PMID: 36159422 PMCID: PMC9477669 DOI: 10.12998/wjcc.v10.i26.9228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 05/29/2022] [Accepted: 08/05/2022] [Indexed: 02/05/2023] Open
Abstract
Management of colorectal cancer (CRC) was severely affected by the changes implemented during the pandemic, and this resulted in delayed elective presentation, increased emergency presentation, reduced screening and delayed definitive therapy. This review was conducted to analyze the impact of the coronavirus disease 2019 (COVID-19) pandemic on management of CRC and to identify the changes made in order to adapt to the pandemic. We performed a literature search in PubMed, Medline, Index Medicus, EMBASE, SCOPUS, Reference Citation Analysis (https://www.referencecitationanalysis.com/) and Google Scholar using the following keywords in various combinations: Colorectal cancer, elective surgery, emergency surgery, stage upgrading, screening, surveillance and the COVID-19 pandemic. Only studies published in English were included. To curtail the spread of COVID-19 infection, there were modifications made in the management of CRC. Screening was limited to high risk individuals, and the screening tests of choice during the pandemic were fecal occult blood test, fecal immunochemical test and stool DNA testing. The use of capsule colonoscopy and open access colonoscopy was also encouraged. Blood-based tests like serum methylated septin 9 were also encouraged for screening of CRC during the pandemic. The presentation of CRC was also affected by the pandemic with more patients presenting with emergencies like obstruction and perforation. Stage migration was also observed during the pandemic with more patients presenting with more advanced tumors. The operative therapy of CRC was altered by the pandemic as more emergencies surgeries were done, which may require exteriorization by stoma. This was to reduce the morbidity associated with anastomosis and encourage early discharge from the hospital. There was also an initial reduction in laparoscopic surgical procedures due to the fear of aerosols and COVID-19 infection. As we gradually come out of the pandemic, we should remember the lessons learned and continue to apply them even after the pandemic passes.
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Affiliation(s)
- Sami Akbulut
- Department of Surgery, Inonu University Faculty of Medicine, Malatya 44280, Turkey
- Biostatistics and Medical Informatics, Inonu University Faculty of Medicine, Malatya 44280, Turkey
| | - Abdirahman Sakulen Hargura
- Department of Surgery, Inonu University Faculty of Medicine, Malatya 44280, Turkey
- Department of Surgery, Kenyatta University Teaching, Referral and Research Hospital, Nairobi 00100, Kenya
| | - Ibrahim Umar Garzali
- Department of Surgery, Inonu University Faculty of Medicine, Malatya 44280, Turkey
- Department of Surgery, Aminu Kano Teaching Hospital, Kano 700101, Nigeria
| | - Ali Aloun
- Department of Surgery, King Hussein Medical Center, Amman 11855, Jordan
| | - Cemil Colak
- Biostatistics and Medical Informatics, Inonu University Faculty of Medicine, Malatya 44280, Turkey
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Mazidimoradi A, Tiznobaik A, Salehiniya H. Impact of the COVID-19 Pandemic on Colorectal Cancer Screening: a Systematic Review. J Gastrointest Cancer 2022; 53:730-744. [PMID: 34406626 PMCID: PMC8371036 DOI: 10.1007/s12029-021-00679-x] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND After the World Health Organization (WHO) announcing about global pandemic of COVID-19 in March 2020 and relocation of health care resources for controlling this infection, cancer screening programs especially colorectal cancer (CRC) have been suspended in many countries. According to GLOBOCAN 2020 data, CRC is the third prevalent and second deadliest cancer in the world. So, early detection through screening is essential to reduce the mortality associated with this cancer. The present study was designed to investigate the impact of COVID-19 pandemic on colorectal cancer screening. METHODS AND MATERIALS A comprehensive search performed on June 2021 in various databases, including Medline, Web of Science, and Scopus. Keywords such as "Early Detection," "Cancer," "Cancer Screening," "Cancer Screening Tests," "Coronavirus Disease-19," "COVID 19," "Coronavirus Disease," "SARS-CoV-2 Infection," "SARS-CoV-2," "2019-nCoV," "coronavirus, 2019 Novel," "SARS COV 2 Virus," "Severe Acute Respiratory Syndrome Coronavirus 2," "COVID-19," "COVID-19, Coronavirus Disease 19," "SARS Coronavirus 2","Colorectal neoplasm" and "Colorectal Cancer" were used individually or in combination to search. All articles were entered into Endnote X7 software that remove duplicates. Then, studies were first selected by title and then by abstract and at the end full texts were investigated. RESULTS Of the 850 identified studies, 25 were identified as eligible. The results of studies show that in general, colorectal cancer screening has decreased from 28 to 100% in different countries and at different times after the onset of the COVID-19 pandemic. During this period, only 2 to 2.5% of hospitals and screening centers with 100% capacity continued to operate, and more than 77% of them limited their activities to less than 10% of their normal capacity. Also, completion of colonoscopies requiring examination showed a decrease of 65.7%, surveillance colonoscopy showed a decrease of 44.6 to 79%, prescription colonoscopy decreased 60 to 81%, and referrals to colonoscopy showed a 43% decline. However, emergency colonoscopy shows a 2 to 9% increase. The use of the Fecal immunochemical test (FIT) test is also generally declining but is increasing in areas used as a colonoscopy alternative. CONCLUSIONS Considering that the reduction in colorectal cancer screening following COVID-19 pandemic is due to the restrictions imposed for the high prevalence of COVID-19 disease and the lack of referrals due to the fear of developing COVID-19 infection; compensating for the decline and preventing the continuation of this decreasing trend requires serious and effective interventions to maintain the capacity of screening services during the COVID-19 crisis, increase the capacity of screening centers during the lifting of restrictions and reduce fear in the public.
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Affiliation(s)
| | - Azita Tiznobaik
- Department of Midwifery and Reproductive Health, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Hamid Salehiniya
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran.
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15
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Domper-Arnal MJ, Hijos-Mallada G, Lanas Á. The impact of COVID-19 pandemic in the diagnosis and management of colorectal cancer patients. Therap Adv Gastroenterol 2022; 15:17562848221117636. [PMID: 36035306 PMCID: PMC9403473 DOI: 10.1177/17562848221117636] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 07/18/2022] [Indexed: 02/04/2023] Open
Abstract
The novel coronavirus disease 2019 (COVID-19) pandemic has posed an unprecedented challenge to healthcare systems worldwide, causing downscaling of almost all other activities, especially in its early stages. Currently, the availability of vaccines along with the spread of new viral variants has modified the epidemiology of the disease, and the previous activity is being gradually resumed in most healthcare facilities. In this review, we have summarized the influence of the COVID-19 pandemic in the diagnosis and management of colorectal cancer (CRC) patients. Population-based screening with either colonoscopy or fecal occult blood tests has proven to reduce CRC incidence and mortality, so screening programs have been implemented in most western countries. However, during the first COVID-19 wave, most of these programs had to be disrupted temporarily. In this review, we have thoroughly analyzed the consequences of these disruptions of screening programs as well as of the forced delays in diagnostic and therapeutic services on CRC prognosis, although its exact impact cannot be exactly measured yet. In any way, strategies to minimize its effect, such as catch-up strategies expanding the colonoscopy capacity or using fecal occult blood concentration and other risk factors to prioritize patients, are urgently needed. The COVID-19 pandemic has also led to a change in CRC patient presentation, with an overall temporary decreased incidence due to postponed diagnoses, but with more patients presenting in need of an emergency admission or with symptoms. Finally, changes in treatment approaches in CRC patients have been reported during the pandemic, namely a drop in the proportion of laparoscopic surgeries or a rise in short-term radiotherapy courses. We have therefore aimed to summarize the available evidence to guide the healthcare professionals treating CRC patients to choose the best treatment options in the current pandemic situation.
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Affiliation(s)
| | | | - Ángel Lanas
- Service of Digestive Diseases, University
Clinic Hospital, Zaragoza, Spain,Aragón Health Research Institute (IIS Aragón),
Zaragoza, Spain,CIBERehd, Madrid, Spain,University of Zaragoza, Zaragoza, Spain
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Fancellu A, Veneroni S, Santoru A, Meloni A, Sanna V, Ginesu GC, Deiana G, Paliogiannis P, Ninniri C, Perra T, Porcu A. How the COVID-19 pandemic has affected the colorectal cancer screening in Italy: A minireview. World J Gastrointest Oncol 2022; 14:1490-1498. [PMID: 36160740 PMCID: PMC9412930 DOI: 10.4251/wjgo.v14.i8.1490] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/23/2022] [Accepted: 07/11/2022] [Indexed: 02/05/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has caused detrimental effects on many aspects of healthcare practice. Screening programs for the commonest malignancies, namely colorectal cancer (CRC), breast cancer and cervical cancer have been discontinued or interrupted since the beginning of restriction measures aimed to limit transmission of the new coronavirus infection. Robust evidence exists in favour of the role of screening campaigns in reducing mortality from CRC. In fact, the majority of pre-malignant lesions of the colon and rectum can be diagnosed with colonoscopy and treated by endoscopic or surgical resection. Besides, colonoscopy screening allows the diagnosis of CRCs in their pre-clinical stage. Italy was one of the first European countries where a high level of COVID-19 infections and deaths was observed, and one of the first where lockdowns and strict measures were adopted to reduce the risk of COVID-19 diffusion among the population. A systematic review of the literature was performed, including the PubMed, Scopus, Web of Sciences, and Reference Citation Analysis databases, with the aim of critically evaluating the impact of the COVID-19 pandemic on CRC screening in Italy. We found that reduction of CRC screening activity surpassed 50% in most endoscopic units, with almost 600000 fewer CRC screening exams conducted in the first 5 mo of 2020 vs the same period of 2019. While the consequences of the discontinuation of endoscopy screening for the prognosis and mortality of CRC will be evident in the next few years, recent data confirm that CRC is currently treated at a more advanced stage than in the pre-COVID-19 era. Since delays in CRC prevention and early diagnosis may translate to increased CRC-specific mortality, world healthcare systems should adopt strategies to maintain the regularity of CRC screening during subsequent peaks of the COVID-19 pandemic, or future events that might hamper screening programs.
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Affiliation(s)
- Alessandro Fancellu
- Department of Medical, Surgical, and Experiemental Sciences, Unit of General Surgery 2-Clinica Chirurgica, University of Sassari, Sassari 07100, Italy
| | - Simone Veneroni
- Department of Medical, Surgical, and Experiemental Sciences, Unit of General Surgery 2-Clinica Chirurgica, University of Sassari, Sassari 07100, Italy
| | - Antonio Santoru
- Department of Medical, Surgical, and Experiemental Sciences, Unit of General Surgery 2-Clinica Chirurgica, University of Sassari, Sassari 07100, Italy
| | - Arianna Meloni
- Department of Medical, Surgical, and Experiemental Sciences, Unit of General Surgery 2-Clinica Chirurgica, University of Sassari, Sassari 07100, Italy
| | | | - Giorgio C Ginesu
- Department of Medical, Surgical, and Experiemental Sciences, Unit of General Surgery 2-Clinica Chirurgica, University of Sassari, Sassari 07100, Italy
| | - Giulia Deiana
- Department of Medical, Surgical, and Experiemental Sciences, Unit of General Surgery 2-Clinica Chirurgica, University of Sassari, Sassari 07100, Italy
| | - Panagiotis Paliogiannis
- Department of Medical, Surgical, and Experimental Sciences. Unit of Pathology, University of Sassari, Sassari 07100, Italy
| | - Chiara Ninniri
- Department of Medical, Surgical, and Experiemental Sciences, Unit of General Surgery 2-Clinica Chirurgica, University of Sassari, Sassari 07100, Italy
| | - Teresa Perra
- Department of Medical, Surgical, and Experiemental Sciences, Unit of General Surgery 2-Clinica Chirurgica, University of Sassari, Sassari 07100, Italy
| | - Alberto Porcu
- Department of Medical, Surgical, and Experiemental Sciences, Unit of General Surgery 2-Clinica Chirurgica, University of Sassari, Sassari 07100, Italy
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17
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Laurent L, Brugel M, Carlier C, Clere F, Bertrand A, Botsen D, Boulagnon‐Rombi C, Dalstein V, Debreuve‐Theresette A, Deguelte S, Garbar C, Mahmoudi R, Marechal A, Morland D, Rey J, Schvartz C, Vallet C, Merrouche Y, Slimano F, Bouché O. One-year COVID-19 outcomes on the oncology care patient pathway: Results of a French descriptive, cross-sectional comprehensive study (ONCOCARE-COV). Cancer Med 2022; 11:4865-4879. [PMID: 35593199 PMCID: PMC9348299 DOI: 10.1002/cam4.4817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 05/03/2022] [Accepted: 05/04/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic led to a widely documented disruption in cancer care pathway. Since a resurgence of the pandemic was expected after the first lockdown in France, the global impact on the cancer care pathway over the year 2020 was investigated. AIMS This study aimed to describe the changes in the oncology care pathway for cancer screening, diagnosis, assessment, diagnosis annoucement procedure and treatment over a one-year period. MATERIALS & METHODS The ONCOCARE-COV study was a comprehensive, retrospective, descriptive, and cross-sectional study comparing the years 2019 and 2020. All key indicators along the cancer care pathway assessing the oncological activity over four periods were described. This study was set in a high-volume, public, single tertiary care center divided in two complementary sites (Reims University Hospital and Godinot Cancer Institute, Reims, France) which was located in a high COVID-19 incidence area during both peaks of the outbreak. RESULTS A total of 26,566 patient's files were active during the year 2020. Breast screening (-19.5%), announcement dedicated consultations (-9.2%), Intravenous and Hyperthermic Intraoperative Intraperitoneal Chemotherapy (HIPECs) (-25%), and oncogeriatric evaluations (-14.8%) were heavily disrupted in regard to 2020 activity. We identified a clear second outbreak wave impact on medical announcement procedures (October, -14.4%), radiotherapy sessions (October, -16%), number of new health record discussed in multidisciplinary tumor board meeting (November, -14.6%) and HIPECs (November, -100%). Moreover, 2020 cancer care activity stagnated compared to 2019. DISCUSSION The oncological care pathway was heavily disrupted during the first and second peaks of the COVID-19 outbreak. Between lockdowns, we observed a remarkable but non-compensatory recovery as well as a lesser impact from the pandemic resurgence. However, in absence of an increase in activity, a backlog persisted. CONCLUSION Public health efforts are needed to deal with the consequences of the COVID-19 pandemic on the oncology care pathway.
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Affiliation(s)
- Léonard Laurent
- Medical Oncology DepartmentGodinot Cancer InstituteReimsFrance
| | - Mathias Brugel
- Ambulatory Oncology Care UnitReims University HospitalReimsFrance
| | - Claire Carlier
- Medical Oncology DepartmentGodinot Cancer InstituteReimsFrance,Ambulatory Oncology Care UnitReims University HospitalReimsFrance
| | - Florentin Clere
- Care‐Associated Risks and Care Quality DepartmentUniversity HospitalReimsFrance
| | - Aurélie Bertrand
- Marne Site, Regional Coordination Center for Cancer Screening Grand‐EstReimsFrance
| | - Damien Botsen
- Medical Oncology DepartmentGodinot Cancer InstituteReimsFrance,Ambulatory Oncology Care UnitReims University HospitalReimsFrance
| | | | - Véronique Dalstein
- Pathology DepartmentReims University HospitalReimsFrance,INSERM, P3 Cell UMR‐S1250, SFR CAP‐SANTEUniversité de Reims Champagne‐ArdenneReimsFrance
| | | | | | | | - Rachid Mahmoudi
- Department of Internal Medicine and GeriatricsReims University HospitalReimsFrance,Université de Reims Champagne‐ArdenneReimsFrance
| | | | - David Morland
- Nuclear Medicine DepartmentGodinot Cancer InstituteReimsFrance,CReSTIC EA 3804Université de Reims Champagne‐ArdenneReimsFrance
| | | | - Claire Schvartz
- Medical Oncology DepartmentGodinot Cancer InstituteReimsFrance,INSERM, P3 Cell UMR‐S1250, SFR CAP‐SANTEUniversité de Reims Champagne‐ArdenneReimsFrance
| | - Catherine Vallet
- Medical Information DepartmentReims University HospitalReimsFrance
| | - Yacine Merrouche
- Medical Oncology DepartmentGodinot Cancer InstituteReimsFrance,Université de Reims Champagne‐ArdenneReimsFrance
| | - Florian Slimano
- Université de Reims Champagne‐ArdenneReimsFrance,Pharmacy DepartmentReims University HospitalReimsFrance
| | - Olivier Bouché
- Ambulatory Oncology Care UnitReims University HospitalReimsFrance,Université de Reims Champagne‐ArdenneReimsFrance
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18
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Feier CVI, Muntean C, Bardan R, Olariu A, Olariu S. The influence of the Covid-19 pandemic on the 90-day mortality rate after emergency surgery for colon cancer. J Med Life 2022; 15:640-644. [PMID: 35815093 PMCID: PMC9262266 DOI: 10.25122/jml-2022-0108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 05/02/2022] [Indexed: 11/06/2022] Open
Abstract
The Covid-19 pandemic had a significant impact on the treatment of colon cancer. This was due to the redistribution of doctors and medical resources to empower the treatment of Sars-CoV-2-infected patients. Moreover, the restrictions imposed by the authorities on the general population and hospitals were other key elements that had to be taken into consideration. The surgical activity was massively reduced for both elective and emergency surgeries during the pandemic; initially, the elective ones were postponed. This study aimed to analyze the impact of the Covid-19 pandemic on the 90-day postoperative mortality rate of patients who underwent emergency surgery for colon cancer in the First General Surgery Clinic of Pius Brinzeu County Hospital Timisoara. For conducting this study, data from patients who underwent emergency surgery for colon cancer between 26.02.2020-01.10.2021 and the same period of 2016-2017 and 2018-2019 were collected and analyzed, with a p<0.05 being considered statistically significant. As a result, the 90-days postoperative mortality rate increased to 34.5% during the pandemic. A 22.55% rate was observed during 2016-2017 and an 18.4% rate in 2018-2019. In addition, during the pandemic, correlations w ere identified between the presence of 90-day postoperative mortality and severe symptomatology when presenting to the hospital, stage of the disease, and Charlson comorbidity index. All these aspects influenced the 90-days mortality rate of patients undergoing emergency surgery to treat colon cancer during the pandemic.
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Affiliation(s)
- Catalin Vladut Ionut Feier
- Department of First General Surgery Clinic, Pius Brinzeu Clinical Emergency Hospital, Timisoara, Romania,Corresponding Author: Catalin Vladut Ionut Feier, Department of First General Surgery Clinic, Pius Brinzeu Clinical Emergency Hospital, Timisoara, Romania. E-mail:
| | - Calin Muntean
- Department of Informatics and Medical Biostatistics, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Razvan Bardan
- Department of Urology, Pius Brinzeu Clinical Emergency Hospital, Timisoara, Romania
| | - Andra Olariu
- Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Sorin Olariu
- Department of First General Surgery Clinic, Pius Brinzeu Clinical Emergency Hospital, Timisoara, Romania
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19
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Decreased numbers of gastric, colorectal, lung, and breast cancer surgeries performed in 17 cancer-designated hospitals in Gunma Prefecture of Japan during the COVID-19 pandemic. Surg Today 2022; 52:1714-1720. [PMID: 35426582 PMCID: PMC9010936 DOI: 10.1007/s00595-022-02501-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/15/2022] [Indexed: 11/16/2022]
Abstract
Purpose This study aims to clarify the influence of the COVID-19 pandemic on cancer surgery in Gunma Prefecture. Methods A total of 9839 cases (1406 gastric cancer, 3569 colorectal cancer, 1614 lung cancer, and 3250 breast cancer) from 17 hospitals in Gunma Prefecture were investigated. We compared the number of surgical cases, proportion of cases found by screening, and cStage at the time of the first visit by month in 2020 and 2021 with those in 2019. Results The rate of decline in cancer surgery was 8.9% in 2020 compared with 2019 (p = 0.0052). Compared with the same month of 2019, in some months of 2020 and 2021, significant decreases were observed in the number of surgeries for gastric and colorectal cancer, the percentage of surgical cases detected by screening in all four cancers, and the proportion of cancers with a relatively early cStage in gastric and breast cancer. Conclusions The number of surgical cases of the four cancer types detected by cancer screening decreased in Gunma Prefecture owing to the influence of the COVID-19 pandemic. Furthermore, for some cancer types, the number of operations performed in patients with early-stage cancer is also decreased.
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20
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Iijima K, Jin M, Miura M, Watanabe K, Watanabe N, Shimodaira Y, Koizumi S, Tobori F, Motoyama S. Disturbance of Gastrointestinal Cancers Diagnoses by the COVID-19 Pandemic in a Depopulated Area of Japan: A Population-Based Study in Akita Prefecture. TOHOKU J EXP MED 2022; 257:65-71. [PMID: 35387907 DOI: 10.1620/tjem.2022.j020] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Katsunori Iijima
- Department of Gastroenterology, Akita University Graduate School of Medicine
| | | | - Masahito Miura
- Department of Gastroenterology, Omagari Kosei Medical Center
| | - Kenta Watanabe
- Department of Gastroenterology, Akita University Graduate School of Medicine
| | - Noboru Watanabe
- Department of Gastroenterology, Akita University Graduate School of Medicine
| | - Yosuke Shimodaira
- Department of Gastroenterology, Akita University Graduate School of Medicine
| | - Shigeto Koizumi
- Department of Gastroenterology, Akita University Graduate School of Medicine
| | | | - Satoru Motoyama
- Department of Esophageal Surgery, Akita University Graduate School of Medicine
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21
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Fritz CDL, Sayuk GS, Elwing JE, Wilgus NC, Dieckgraefe BK, Presti ME. Colonoscopy Following COVID-19 Delays in Procedures: Risk Stratification for Procedures Is Critical. GASTRO HEP ADVANCES 2022; 1:546-548. [PMID: 35262068 PMCID: PMC8890980 DOI: 10.1016/j.gastha.2022.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 02/15/2022] [Indexed: 11/22/2022]
Affiliation(s)
- C D L Fritz
- Division of Gastroenterology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - G S Sayuk
- Division of Gastroenterology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Gastroenterology, John Cochran Veterans Affairs Medical Center, St. Louis, Missouri, USA
| | - J E Elwing
- Division of Gastroenterology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Gastroenterology, John Cochran Veterans Affairs Medical Center, St. Louis, Missouri, USA
| | - N C Wilgus
- Department of Pathology, John Cochran Veterans Affairs Medical Center, St. Louis, Missouri, USA
| | - B K Dieckgraefe
- Division of Gastroenterology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Gastroenterology, John Cochran Veterans Affairs Medical Center, St. Louis, Missouri, USA
| | - M E Presti
- Department of Gastroenterology, John Cochran Veterans Affairs Medical Center, St. Louis, Missouri, USA
- Division of Gastroenterology, Department of Medicine, St. Louis University, St. Louis, Missouri, USA
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22
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Colorectal Surgery in the COVID-19 Era: A Systematic Review and Meta-Analysis. Cancers (Basel) 2022; 14:cancers14051229. [PMID: 35267537 PMCID: PMC8909364 DOI: 10.3390/cancers14051229] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 02/22/2022] [Accepted: 02/25/2022] [Indexed: 12/10/2022] Open
Abstract
(1) Background: To determine the impact of the COVID-19 pandemic in the management of colorectal cancer patients requiring surgery and to examine whether the restructuring of healthcare systems led to cancer stage upshifting or adverse treatment outcomes; (2) Methods: A systematic literature search of the MedLine, Scopus, Web of Science, and CNKI databases was performed (PROSPERO ID: CRD42021288432). Data were summarized as odds ratios (OR) or weighted mean differences (WMDs) with 95% confidence intervals (95% CIs); (3) Results: Ten studies were examined, including 26,808 patients. The number of patients presenting with metastases during the pandemic was significantly increased (OR 1.65, 95% CI 1.02−2.67, p = 0.04), with no differences regarding the extent of the primary tumor (T) and nodal (N) status. Patients were more likely to have undergone neoadjuvant therapy (OR 1.22, 95% CI 1.09−1.37, p < 0.001), while emergency presentations (OR 1.74, 95% CI 1.07−2.84, p = 0.03) and palliative surgeries (OR 1.95, 95% CI 1.13−3.36, p = 0.02) were more frequent during the pandemic. There was no significant difference recorded in terms of postoperative morbidity; (4) Conclusions: Patients during the pandemic were more likely to undergo palliative interventions or receive neoadjuvant treatment.
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23
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Kopel J, Ristic B, Brower GL, Goyal H. Global Impact of COVID-19 on Colorectal Cancer Screening: Current Insights and Future Directions. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58010100. [PMID: 35056408 PMCID: PMC8778776 DOI: 10.3390/medicina58010100] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 12/30/2021] [Accepted: 01/04/2022] [Indexed: 12/17/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has brought significant challenges to many aspects of healthcare delivery since the first reported case in early December 2019. Once in the body, SARS-CoV-2 can spread to other digestive organs, such as the liver, because of the presence of ACE2 receptors. Colorectal cancer (CRC) remains the second-leading cause of death in the United States (US). Therefore, individuals are routinely screened using either endoscopic methods (i.e., flexible sigmoidoscopy and colonoscopy) or stool-based tests, as per the published guidelines. At the beginning of the COVID-19 pandemic, the Centers for Medicare and Medicaid Services (CMS) recommended that all non-urgent surgical and medical procedures, including screening colonoscopies, be delayed until the pandemic stabilization. This article aims to review the impact of COVID-19 on CRC screening.
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Affiliation(s)
- Jonathan Kopel
- Department of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
- Correspondence:
| | - Bojana Ristic
- Cell Biology and Biochemistry, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA;
| | - Gregory L. Brower
- Department of Medication Education, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA;
| | - Hemant Goyal
- The Wright Center for Graduate Medical Education, Scranton, PA 18501, USA;
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24
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Kempf E, Priou S, Lamé G, Daniel C, Bellamine A, Sommacale D, Belkacemi Y, Bey R, Galula G, Taright N, Tannier X, Rance B, Flicoteaux R, Hemery F, Audureau E, Chatellier G, Tournigand C. Impact of two waves of Sars-Cov2 outbreak on the number, clinical presentation, care trajectories and survival of patients newly referred for a colorectal cancer: A French multicentric cohort study from a large group of university hospitals. Int J Cancer 2022; 150:1609-1618. [PMID: 35001364 PMCID: PMC9015603 DOI: 10.1002/ijc.33928] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/08/2021] [Accepted: 12/16/2021] [Indexed: 12/17/2022]
Abstract
The SARS‐Cov2 may have impaired care trajectories, patient overall survival (OS), tumor stage at initial presentation for new colorectal cancer (CRC) cases. This study aimed at assessing those indicators before and after the beginning of the pandemic in France. In this retrospective cohort study, we collected prospectively the clinical data of the 11.4 million of patients referred to the Greater Paris University Hospitals (AP‐HP). We identified new CRC cases between 1 January 2018 and 31 December 2020, and compared indicators for 2018‐2019 to 2020. pTNM tumor stage was extracted from postoperative pathology reports for localized colon cancer, and metastatic status was extracted from CT‐scan baseline text reports. Between 2018 and 2020, 3602 and 1083 new colon and rectal cancers were referred to the AP‐HP, respectively. The 1‐year OS rates reached 94%, 93% and 76% for new CRC patients undergoing a resection of the primary tumor, in 2018‐2019, in 2020 without any Sars‐Cov2 infection and in 2020 with a Sars‐Cov2 infection, respectively (HR 3.78, 95% CI 2.1‐7.1). For patients undergoing other kind of anticancer treatment, the percentages are 64%, 66% and 27% (HR 2.1, 95% CI 1.4‐3.3). Tumor stage at initial presentation, emergency level of primary tumor resection, delays between the first multidisciplinary meeting and the first anticancer treatment did not differ over time. The SARS‐Cov2 pandemic has been associated with less newly diagnosed CRC patients and worse 1‐year OS rates attributable to the infection itself rather than to its impact on hospital care delivery or tumor stage at initial presentation.
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Affiliation(s)
- Emmanuelle Kempf
- Department of Medical Oncology, Henri Mondor and Albert Chenevier Teaching Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France.,Laboratoire d'Informatique Médicale et d'Ingénierie des Connaissances pour la e-Santé, LIMICS, Sorbonne Université, Inserm, Université Sorbonne Paris Nord, Paris, France
| | - Sonia Priou
- IT Department, Assistance Publique-Hôpitaux de Paris, Innovation and Data, Paris, France
| | - Guillaume Lamé
- Laboratoire Génie Industriel, Université Paris-Saclay, CentraleSupélec, Gif-sur-Yvette, France
| | - Christel Daniel
- Laboratoire d'Informatique Médicale et d'Ingénierie des Connaissances pour la e-Santé, LIMICS, Sorbonne Université, Inserm, Université Sorbonne Paris Nord, Paris, France.,IT Department, Assistance Publique-Hôpitaux de Paris, Innovation and Data, Paris, France
| | - Ali Bellamine
- IT Department, Assistance Publique-Hôpitaux de Paris, Innovation and Data, Paris, France
| | - Daniele Sommacale
- Department of Digestive Surgery, Henri Mondor and Albert Chenevier Teaching Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | - Yazid Belkacemi
- Department of Radiation Oncology, Henri Mondor and Albert Chenevier Teaching Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | - Romain Bey
- IT Department, Assistance Publique-Hôpitaux de Paris, Innovation and Data, Paris, France
| | - Gilles Galula
- Department of Chronic Diseases and Cancer, Assistance Publique-Hôpitaux de Paris, Head Office, Paris, France
| | - Namik Taright
- Department of Medical Information, Assistance Publique-Hôpitaux de Paris, Head Office, Paris, France
| | - Xavier Tannier
- Laboratoire d'Informatique Médicale et d'Ingénierie des Connaissances pour la e-Santé, LIMICS, Sorbonne Université, Inserm, Université Sorbonne Paris Nord, Paris, France
| | - Bastien Rance
- Department of Medical Informatics, Centre-Université de Paris (APHP-CUP), Université de Paris, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Rémi Flicoteaux
- Department of Medical Information, Assistance Publique-Hôpitaux de Paris, Head Office, Paris, France
| | - François Hemery
- Department of Medical Information, Henri Mondor and Albert Chenevier Teaching Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | - Etienne Audureau
- Clinical Research Unit, Henri Mondor and Albert Chenevier Teaching Hospital, Université Paris Est Créteil, INSERM, IMRB, CEpiA Team, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | - Gilles Chatellier
- Department of Medical Informatics, Centre-Université de Paris (APHP-CUP), Université de Paris, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Christophe Tournigand
- Department of Medical Oncology, Henri Mondor and Albert Chenevier Teaching Hospital, Université Paris Est Créteil, INSERM, IMRB, Assistance Publique-Hôpitaux de Paris, Créteil, France
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25
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van Wifferen F, de Jonge L, Worthington J, Greuter MJ, Lew JB, Nadeau C, van den Puttelaar R, Feletto E, Yong JH, Lansdorp-Vogelaar I, Canfell K, Coupé VM, Anderson L, Besó Delgado M, Binefa G, Cust A, Dekker E, Dell’Anna V, Essue B, Espinas J, Flander L, Garcia M, Hahn A, Idigoras I, Katanoda K, Laghi L, Lamrock F, McFerran E, Majek O, Molina-Barceló A, Ledger M, Musa O, Njor S, O’Connor K, Portillo I, Salas D, Senore C, Smith H, Symonds E, Tachecí I, Taksler G, Tolani M, Treby M, Zauber A, Zheng Y. Prioritisation of colonoscopy services in colorectal cancer screening programmes to minimise impact of COVID-19 pandemic on predicted cancer burden: A comparative modelling study. J Med Screen 2021; 29:72-83. [PMID: 35100894 PMCID: PMC9087314 DOI: 10.1177/09691413211056777] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Objectives Colorectal cancer (CRC) screening with a faecal immunochemical test (FIT) has
been disrupted in many countries during the COVID-19 pandemic. Performing
catch-up of missed screens while maintaining regular screening services
requires additional colonoscopy capacity that may not be available. This
study aimed to compare strategies that clear the screening backlog using
limited colonoscopy resources. Methods A range of strategies were simulated using four country-specific CRC
natural-history models: Adenoma and Serrated pathway to Colorectal CAncer
(ASCCA) and MIcrosimulation SCreening ANalysis for CRC (MISCAN-Colon) (both
in the Netherlands), Policy1-Bowel (Australia) and OncoSim (Canada).
Strategies assumed a 3-month screening disruption with varying recovery
period lengths (6, 12, and 24 months) and varying FIT thresholds for
diagnostic colonoscopy. Increasing the FIT threshold reduces the number of
referrals to diagnostic colonoscopy. Outcomes for each strategy were
colonoscopy demand and excess CRC-related deaths due to the disruption. Results Performing catch-up using the regular FIT threshold in 6, 12 and 24 months
could prevent most excess CRC-related deaths, but required 50%, 25% and
12.5% additional colonoscopy demand, respectively. Without exceeding usual
colonoscopy demand, up to 60% of excess CRC-related deaths can be prevented
by increasing the FIT threshold for 12 or 24 months. Large increases in FIT
threshold could lead to additional deaths rather than preventing them. Conclusions Clearing the screening backlog in 24 months could avert most excess
CRC-related deaths due to a 3-month disruption but would require a small
increase in colonoscopy demand. Increasing the FIT threshold slightly over
24 months could ease the pressure on colonoscopy resources.
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Affiliation(s)
- Francine van Wifferen
- Decision Modeling Center, Department of Epidemiology and Data Science, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Lucie de Jonge
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Joachim Worthington
- The Daffodil Centre, The University of Sydney, A Joint Venture With Cancer Council NSW, Sydney, Australia
| | - Marjolein J.E. Greuter
- Decision Modeling Center, Department of Epidemiology and Data Science, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Jie-Bin Lew
- The Daffodil Centre, The University of Sydney, A Joint Venture With Cancer Council NSW, Sydney, Australia
| | - Claude Nadeau
- Health Analysis Division, Statistics Canada, Ottawa, Canada
| | | | - Eleonora Feletto
- The Daffodil Centre, The University of Sydney, A Joint Venture With Cancer Council NSW, Sydney, Australia
| | | | - Iris Lansdorp-Vogelaar
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Karen Canfell
- The Daffodil Centre, The University of Sydney, A Joint Venture With Cancer Council NSW, Sydney, Australia
- Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - Veerle M.H. Coupé
- Decision Modeling Center, Department of Epidemiology and Data Science, Amsterdam University Medical Center, Amsterdam, The Netherlands
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26
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Pelland-Marcotte MC, Xie L, Barber R, Elkhalifa S, Frechette M, Kaur J, Onysko J, Bouffet E, Fernandez CV, Mitchell D, Rayar M, Randall A, Stammers D, Larouche V, Airhart A, Fidler-Benaoudia M, Cohen-Gogo S, Sung L, Gibson P. Incidence of childhood cancer in Canada during the COVID-19 pandemic. CMAJ 2021; 193:E1798-E1806. [PMID: 34844937 PMCID: PMC8654886 DOI: 10.1503/cmaj.210659] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2021] [Indexed: 12/20/2022] Open
Abstract
Background: The COVID-19 pandemic has had a major impact on access to health care resources. Our objective was to estimate the impact of the COVID-19 pandemic on the incidence of childhood cancer in Canada. We also aimed to compare the proportion of patients who enrolled in clinical trials at diagnosis, presented with metastatic disease or had an early death during the first 9 months of the COVID-19 pandemic compared with previous years. Methods: We conducted an observational study that included children younger than 15 years with a new diagnosis of cancer between March 2016 and November 2020 at 1 of 17 Canadian pediatric oncology centres. Our primary outcome was the monthly age-standardized incidence rates (ASIRs) of cancers. We evaluated level and trend changes using interventional autoregressive integrated moving average models. Secondary outcomes were the proportion of patients who were enrolled in a clinical trial, who had metastatic or advanced disease and who died within 30 days. We compared the baseline and pandemic periods using rate ratios (RRs) and 95% confidence intervals (CIs). Results: Age-standardized incidence rates during COVID-19 quarters were 157.7, 164.6, and 148.0 per million, respectively, whereas quarterly baseline ASIRs ranged between 150.3 and 175.1 per million (incidence RR 0.93 [95% CI 0.78 to 1.12] to incidence RR 1.04 [95% CI 0.87 to 1.24]). We found no statistically significant level or slope changes between the projected and observed ASIRs for all new cancers (parameter estimate [β], level 4.98, 95% CI −15.1 to 25.04, p = 0.25), or when stratified by cancer type or by geographic area. Clinical trial enrolment rate was stable or increased during the pandemic compared with baseline (RR 1.22 [95% CI 0.70 to 2.13] to RR 1.71 [95% CI 1.01 to 2.89]). There was no difference in the proportion of patients with metastatic disease (RR 0.84 [95% CI 0.55 to 1.29] to RR 1.22 [0.84 to 1.79]), or who died within 30 days (RR 0.16 [95% CI 0.01 to 3.04] to RR 1.73 [95% CI 0.38 to 15.2]). Interpretation: We did not observe a statistically significant change in the incidence of childhood cancer, or in the proportion of children enrolling in a clinical trial, presenting with metastatic disease or who died early during the first 9 months of the COVID-19 pandemic, which suggests that access to health care in pediatric oncology was not reduced substantially in Canada.
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Affiliation(s)
- Marie-Claude Pelland-Marcotte
- Division of Hematology-Oncology (Pelland-Marcotte, Larouche), CHU de Québec - Centre Mère-Enfant Soleil, Québec, Que.; Public Health Agency of Canada (Xie, Elkhalifa, Frechette, Kaur, Onysko), Ottawa, Ont.; C17 Council (Barber), Edmonton, Alta.; Division of Hematology-Oncology (Bouffet, Cohen-Gogo, Sung) and Program in Child Health Evaluative Sciences (Sung), Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ont.; Division of Pediatric Hematology/Oncology (Fernandez, Randall), IWK Health Centre, Halifax, NS; Division of Hematology/Oncology (Mitchell), Montreal Children's Hospital, Montréal, Que.; Division of Pediatric Hematology/Oncology/BMT (Rayar), BC Children's Hospital, Vancouver, BC; Jim Pattison Children's Hospital (Stammers), Saskatoon, Sask.; Pediatric Oncology Group of Ontario (Airhart), Toronto, Ont.; Department of Cancer Epidemiology and Prevention Research (Fidler-Benaoudia), Cancer Care Alberta, Alberta Health Services, Calgary, Alta.; Division of Hematology-Oncology (Gibson), McMaster Children's Hospital, Hamilton, Ont.
| | - Lin Xie
- Division of Hematology-Oncology (Pelland-Marcotte, Larouche), CHU de Québec - Centre Mère-Enfant Soleil, Québec, Que.; Public Health Agency of Canada (Xie, Elkhalifa, Frechette, Kaur, Onysko), Ottawa, Ont.; C17 Council (Barber), Edmonton, Alta.; Division of Hematology-Oncology (Bouffet, Cohen-Gogo, Sung) and Program in Child Health Evaluative Sciences (Sung), Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ont.; Division of Pediatric Hematology/Oncology (Fernandez, Randall), IWK Health Centre, Halifax, NS; Division of Hematology/Oncology (Mitchell), Montreal Children's Hospital, Montréal, Que.; Division of Pediatric Hematology/Oncology/BMT (Rayar), BC Children's Hospital, Vancouver, BC; Jim Pattison Children's Hospital (Stammers), Saskatoon, Sask.; Pediatric Oncology Group of Ontario (Airhart), Toronto, Ont.; Department of Cancer Epidemiology and Prevention Research (Fidler-Benaoudia), Cancer Care Alberta, Alberta Health Services, Calgary, Alta.; Division of Hematology-Oncology (Gibson), McMaster Children's Hospital, Hamilton, Ont
| | - Randy Barber
- Division of Hematology-Oncology (Pelland-Marcotte, Larouche), CHU de Québec - Centre Mère-Enfant Soleil, Québec, Que.; Public Health Agency of Canada (Xie, Elkhalifa, Frechette, Kaur, Onysko), Ottawa, Ont.; C17 Council (Barber), Edmonton, Alta.; Division of Hematology-Oncology (Bouffet, Cohen-Gogo, Sung) and Program in Child Health Evaluative Sciences (Sung), Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ont.; Division of Pediatric Hematology/Oncology (Fernandez, Randall), IWK Health Centre, Halifax, NS; Division of Hematology/Oncology (Mitchell), Montreal Children's Hospital, Montréal, Que.; Division of Pediatric Hematology/Oncology/BMT (Rayar), BC Children's Hospital, Vancouver, BC; Jim Pattison Children's Hospital (Stammers), Saskatoon, Sask.; Pediatric Oncology Group of Ontario (Airhart), Toronto, Ont.; Department of Cancer Epidemiology and Prevention Research (Fidler-Benaoudia), Cancer Care Alberta, Alberta Health Services, Calgary, Alta.; Division of Hematology-Oncology (Gibson), McMaster Children's Hospital, Hamilton, Ont
| | - Sulaf Elkhalifa
- Division of Hematology-Oncology (Pelland-Marcotte, Larouche), CHU de Québec - Centre Mère-Enfant Soleil, Québec, Que.; Public Health Agency of Canada (Xie, Elkhalifa, Frechette, Kaur, Onysko), Ottawa, Ont.; C17 Council (Barber), Edmonton, Alta.; Division of Hematology-Oncology (Bouffet, Cohen-Gogo, Sung) and Program in Child Health Evaluative Sciences (Sung), Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ont.; Division of Pediatric Hematology/Oncology (Fernandez, Randall), IWK Health Centre, Halifax, NS; Division of Hematology/Oncology (Mitchell), Montreal Children's Hospital, Montréal, Que.; Division of Pediatric Hematology/Oncology/BMT (Rayar), BC Children's Hospital, Vancouver, BC; Jim Pattison Children's Hospital (Stammers), Saskatoon, Sask.; Pediatric Oncology Group of Ontario (Airhart), Toronto, Ont.; Department of Cancer Epidemiology and Prevention Research (Fidler-Benaoudia), Cancer Care Alberta, Alberta Health Services, Calgary, Alta.; Division of Hematology-Oncology (Gibson), McMaster Children's Hospital, Hamilton, Ont
| | - Mylene Frechette
- Division of Hematology-Oncology (Pelland-Marcotte, Larouche), CHU de Québec - Centre Mère-Enfant Soleil, Québec, Que.; Public Health Agency of Canada (Xie, Elkhalifa, Frechette, Kaur, Onysko), Ottawa, Ont.; C17 Council (Barber), Edmonton, Alta.; Division of Hematology-Oncology (Bouffet, Cohen-Gogo, Sung) and Program in Child Health Evaluative Sciences (Sung), Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ont.; Division of Pediatric Hematology/Oncology (Fernandez, Randall), IWK Health Centre, Halifax, NS; Division of Hematology/Oncology (Mitchell), Montreal Children's Hospital, Montréal, Que.; Division of Pediatric Hematology/Oncology/BMT (Rayar), BC Children's Hospital, Vancouver, BC; Jim Pattison Children's Hospital (Stammers), Saskatoon, Sask.; Pediatric Oncology Group of Ontario (Airhart), Toronto, Ont.; Department of Cancer Epidemiology and Prevention Research (Fidler-Benaoudia), Cancer Care Alberta, Alberta Health Services, Calgary, Alta.; Division of Hematology-Oncology (Gibson), McMaster Children's Hospital, Hamilton, Ont
| | - Jaskiran Kaur
- Division of Hematology-Oncology (Pelland-Marcotte, Larouche), CHU de Québec - Centre Mère-Enfant Soleil, Québec, Que.; Public Health Agency of Canada (Xie, Elkhalifa, Frechette, Kaur, Onysko), Ottawa, Ont.; C17 Council (Barber), Edmonton, Alta.; Division of Hematology-Oncology (Bouffet, Cohen-Gogo, Sung) and Program in Child Health Evaluative Sciences (Sung), Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ont.; Division of Pediatric Hematology/Oncology (Fernandez, Randall), IWK Health Centre, Halifax, NS; Division of Hematology/Oncology (Mitchell), Montreal Children's Hospital, Montréal, Que.; Division of Pediatric Hematology/Oncology/BMT (Rayar), BC Children's Hospital, Vancouver, BC; Jim Pattison Children's Hospital (Stammers), Saskatoon, Sask.; Pediatric Oncology Group of Ontario (Airhart), Toronto, Ont.; Department of Cancer Epidemiology and Prevention Research (Fidler-Benaoudia), Cancer Care Alberta, Alberta Health Services, Calgary, Alta.; Division of Hematology-Oncology (Gibson), McMaster Children's Hospital, Hamilton, Ont
| | - Jay Onysko
- Division of Hematology-Oncology (Pelland-Marcotte, Larouche), CHU de Québec - Centre Mère-Enfant Soleil, Québec, Que.; Public Health Agency of Canada (Xie, Elkhalifa, Frechette, Kaur, Onysko), Ottawa, Ont.; C17 Council (Barber), Edmonton, Alta.; Division of Hematology-Oncology (Bouffet, Cohen-Gogo, Sung) and Program in Child Health Evaluative Sciences (Sung), Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ont.; Division of Pediatric Hematology/Oncology (Fernandez, Randall), IWK Health Centre, Halifax, NS; Division of Hematology/Oncology (Mitchell), Montreal Children's Hospital, Montréal, Que.; Division of Pediatric Hematology/Oncology/BMT (Rayar), BC Children's Hospital, Vancouver, BC; Jim Pattison Children's Hospital (Stammers), Saskatoon, Sask.; Pediatric Oncology Group of Ontario (Airhart), Toronto, Ont.; Department of Cancer Epidemiology and Prevention Research (Fidler-Benaoudia), Cancer Care Alberta, Alberta Health Services, Calgary, Alta.; Division of Hematology-Oncology (Gibson), McMaster Children's Hospital, Hamilton, Ont
| | - Eric Bouffet
- Division of Hematology-Oncology (Pelland-Marcotte, Larouche), CHU de Québec - Centre Mère-Enfant Soleil, Québec, Que.; Public Health Agency of Canada (Xie, Elkhalifa, Frechette, Kaur, Onysko), Ottawa, Ont.; C17 Council (Barber), Edmonton, Alta.; Division of Hematology-Oncology (Bouffet, Cohen-Gogo, Sung) and Program in Child Health Evaluative Sciences (Sung), Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ont.; Division of Pediatric Hematology/Oncology (Fernandez, Randall), IWK Health Centre, Halifax, NS; Division of Hematology/Oncology (Mitchell), Montreal Children's Hospital, Montréal, Que.; Division of Pediatric Hematology/Oncology/BMT (Rayar), BC Children's Hospital, Vancouver, BC; Jim Pattison Children's Hospital (Stammers), Saskatoon, Sask.; Pediatric Oncology Group of Ontario (Airhart), Toronto, Ont.; Department of Cancer Epidemiology and Prevention Research (Fidler-Benaoudia), Cancer Care Alberta, Alberta Health Services, Calgary, Alta.; Division of Hematology-Oncology (Gibson), McMaster Children's Hospital, Hamilton, Ont
| | - Conrad V Fernandez
- Division of Hematology-Oncology (Pelland-Marcotte, Larouche), CHU de Québec - Centre Mère-Enfant Soleil, Québec, Que.; Public Health Agency of Canada (Xie, Elkhalifa, Frechette, Kaur, Onysko), Ottawa, Ont.; C17 Council (Barber), Edmonton, Alta.; Division of Hematology-Oncology (Bouffet, Cohen-Gogo, Sung) and Program in Child Health Evaluative Sciences (Sung), Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ont.; Division of Pediatric Hematology/Oncology (Fernandez, Randall), IWK Health Centre, Halifax, NS; Division of Hematology/Oncology (Mitchell), Montreal Children's Hospital, Montréal, Que.; Division of Pediatric Hematology/Oncology/BMT (Rayar), BC Children's Hospital, Vancouver, BC; Jim Pattison Children's Hospital (Stammers), Saskatoon, Sask.; Pediatric Oncology Group of Ontario (Airhart), Toronto, Ont.; Department of Cancer Epidemiology and Prevention Research (Fidler-Benaoudia), Cancer Care Alberta, Alberta Health Services, Calgary, Alta.; Division of Hematology-Oncology (Gibson), McMaster Children's Hospital, Hamilton, Ont
| | - David Mitchell
- Division of Hematology-Oncology (Pelland-Marcotte, Larouche), CHU de Québec - Centre Mère-Enfant Soleil, Québec, Que.; Public Health Agency of Canada (Xie, Elkhalifa, Frechette, Kaur, Onysko), Ottawa, Ont.; C17 Council (Barber), Edmonton, Alta.; Division of Hematology-Oncology (Bouffet, Cohen-Gogo, Sung) and Program in Child Health Evaluative Sciences (Sung), Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ont.; Division of Pediatric Hematology/Oncology (Fernandez, Randall), IWK Health Centre, Halifax, NS; Division of Hematology/Oncology (Mitchell), Montreal Children's Hospital, Montréal, Que.; Division of Pediatric Hematology/Oncology/BMT (Rayar), BC Children's Hospital, Vancouver, BC; Jim Pattison Children's Hospital (Stammers), Saskatoon, Sask.; Pediatric Oncology Group of Ontario (Airhart), Toronto, Ont.; Department of Cancer Epidemiology and Prevention Research (Fidler-Benaoudia), Cancer Care Alberta, Alberta Health Services, Calgary, Alta.; Division of Hematology-Oncology (Gibson), McMaster Children's Hospital, Hamilton, Ont
| | - Meera Rayar
- Division of Hematology-Oncology (Pelland-Marcotte, Larouche), CHU de Québec - Centre Mère-Enfant Soleil, Québec, Que.; Public Health Agency of Canada (Xie, Elkhalifa, Frechette, Kaur, Onysko), Ottawa, Ont.; C17 Council (Barber), Edmonton, Alta.; Division of Hematology-Oncology (Bouffet, Cohen-Gogo, Sung) and Program in Child Health Evaluative Sciences (Sung), Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ont.; Division of Pediatric Hematology/Oncology (Fernandez, Randall), IWK Health Centre, Halifax, NS; Division of Hematology/Oncology (Mitchell), Montreal Children's Hospital, Montréal, Que.; Division of Pediatric Hematology/Oncology/BMT (Rayar), BC Children's Hospital, Vancouver, BC; Jim Pattison Children's Hospital (Stammers), Saskatoon, Sask.; Pediatric Oncology Group of Ontario (Airhart), Toronto, Ont.; Department of Cancer Epidemiology and Prevention Research (Fidler-Benaoudia), Cancer Care Alberta, Alberta Health Services, Calgary, Alta.; Division of Hematology-Oncology (Gibson), McMaster Children's Hospital, Hamilton, Ont
| | - Alicia Randall
- Division of Hematology-Oncology (Pelland-Marcotte, Larouche), CHU de Québec - Centre Mère-Enfant Soleil, Québec, Que.; Public Health Agency of Canada (Xie, Elkhalifa, Frechette, Kaur, Onysko), Ottawa, Ont.; C17 Council (Barber), Edmonton, Alta.; Division of Hematology-Oncology (Bouffet, Cohen-Gogo, Sung) and Program in Child Health Evaluative Sciences (Sung), Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ont.; Division of Pediatric Hematology/Oncology (Fernandez, Randall), IWK Health Centre, Halifax, NS; Division of Hematology/Oncology (Mitchell), Montreal Children's Hospital, Montréal, Que.; Division of Pediatric Hematology/Oncology/BMT (Rayar), BC Children's Hospital, Vancouver, BC; Jim Pattison Children's Hospital (Stammers), Saskatoon, Sask.; Pediatric Oncology Group of Ontario (Airhart), Toronto, Ont.; Department of Cancer Epidemiology and Prevention Research (Fidler-Benaoudia), Cancer Care Alberta, Alberta Health Services, Calgary, Alta.; Division of Hematology-Oncology (Gibson), McMaster Children's Hospital, Hamilton, Ont
| | - David Stammers
- Division of Hematology-Oncology (Pelland-Marcotte, Larouche), CHU de Québec - Centre Mère-Enfant Soleil, Québec, Que.; Public Health Agency of Canada (Xie, Elkhalifa, Frechette, Kaur, Onysko), Ottawa, Ont.; C17 Council (Barber), Edmonton, Alta.; Division of Hematology-Oncology (Bouffet, Cohen-Gogo, Sung) and Program in Child Health Evaluative Sciences (Sung), Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ont.; Division of Pediatric Hematology/Oncology (Fernandez, Randall), IWK Health Centre, Halifax, NS; Division of Hematology/Oncology (Mitchell), Montreal Children's Hospital, Montréal, Que.; Division of Pediatric Hematology/Oncology/BMT (Rayar), BC Children's Hospital, Vancouver, BC; Jim Pattison Children's Hospital (Stammers), Saskatoon, Sask.; Pediatric Oncology Group of Ontario (Airhart), Toronto, Ont.; Department of Cancer Epidemiology and Prevention Research (Fidler-Benaoudia), Cancer Care Alberta, Alberta Health Services, Calgary, Alta.; Division of Hematology-Oncology (Gibson), McMaster Children's Hospital, Hamilton, Ont
| | - Valérie Larouche
- Division of Hematology-Oncology (Pelland-Marcotte, Larouche), CHU de Québec - Centre Mère-Enfant Soleil, Québec, Que.; Public Health Agency of Canada (Xie, Elkhalifa, Frechette, Kaur, Onysko), Ottawa, Ont.; C17 Council (Barber), Edmonton, Alta.; Division of Hematology-Oncology (Bouffet, Cohen-Gogo, Sung) and Program in Child Health Evaluative Sciences (Sung), Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ont.; Division of Pediatric Hematology/Oncology (Fernandez, Randall), IWK Health Centre, Halifax, NS; Division of Hematology/Oncology (Mitchell), Montreal Children's Hospital, Montréal, Que.; Division of Pediatric Hematology/Oncology/BMT (Rayar), BC Children's Hospital, Vancouver, BC; Jim Pattison Children's Hospital (Stammers), Saskatoon, Sask.; Pediatric Oncology Group of Ontario (Airhart), Toronto, Ont.; Department of Cancer Epidemiology and Prevention Research (Fidler-Benaoudia), Cancer Care Alberta, Alberta Health Services, Calgary, Alta.; Division of Hematology-Oncology (Gibson), McMaster Children's Hospital, Hamilton, Ont
| | - Alexandra Airhart
- Division of Hematology-Oncology (Pelland-Marcotte, Larouche), CHU de Québec - Centre Mère-Enfant Soleil, Québec, Que.; Public Health Agency of Canada (Xie, Elkhalifa, Frechette, Kaur, Onysko), Ottawa, Ont.; C17 Council (Barber), Edmonton, Alta.; Division of Hematology-Oncology (Bouffet, Cohen-Gogo, Sung) and Program in Child Health Evaluative Sciences (Sung), Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ont.; Division of Pediatric Hematology/Oncology (Fernandez, Randall), IWK Health Centre, Halifax, NS; Division of Hematology/Oncology (Mitchell), Montreal Children's Hospital, Montréal, Que.; Division of Pediatric Hematology/Oncology/BMT (Rayar), BC Children's Hospital, Vancouver, BC; Jim Pattison Children's Hospital (Stammers), Saskatoon, Sask.; Pediatric Oncology Group of Ontario (Airhart), Toronto, Ont.; Department of Cancer Epidemiology and Prevention Research (Fidler-Benaoudia), Cancer Care Alberta, Alberta Health Services, Calgary, Alta.; Division of Hematology-Oncology (Gibson), McMaster Children's Hospital, Hamilton, Ont
| | - Miranda Fidler-Benaoudia
- Division of Hematology-Oncology (Pelland-Marcotte, Larouche), CHU de Québec - Centre Mère-Enfant Soleil, Québec, Que.; Public Health Agency of Canada (Xie, Elkhalifa, Frechette, Kaur, Onysko), Ottawa, Ont.; C17 Council (Barber), Edmonton, Alta.; Division of Hematology-Oncology (Bouffet, Cohen-Gogo, Sung) and Program in Child Health Evaluative Sciences (Sung), Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ont.; Division of Pediatric Hematology/Oncology (Fernandez, Randall), IWK Health Centre, Halifax, NS; Division of Hematology/Oncology (Mitchell), Montreal Children's Hospital, Montréal, Que.; Division of Pediatric Hematology/Oncology/BMT (Rayar), BC Children's Hospital, Vancouver, BC; Jim Pattison Children's Hospital (Stammers), Saskatoon, Sask.; Pediatric Oncology Group of Ontario (Airhart), Toronto, Ont.; Department of Cancer Epidemiology and Prevention Research (Fidler-Benaoudia), Cancer Care Alberta, Alberta Health Services, Calgary, Alta.; Division of Hematology-Oncology (Gibson), McMaster Children's Hospital, Hamilton, Ont
| | - Sarah Cohen-Gogo
- Division of Hematology-Oncology (Pelland-Marcotte, Larouche), CHU de Québec - Centre Mère-Enfant Soleil, Québec, Que.; Public Health Agency of Canada (Xie, Elkhalifa, Frechette, Kaur, Onysko), Ottawa, Ont.; C17 Council (Barber), Edmonton, Alta.; Division of Hematology-Oncology (Bouffet, Cohen-Gogo, Sung) and Program in Child Health Evaluative Sciences (Sung), Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ont.; Division of Pediatric Hematology/Oncology (Fernandez, Randall), IWK Health Centre, Halifax, NS; Division of Hematology/Oncology (Mitchell), Montreal Children's Hospital, Montréal, Que.; Division of Pediatric Hematology/Oncology/BMT (Rayar), BC Children's Hospital, Vancouver, BC; Jim Pattison Children's Hospital (Stammers), Saskatoon, Sask.; Pediatric Oncology Group of Ontario (Airhart), Toronto, Ont.; Department of Cancer Epidemiology and Prevention Research (Fidler-Benaoudia), Cancer Care Alberta, Alberta Health Services, Calgary, Alta.; Division of Hematology-Oncology (Gibson), McMaster Children's Hospital, Hamilton, Ont
| | - Lillian Sung
- Division of Hematology-Oncology (Pelland-Marcotte, Larouche), CHU de Québec - Centre Mère-Enfant Soleil, Québec, Que.; Public Health Agency of Canada (Xie, Elkhalifa, Frechette, Kaur, Onysko), Ottawa, Ont.; C17 Council (Barber), Edmonton, Alta.; Division of Hematology-Oncology (Bouffet, Cohen-Gogo, Sung) and Program in Child Health Evaluative Sciences (Sung), Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ont.; Division of Pediatric Hematology/Oncology (Fernandez, Randall), IWK Health Centre, Halifax, NS; Division of Hematology/Oncology (Mitchell), Montreal Children's Hospital, Montréal, Que.; Division of Pediatric Hematology/Oncology/BMT (Rayar), BC Children's Hospital, Vancouver, BC; Jim Pattison Children's Hospital (Stammers), Saskatoon, Sask.; Pediatric Oncology Group of Ontario (Airhart), Toronto, Ont.; Department of Cancer Epidemiology and Prevention Research (Fidler-Benaoudia), Cancer Care Alberta, Alberta Health Services, Calgary, Alta.; Division of Hematology-Oncology (Gibson), McMaster Children's Hospital, Hamilton, Ont
| | - Paul Gibson
- Division of Hematology-Oncology (Pelland-Marcotte, Larouche), CHU de Québec - Centre Mère-Enfant Soleil, Québec, Que.; Public Health Agency of Canada (Xie, Elkhalifa, Frechette, Kaur, Onysko), Ottawa, Ont.; C17 Council (Barber), Edmonton, Alta.; Division of Hematology-Oncology (Bouffet, Cohen-Gogo, Sung) and Program in Child Health Evaluative Sciences (Sung), Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ont.; Division of Pediatric Hematology/Oncology (Fernandez, Randall), IWK Health Centre, Halifax, NS; Division of Hematology/Oncology (Mitchell), Montreal Children's Hospital, Montréal, Que.; Division of Pediatric Hematology/Oncology/BMT (Rayar), BC Children's Hospital, Vancouver, BC; Jim Pattison Children's Hospital (Stammers), Saskatoon, Sask.; Pediatric Oncology Group of Ontario (Airhart), Toronto, Ont.; Department of Cancer Epidemiology and Prevention Research (Fidler-Benaoudia), Cancer Care Alberta, Alberta Health Services, Calgary, Alta.; Division of Hematology-Oncology (Gibson), McMaster Children's Hospital, Hamilton, Ont
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A Review of the Impact of the COVID-19 Pandemic on Colorectal Cancer Screening: Implications and Solutions. Pathogens 2021; 10:pathogens10111508. [PMID: 34832663 PMCID: PMC8619517 DOI: 10.3390/pathogens10111508] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/31/2021] [Accepted: 11/01/2021] [Indexed: 02/07/2023] Open
Abstract
The COVID-19 pandemic has impacted all aspects of medical care, including cancer screening and preventative measures. Colorectal cancer screening declined significantly at the onset of the pandemic as the result of an intentional effort to conserve resources, prioritize emergencies and reduce risk of transmission. There has already been an increase in diagnosis at more advanced stages and symptomatic emergencies due to suspended screenings. As endoscopy units find their way back to pre-pandemic practices, a backlog of cases remains. The missed CRC diagnoses amongst the missed screenings carry a risk of increased morbidity and mortality which will only increase as time-to-diagnosis grows. This review discusses the impact of COVID-19 on colonoscopy screening rates, trends in stages/symptoms/circumstances at diagnosis, and economic and social impact of delayed diagnosis. Triaging and use of FITs are proposed solutions to the challenge of catching up with the large number of pandemic-driven missed CRC screenings.
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Mayo M, Potugari B, Bzeih R, Scheidel C, Carrera C, Shellenberger RA. Cancer Screening During the COVID-19 Pandemic: A Systematic Review and Meta-analysis. Mayo Clin Proc Innov Qual Outcomes 2021; 5:1109-1117. [PMID: 34693211 PMCID: PMC8520861 DOI: 10.1016/j.mayocpiqo.2021.10.003] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The purpose of this study was to assess the impact of measures designed to mitigate the spread of coronavirus disease 2019 (COVID-19) on worldwide cancer screening. We systematically searched PubMed, Ovid MEDLINE, the Cochrane COVID-19 Study Register, ClinicalTrials.gov, and EMBASE without language restrictions for studies published between January 1, 2021, and February 10, 2021. Studies selected for full-text review contained data on patients screened for any type of cancer during the COVID-19 pandemic and comparison data from a time interval just prior to the pandemic. Data were obtained through dual extraction. All the included studies were assessed for quality and risk of bias. A meta-analysis was performed on 13 studies: 7 on screening mammography, 5 on colon cancer screening, and 3 on cervical cancer screening. Two of our studies reported on more than one type of cancer screening. The screening outcomes were reported as pooled incidence rate ratios using the inverse variance method and random effects models. All studies included in our meta-analysis reported the number of patients screened for cancer in defined time intervals before and during the COVID-19 pandemic. We found that the pooled incidence rate ratios were significantly lower for screening during the COVID-19 pandemic for breast cancer (0.63; 95% CI, 0.53 to 0.77; P<.001), colon cancer (0.11; 95% CI, 0.05 to 0.24; P<.001), and cervical cancer (0.10; 95% CI, 0.04 to 0.24; P<.001). These findings may add further morbidity and mortality to this public health crisis.
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Affiliation(s)
- MacKenzie Mayo
- Internal Medicine Residency Program, St. Joseph Mercy Ann Arbor Hospital, Ypsilanti, MI
| | - Bindu Potugari
- Hematology and Oncology Fellowship Program, St. Joseph Mercy Ann Arbor Hospital, Ypsilanti, MI
| | - Rami Bzeih
- Department of Internal Medicine, University of Louisville, Louisville, KY
| | - Caleb Scheidel
- Research Department, St. Joseph Mercy Ann Arbor Hospital, Ypsilanti, MI
| | - Carolyn Carrera
- Department of Hematology and Oncology, St. Joseph Mercy Ann Arbor Hospital, Ypsilanti, MI
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Sultan S, Siddique SM, Singh S, Altayar O, Caliendo AM, Davitkov P, Feuerstein JD, Kaul V, Lim JK, Mustafa RA, Falck-Ytter Y, Inadomi JM. AGA Rapid Review and Guideline for SARS-CoV2 Testing and Endoscopy Post-Vaccination: 2021 Update. Gastroenterology 2021; 161:1011-1029.e11. [PMID: 34029569 PMCID: PMC8139430 DOI: 10.1053/j.gastro.2021.05.039] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
This guideline provides updated recommendations on the role of preprocedure testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) in individuals undergoing endoscopy in the post-vaccination period and replaces the prior guideline from the American Gastroenterological Association (AGA) (released July 29, 2020). Since the start of the pandemic, our increased understanding of transmission has facilitated the implementation of practices to promote patient and health care worker (HCW) safety. Simultaneously, there has been increasing recognition of the potential harm associated with delays in patient care, as well as inefficiency of endoscopy units. With widespread vaccination of HCWs and the general population, a re-evaluation of AGA's prior recommendations was warranted. In order to update the role of preprocedure testing for SARS-CoV2, the AGA guideline panel reviewed the evidence on prevalence of asymptomatic SARS-CoV2 infections in individuals undergoing endoscopy; patient and HCW risk of infections that may be acquired immediately before, during, or after endoscopy; effectiveness of COVID-19 vaccine in reducing risk of infections and transmission; patient and HCW anxiety; patient delays in care and potential impact on cancer burden; and endoscopy volumes. The panel considered the certainty of the evidence, weighed the benefits and harms of routine preprocedure testing, and considered burden, equity, and cost using the Grading of Recommendations Assessment, Development and Evaluation framework. Based on very low certainty evidence, the panel made a conditional recommendation against routine preprocedure testing for SARS-CoV2 in patients scheduled to undergo endoscopy. The panel placed a high value on minimizing additional delays in patient care, acknowledging the reduced endoscopy volumes, downstream impact on delayed cancer diagnoses, and burden of testing on patients.
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Affiliation(s)
- Shahnaz Sultan
- Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Minneapolis Veterans Affairs Healthcare System, Minneapolis, Minnesota.
| | - Shazia M Siddique
- Division of Gastroenterology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Siddharth Singh
- Division of Gastroenterology, University of California San Diego, La Jolla, California
| | - Osama Altayar
- Division of Gastroenterology, Washington University School of Medicine, St. Louis, Missouri
| | - Angela M Caliendo
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Perica Davitkov
- Division of Gastroenterology, Northeast Ohio Veterans Affairs Healthcare System, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Joseph D Feuerstein
- Division of Gastroenterology and Center for Inflammatory Bowel Diseases, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Vivek Kaul
- Division of Gastroenterology and Hepatology at the University of Rochester Medical Center, Rochester, New York
| | - Joseph K Lim
- Yale Liver Center and Section of Digestive Diseases, Yale University School of Medicine, New Haven, Connecticut
| | - Reem A Mustafa
- Division of Nephrology and Hypertension, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas
| | - Yngve Falck-Ytter
- Division of Gastroenterology, Northeast Ohio Veterans Affairs Healthcare System, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - John M Inadomi
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah
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Alkatout I, Biebl M, Momenimovahed Z, Giovannucci E, Hadavandsiri F, Salehiniya H, Allahqoli L. Has COVID-19 Affected Cancer Screening Programs? A Systematic Review. Front Oncol 2021; 11:675038. [PMID: 34079764 PMCID: PMC8165307 DOI: 10.3389/fonc.2021.675038] [Citation(s) in RCA: 91] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 04/14/2021] [Indexed: 12/11/2022] Open
Abstract
Background Health care services across the world have been enormously affected by the onset of the coronavirus disease 2019 (COVID-19). Services in oncology have been curtailed because medical services have been focused on preventing the spread of the virus and maximizing the number of available hospital beds. The present study was designed to investigate the impact of COVID-19 on cancer screening. Methods Databases such as Medline, Web of Science Core Collection (Indexes = SCI-EXPANDED, SSCI, A & HCI Timespan) and Scopus were searched comprehensively for articles published until January 2021. The keywords used were COVID-19 and cancer screening, Articles dealing with cancer screening in the COVID-19 pandemic were included in the review. Results The review comprised 17 publications. The impact of COVID-19 was categorized into four dimensions: a significant decline in cancer screening and pathology samples, the cancer diagnosis rate, an increase in advanced cancers, mortality rate and years of life lost (YLLs). Conclusion Cancer screening programs have been clearly interrupted since the onset of the COVID-19 disease. The anticipated outcomes include delayed diagnosis and marked increases in the numbers of avoidable cancer deaths. Urgent policy interventions are needed to handle the backlog of routine diagnostic services and minimize the harmful effects of the COVID-19 pandemic on cancer patients.
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Affiliation(s)
- Ibrahim Alkatout
- Kiel School of Gynaecological Endoscopy, University Hospitals Schleswig-Holstein, Kiel, Germany
| | - Matthias Biebl
- Department of Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Zohre Momenimovahed
- Department of Midwifery and Reproductive Health, Faculty of Nursing and Midwifery, Qom University of Medical Sciences, Qom, Iran
| | - Edward Giovannucci
- Departments of Nutrition and Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Fatemeh Hadavandsiri
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Salehiniya
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Leila Allahqoli
- School of Public Health, Iran University of Medical Sciences (IUMS), Tehran, Iran
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