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Miyamori D, Kamitani T, Yoshida S, Kikuchi Y, Shigenobu Y, Ikeda K, Yamamoto Y, Ito M. Effects of the Coronavirus disease 2019 pandemic on mortality in patients with lung cancer: A multiple mediation analysis in Japan. Int J Cancer 2024; 155:1422-1431. [PMID: 38794791 DOI: 10.1002/ijc.35042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 04/20/2024] [Accepted: 05/06/2024] [Indexed: 05/26/2024]
Abstract
COVID-19 pandemic has had a substantial effect on healthcare systems worldwide, including the care of patients with lung cancer. The impact of healthcare disruptions and behavioral changes on lung cancer mortality is unclear. Patients newly diagnosed with lung cancer during the pandemic period 2020-2021 were compared with those diagnosed in the pre-pandemic 2018-2019. The primary outcome was all-cause mortality within 1 year. Cox proportional hazards regression analyses were conducted to estimate the changes in mortality between pandemic and pre-pandemic. Multiple mediation analyses were performed to determine the factors that accounted for the changes in mortality. In total, 5785 patients with lung cancer were included in this study. The overall mortality rate was significantly higher during the pandemic compared with the pre-pandemic (crude hazard ratio [HR]: 1.19, 95% confidence interval [CI]: 1.05, 1.29). Mediation analyses showed that not receiving tumor-directed treatment, diagnosis at an older age, and decreased diagnosis through cancer screening significantly accounted for 17.5% (95%CI: 4.2, 30.7), 13.9% (95%CI: 0.8, 27.0), and 12.4% (95%CI: 3.0, 21.8) of the increased mortality, respectively. This study revealed a significant increase in mortality risk in patients with lung cancer who have not received tumor-directed treatment or cancer screening, despite potential selection bias for follow-up status. Efforts should be focused on ensuring timely access to healthcare services, optimizing treatment delivery, and addressing the unique challenges faced by patients with lung cancer during the pandemic to mitigate the impact of the pandemic on lung cancer outcomes and provide clinical care to vulnerable populations.
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Affiliation(s)
- Daisuke Miyamori
- Department of General Internal Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Tsukasa Kamitani
- Section of Education for Clinical Research, Kyoto University Hospital, Kyoto, Japan
| | - Shuhei Yoshida
- Department of General Internal Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Yuka Kikuchi
- Department of General Internal Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Yuya Shigenobu
- Department of General Internal Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Kotaro Ikeda
- Department of General Internal Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Yosuke Yamamoto
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masanori Ito
- Department of General Internal Medicine, Hiroshima University Hospital, Hiroshima, Japan
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Soliman SH, Atef MM. Knowledge attitude practice among oncologists and health care workers during COVID19 pandemic. J Egypt Natl Canc Inst 2024; 36:26. [PMID: 39245655 DOI: 10.1186/s43046-024-00231-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 07/27/2024] [Indexed: 09/10/2024] Open
Abstract
INTRODUCTION Healthcare providers should be well prepared to fight the COVID-19 pandemic and protect their patients and themselves as frontline workers. The aim of this study was to assess oncologists' and health care workers (HCWs) knowledge, attitude, and practice in response to the COVID-19 pandemic and its impact on them. MATERIAL AND METHODS This cross-sectional study was conducted among Egyptian oncologists and HCWs in the oncology department at Suez Canal University Hospitals, Egypt. Participants were reached through a Google Form questionnaire. The questionnaire was shared on social media (Facebook, Twitter, and WhatsApp) over four months, from June 1st to September 30, 2022. All physicians and HCWs in the oncology department were invited to participate in the survey. Researchers intended to enroll all physicians and HCWs within the study period. RESULTS Out of the 110 participants included in the study, there was a female predominance, and the majority were oncology nurses and clinical oncologists. Knowledge with significant participants' characteristics showed that knowledge significantly varied by age. The level of knowledge was significantly higher among participants between 30 and 40 years old (OR = 5.111; 95% CI, 1.202-21.738; P = 0.027). 65.5% of the participants had poor knowledge, with a mean ± SD of 4.9 ± 1.4. About 43.6% of the participants experienced more burnout than before the COVID-19 pandemic, with a negative emotional impact. 63.7% reported a negative financial impact due to the pandemic. 62.7% had support from their family, even though their job increases their risk of infection. 7.3% only reported a positive impact regarding their friend's relationship. CONCLUSION COVID-19 pandemic has a negative impact on oncologists' personal and professional lives. Interventions should be implemented to lessen the negative impact and better prepare oncologists to handle future crises with greater efficiency and resilience.
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Affiliation(s)
- Sharehan Hassan Soliman
- Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
| | - Mahinour Mohamed Atef
- Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
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Purdie C, Clark GRC, Cameron DA, Petty R, Mariappan P, Graham J, Burton KA, Morrison DS. Emergency and non-emergency routes to cancer diagnoses in 2020 and 2021: A Population-based study of 154,863 patients. J Cancer Policy 2024; 42:100502. [PMID: 39243812 DOI: 10.1016/j.jcpo.2024.100502] [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: 07/19/2024] [Accepted: 08/31/2024] [Indexed: 09/09/2024]
Abstract
INTRODUCTION The COVID-19 pandemic disrupted normal pathways to cancer diagnosis, particularly for screening and non-acute symptomatic patients. While reductions in overall cancer diagnoses have been reported elsewhere, any differential effects on emergency presentations, which are associated with poorer outcomes, have not been described. MATERIAL AND METHODS Cross-sectional descriptive study from 2015 to 2021, based on International Cancer Benchmarking Partnership methods, where emergency route to diagnosis is defined as presenting as an emergency admission in the 30 days prior to cancer incidence date. Acute hospital records and cancer registrations were individually linked. Includes all individuals with a new diagnosis of specific cancers on the national cancer registry. RESULTS All cancers included showed reductions in non-emergency diagnoses in 2020, with varying recovery in 2021. The largest reductions in non-emergency diagnoses of about a third were for colorectal and cervical cancers in 2020. Non-emergency diagnoses of prostate cancer remained lower but upper GI higher in 2021. Emergency routes to diagnosis were significantly higher in 2020 for breast, cervical, colorectal and upper GI cancers and were higher in 2021 for breast and cervical cancers. The absolute magnitude of reductions in non-emergency diagnoses was greater than any increases in emergency diagnoses. CONCLUSIONS In 2020, there were large reductions in numbers of cancers diagnosed through non-emergency pathways in Scotland, while those diagnosed via emergency routes fell only for prostate cancer. Some effects persisted or emerged through 2021. It is likely that opportunities to diagnose cancers in a favourable, elective manner have been lost. Further work is needed to describe outcomes among these patients.
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Affiliation(s)
- Calum Purdie
- Public Health Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh EH12 9EB, United Kingdom.
| | - Gavin R C Clark
- Public Health Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh EH12 9EB, United Kingdom
| | - David A Cameron
- Institute of Genetics and Cancer, The University of Edinburgh, Western General Hospital Campus, Crew Road, Edinburgh, Scotland EH4 2XU, United Kingdom
| | - Russell Petty
- Ninewells Hospital and Medical School, Dundee, Scotland DD1 9SY, United Kingdom
| | - Paramananthan Mariappan
- Edinburgh Bladder Cancer Surgery (EBCS), Department of Urology, Western General Hospital, Edinburgh, Scotland EH4 2XU, United Kingdom
| | - Janet Graham
- Beatson West of Scotland Cancer Centre, 1053 Great Western Road, Glasgow, Scotland G12 0YN, United Kingdom
| | - Kevin A Burton
- Department of Gynaecological Oncology, Glasgow Royal Infirmary, PRMH Building, 16 Alexandra Parade, Glasgow, Scotland G31 2ER, United Kingdom
| | - David S Morrison
- School of Health & Wellbeing, University of Glasgow, Clarice Pears Building, 90 Byres Road, Glasgow, Scotland G12 8TB, United Kingdom
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Ferrari D, Violante T, Day CN, McKenna NP, Mathis KL, Dozois EJ, Larson DW. Unveiling the Hidden Consequences: Initial Impact of COVID-19 on Colorectal Cancer Operation. J Am Coll Surg 2024; 239:85-97. [PMID: 38525960 DOI: 10.1097/xcs.0000000000001042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
BACKGROUND The COVID-19 pandemic has severely affected healthcare systems globally, resulting in significant delays and challenges in various medical treatments, particularly in cancer care. This study aims to investigate the repercussions of the pandemic on surgical interventions for colorectal cancer (CRC) in the US, using data from the National Cancer Database. STUDY DESIGN We conducted a retrospective analysis of the National Cancer Database, encompassing adult patients who underwent surgical procedures for colon and rectal cancer in 2019 (pre-COVID) and 2020 (COVID). We examined various demographic and clinical variables, including patient characteristics, tumor staging, surgical approaches, and socioeconomic factors. RESULTS The analysis included 105,517 patients, revealing a 17.3% reduction in surgical cases during the initial year of the pandemic. Patients who underwent surgery in 2020 displayed more advanced clinical and pathological tumor stages compared to those treated in 2019. After diagnosis, no delay was reported in the treatment. Patients operated during the pandemic, Black patients, uninsured, and Medicaid beneficiaries had worse stage colon and rectal cancer, and individuals with lower incomes bore the burden of advanced colon cancer. CONCLUSIONS The impact of the COVID-19 pandemic on CRC surgery transcends a mere decline in case numbers, resulting in a higher prevalence of patients with advanced disease. This study underscores the exacerbated disparities in cancer care, particularly affecting vulnerable populations. The COVID-19 pandemic has left a significant and enduring imprint on CRC surgery, intensifying the challenges faced by patients and healthcare systems. Comprehensive studies are imperative to comprehend the long-term consequences of delayed screenings, diagnoses, and treatments as healthcare planning for the future must consider the unintended repercussions of pandemic-related disruptions.
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Affiliation(s)
- Davide Ferrari
- From the Divisions of Colon and Rectal Surgery (Ferrari, Violante, McKenna, Mathis, Dozois, Larson), Mayo Clinic, Rochester, MN
- General Surgery Residency Program, University of Milan, Milan, Italy (Ferrari)
| | - Tommaso Violante
- From the Divisions of Colon and Rectal Surgery (Ferrari, Violante, McKenna, Mathis, Dozois, Larson), Mayo Clinic, Rochester, MN
- School of General Surgery, Alma Mater Studiorum Università di Bologna, Bologna, Italy (Violante)
| | | | - Nicholas P McKenna
- From the Divisions of Colon and Rectal Surgery (Ferrari, Violante, McKenna, Mathis, Dozois, Larson), Mayo Clinic, Rochester, MN
| | - Kellie L Mathis
- From the Divisions of Colon and Rectal Surgery (Ferrari, Violante, McKenna, Mathis, Dozois, Larson), Mayo Clinic, Rochester, MN
| | - Eric J Dozois
- From the Divisions of Colon and Rectal Surgery (Ferrari, Violante, McKenna, Mathis, Dozois, Larson), Mayo Clinic, Rochester, MN
| | - David W Larson
- From the Divisions of Colon and Rectal Surgery (Ferrari, Violante, McKenna, Mathis, Dozois, Larson), Mayo Clinic, Rochester, MN
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da Silva AG, Silva TPRD, Vasconcelos NMD, Santos FMD, Oliveira GDC, Malta DC. Time trend analysis and impacts of the COVID-19 pandemic on mammography and Papanicolaou test coverage in Brazilian state capitals. BMC Womens Health 2024; 24:436. [PMID: 39085895 PMCID: PMC11290149 DOI: 10.1186/s12905-024-03278-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Accepted: 07/23/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Breast and cervical cancer are major public health issues globally. The reduction in incidence and mortality rates of these cancers is linked to effective prevention, early detection, and appropriate treatment measures. This study aims to analyze the temporal trends in the prevalence of mammography and Papanicolaou test coverage among women living in Brazilian state capitals between 2007 and 2023, and to compare the coverage of these tests before and during the Covid-19 pandemic. METHODS A time series study was conducted using data from the Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey from 2007 to 2023. The variables analyzed included mammography and Papanicolaou test coverage according to education level, age group, race/skin color, regions, and Brazilian capitals. The Prais-Winsten regression model was used to analyze the time series, and Student's t-test was employed to compare the prevalence rates between 2019 and 2023. RESULTS Between 2007 and 2023, mammography coverage showed a stationary trend (71.1% in 2007 and 73.1% in 2023; p-value = 0.75) with a declining trend observed among women with 12 years or more of education (APC= -0.52% 95%CI -1.01%; -0.02%). Papanicolaou test coverage for all women aged between 25 and 64 exhibited a downward trend from 82% in 2007 to 76.8% in 2023 (APC= -0.45% 95%CI -0.76%; -0.13%). This decline was also noticed among those with 9 years or more of education; in the 25 to 44 age group; among women with white and mixed race; and in the Northeast, Central-West, Southeast, and South regions. When comparing coverage before and during Covid-19 pandemic, a reduction was noted for both tests. CONCLUSIONS Over the years, there has been stability in mammography coverage and a decline in Papanicolaou test. The COVID-19 pandemic negatively impacted the number of these tests carried out among women, highlighting the importance of actions aimed at increasing coverage, especially among the most vulnerable groups.
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Affiliation(s)
- Alanna Gomes da Silva
- School of Nursing, Graduate Program in Nursing, Department of Maternal-Child and Public Health Nursing, Federal University of Minas Gerais (UFMG), Avenida Professor Alfredo Balena, 190, Santa Efigênia, Belo Horizonte, 30130-100, Minas Gerais, Brazil.
| | - Thales Philipe Rodrigues da Silva
- Women's Health Nursing Department, Paulista School of Nursing, Federal University of São Paulo (Unifesp), Rua Napoleão de Barros,754, Vila Clementino, São Paulo, 04023-062, Brazil
| | - Nádia Machado de Vasconcelos
- Graduate Program in Public Health at the Medical School, Federal University of Minas Gerais (UFMG), 190, Santa Efigênia, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Filipe Malta Dos Santos
- Faculty of Medical Sciences of Minas Gerais (CMMG), Alameda Ezequiel Dias, 275, Centro, Belo Horizonte, 30130-110, Minas Gerais, Brazil
| | - Greice de Campos Oliveira
- Sofia Feldman Hospital, Rua Antônio Bandeira 1060, Tupi, Belo Horizonte, 31844-130, Minas Gerais, Brazil
| | - Deborah Carvalho Malta
- School of Nursing, Graduate Program in Nursing, Department of Maternal-Child and Public Health Nursing, Federal University of Minas Gerais (UFMG), Avenida Professor Alfredo Balena, 190, Santa Efigênia, Belo Horizonte, 30130-100, Minas Gerais, Brazil
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Ghassemi-Rad MJ, Dennehy C, Lyons N, Henry MT, Kennedy MP, O'Reilly ÉJ, Connolly RM. The impact of the COVID-19 pandemic on the performance of the Rapid Access Lung Cancer Clinic. Ir J Med Sci 2024:10.1007/s11845-024-03749-8. [PMID: 39037475 DOI: 10.1007/s11845-024-03749-8] [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: 01/21/2024] [Accepted: 06/30/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND The Rapid Access Lung Cancer Clinic (RALC) experienced fewer referrals during the COVID-19 pandemic in Ireland. AIMS Our aim was to determine the impact of the pandemic on the key performance indicators (KPIs) of the Cork University Hospital (CUH) RALC, using a retrospective chart review of the referrals and attendances. METHODS The medical charts of patients referred to CUH-RALC from 03/2019 to 02/2020 (period I), and from 03/2020 to 02/2021 (period II) were reviewed. Performance of the RALC was determined based on average wait time from referral to 1] acquisition of the first CT scan, 2] consultation, and 3] receiving a cancer diagnosis, and compared between periods I and II. RESULTS Average monthly referrals (57.3 vs 42.1, p = 0.0078) and RALC reviews (24.3 vs 22, p = 0.0310) were lower in period II compared to period I. However, no difference was seen in the length of time from referral to review at RALC or time to receive cancer diagnosis. There were shorter wait times from referral to CT scan (11.2 vs. 8.7 days, p = 0.0011) and to surgery (109.0 vs 79.3 days, p = 0.0236) in period II. CONCLUSIONS The COVID-19 pandemic had minimal impact on the performance of RALC at our institution. Fewer referrals to RALC in period II may relate to hesitancy in attending general practitioner (GP) and/or GPs raising the thresholds for referrals to RALC during the early lockdown period of the pandemic. A national evaluation will be required to fully determine the impact of this pandemic on lung cancer in Ireland.
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Affiliation(s)
- Mohammad J Ghassemi-Rad
- School of Medicine, College of Medicine and Health, University College Cork, Cork, Republic of Ireland
| | - Colum Dennehy
- Medical Oncology, Cork University Hospital, Wilton, Republic of Ireland
| | - Noreen Lyons
- Rapid Access Lung Cancer Clinic, Department of Respiratory Medicine, Cork University Hospital, Wilton, Republic of Ireland
| | - Michael T Henry
- Rapid Access Lung Cancer Clinic, Department of Respiratory Medicine, Cork University Hospital, Wilton, Republic of Ireland
| | - Marcus P Kennedy
- Rapid Access Lung Cancer Clinic, Department of Respiratory Medicine, Cork University Hospital, Wilton, Republic of Ireland
| | - Éilis J O'Reilly
- School of Public Health, College of Medicine and Health, University College Cork, Cork, Republic of Ireland
| | - Roisin M Connolly
- School of Medicine, College of Medicine and Health, University College Cork, Cork, Republic of Ireland.
- Cancer Research @ UCC, College of Medicine and Health, University College Cork, Western Gateway Building, 4.110, Western Road, Cork, Republic of Ireland.
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Chen KY, Stanford O, Wenzel JA, Joyner RL, Dobs AS. Patient perspectives on cancer care during COVID-19: A qualitative study. PLoS One 2024; 19:e0306035. [PMID: 38990967 PMCID: PMC11238955 DOI: 10.1371/journal.pone.0306035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 06/10/2024] [Indexed: 07/13/2024] Open
Abstract
PURPOSE The COVID-19 pandemic posed unique challenges to cancer-related care as health systems balanced competing risks of timely delivery of care and minimizing exposure to infection in a high-risk, immunocompromised patient population. This study aimed to better understand how pandemic-related factors affected the patient experience of cancer care during this time. METHODS We conducted fifteen semi-structured interviews with adults from rural counties in Maryland who were diagnosed with and/or actively treated for cancer at the TidalHealth healthcare network between January 2020 and October 2022. RESULTS Interviews from fifteen participants were analyzed. Two major themes emerged including COVID Impact on Care, and COVID Impact on Mental Health. Subthemes under COVID Impact on Care include Staffing Shortages, Hospital Regulations, Visitation, Importance of Advocacy, and Telehealth Utilization, and subthemes under COVID Impact on Mental Health include Loneliness, Support Networks, and Perceptions of COVID and Personal Protection. Overall, participants described positive care experiences despite notable delays, disruptions to continuity of care, difficult transitions to telemedicine, visitation policies that limited patient support, increased mental health struggles related to social distancing measures, and greater desire for patient advocacy. CONCLUSION Our findings reveal significant impacts of the COVID-19 pandemic on experiences of cancer treatment and survivorship in a more vulnerable, rural patient population with lower healthcare access and income level. Our findings suggest areas for targeted interventions to limit disruptions to quality care in future public health emergencies.
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Affiliation(s)
- Krista Y. Chen
- School of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Olivia Stanford
- School of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Office of Community Outreach and Engagement, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Jennifer A. Wenzel
- School of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- School of Nursing, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Robert L. Joyner
- Richard A. Henson Research Institute, TidalHealth Peninsula Regional, Salisbury, Maryland, United States of America
| | - Adrian S. Dobs
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
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Lee ML, Megwalu UC, Finegersh A, Noel JE, Chen MM. Impact of the COVID-19 Pandemic on Thyroid Cancer Surgery. Curr Oncol 2024; 31:3579-3590. [PMID: 38920746 PMCID: PMC11202414 DOI: 10.3390/curroncol31060263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 06/07/2024] [Accepted: 06/17/2024] [Indexed: 06/27/2024] Open
Abstract
The COVID-19 pandemic caused major disruptions to healthcare services in 2020, delaying cancer diagnosis and treatment. While early-stage thyroid cancer often progresses slowly, it is crucial to determine whether treatment delays associated with the pandemic have impacted the clinical presentation and management of advanced-stage thyroid cancer. The purpose of our study was to determine the impact of the early COVID-19 pandemic on thyroid cancer presentation and treatment times. Utilizing the National Cancer Database, chi-squared tests and regression analyses were performed to compare patient demographic and clinical characteristics over time for 56,011 patients diagnosed with primary thyroid cancer who were treated at the Commission on Cancer-accredited sites in 2019 and 2020. We found that thyroid cancer diagnoses decreased between 2019 and 2020, with the biggest drop among patients with cT1 disease relative to other T stages. We also found that patients diagnosed with thyroid cancer in 2020 had similar treatment times to patients diagnosed in 2019, as measured by both the time between diagnosis and start of treatment and the time between surgery and start of radioactive iodine therapy. Overall, our study suggests that resources during the pandemic were allocated to patients with advanced thyroid disease, despite a decrease in diagnoses.
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Affiliation(s)
- Max L. Lee
- Stanford University School of Medicine, Stanford, CA 94305, USA;
| | - Uchechukwu C. Megwalu
- Department of Otolaryngology--Head & Neck Surgery, Stanford University, Palo Alto, CA 94304, USA; (U.C.M.); (A.F.); (J.E.N.)
| | - Andrey Finegersh
- Department of Otolaryngology--Head & Neck Surgery, Stanford University, Palo Alto, CA 94304, USA; (U.C.M.); (A.F.); (J.E.N.)
| | - Julia E. Noel
- Department of Otolaryngology--Head & Neck Surgery, Stanford University, Palo Alto, CA 94304, USA; (U.C.M.); (A.F.); (J.E.N.)
- Santa Clara Valley Medical Center, San Jose, CA 95128, USA
| | - Michelle M. Chen
- Department of Otolaryngology--Head & Neck Surgery, Stanford University, Palo Alto, CA 94304, USA; (U.C.M.); (A.F.); (J.E.N.)
- ValleyCare Pleasanton Cancer Center, Pleasanton, CA 94588, USA
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Ihnát P, Martínek L, Tulinský L, Kala Z, Grolich T, Gurlich R, Šturma J, Klos D, Špička P, Neoral Č, Černý V. Resilience in Rectal Cancer Treatment: Lessons from the COVID-19 Era in Czech Republic. Ther Clin Risk Manag 2024; 20:373-379. [PMID: 38912517 PMCID: PMC11192038 DOI: 10.2147/tcrm.s455332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 05/28/2024] [Indexed: 06/25/2024] Open
Abstract
Introduction The management of patients with COVID-19 infection has placed great pressure on the healthcare systems around the world. The aim of this study was to investigate the impact of the COVID-19 pandemic on the treatment outcomes of patients with rectal cancer by comparing them to those of patients with the same diagnosis in the pre-pandemic period. Methods Retrospective data analysis of patients undergoing multimodal treatment for rectal cancer at the four university hospitals during the COVID-19 pandemic (2020-2021) and the 2-year pre-pandemic period (2018-2019). Results A total of 693 patients (319 in the pre-pandemic period and 374 in the pandemic period) with rectal cancer were included in the study. The demographic and clinical characteristics of patients in both study periods were comparable, as was the spectrum of surgical procedures. Palliative surgery was more common in the pandemic period (18% vs 13%, p=0.084). The proportion of patients undergoing minimally invasive surgery was higher during the COVID-19 pandemic (p=0.025). There were no statistically significant differences between the study periods in the incidence/severity of post-operative complications, 30-day mortality and length of hospital stay. The number of positive resection margins was similar (5% vs 5%). Based on these results, COVID-19 had no effect on the postoperative morbidity and mortality in patients undergoing surgery for rectal cancer. Neoadjuvant treatment was more common in the pre-pandemic period (50% vs 45%). Long-course RT was predominantly offered in the pre-pandemic period, short-course RT during the pandemic. Significantly shorter "diagnosis-surgery" intervals were observed during the pandemic (23 days vs 33 days, p=0.0002). The "surgery-adjuvant therapy" interval was similar in both analysed study periods (p=0.219). Conclusion Our study showed, that despite concerns about the COVID-19 pandemic, multimodal treatment of rectal cancer was associated with unchanged postoperative morbidity rates, increased frequency of short-course neoadjuvant RT administration and shorter "diagnosis-surgery" intervals.
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Affiliation(s)
- Peter Ihnát
- Department of Surgery, University Hospital Ostrava, Ostrava, Czech Republic
- Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Lubomír Martínek
- Department of Surgery, University Hospital Ostrava, Ostrava, Czech Republic
- Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Lubomír Tulinský
- Department of Surgery, University Hospital Ostrava, Ostrava, Czech Republic
- Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Zdeněk Kala
- Department of Surgery, University Hospital Brno, Brno, Czech Republic
| | - Tomáš Grolich
- Department of Surgery, University Hospital Brno, Brno, Czech Republic
| | - Robert Gurlich
- Department of Surgery, University Hospital Královské Vinohrady, Praha, Czech Republic
| | - Jan Šturma
- Department of Surgery, University Hospital Královské Vinohrady, Praha, Czech Republic
| | - Dušan Klos
- 1st Department of Surgery, University Hospital Olomouc, Olomouc, Czech Republic
| | - Petr Špička
- 1st Department of Surgery, University Hospital Olomouc, Olomouc, Czech Republic
| | - Čestmír Neoral
- Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
- 1st Department of Surgery, University Hospital Olomouc, Olomouc, Czech Republic
| | - Vladimir Černý
- Department of Anaesthesia and Intensive Care Medicine, Charles University in Prague, 3rd Faculty of Medicine, Prague, Czech Republic
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Takakubo T, Odagiri Y, Machida M, Takamiya T, Fukushima N, Kikuchi H, Hayashi T, Amagasa S, Inoue S. Association between the Decrease in Medical Visit Frequency and Chronic Disease Worsening in the Early Stages of COVID-19 - A Longitudinal Study. Intern Med 2024; 63:1689-1696. [PMID: 38569913 PMCID: PMC11239260 DOI: 10.2169/internalmedicine.2697-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 02/12/2024] [Indexed: 04/05/2024] Open
Abstract
Objective This longitudinal study aimed to clarify the changes in the medical treatment behavior of Japanese patients with chronic diseases during the early phase of the coronavirus disease 2019 (COVID-19) pandemic and examine the factors associated with disease worsening. Methods Subjects with chronic diseases were selected from a panel survey that started at the beginning of the COVID-19 pandemic consists of 2,400 participants recruited via the Internet. Medical treatment behaviors (decrease in medical visit frequency, inability to take regular medications, and utilization of telephone/online medical care), psychological distress, and sociodemographic factors were evaluated at baseline (May 2020) and at the follow-up survey (February 2021). A worsening of chronic diseases was defined as those who answered "yes" to the question, "Has-the-condition-of-the-chronic-disease-worsened?". The factors related to the worsening of chronic diseases at follow-up were examined. Results A total of 514 participants (mean age 61.6±12.9 years) were analyzed. The percentage of participants who reported decreasing medical visit frequency was 34% at the baseline and 16.5% at follow-up, and those who reported a worsening of chronic diseases was 5.1% and 5.1%, respectively. A worsening of chronic diseases at follow-up was significantly associated with a younger age, a decreased frequency of medical visits, unemployment, a history of smoking, and psychological distress. Conclusions A decreased frequency of medical visits was observed among one-third of the participants with chronic disease in the early stage of the pandemic, and it reduced by half at follow-up. In the early stages of an emerging infectious disease pandemic, decreased regular hospital/clinic visits can lead to a worsening of chronic diseases. Those who had psychological distress, unemployment, and a history of smoking were vulnerable to a worsening chronic disease.
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Affiliation(s)
- Takeshi Takakubo
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Japan
| | - Yuko Odagiri
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Japan
| | - Masaki Machida
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Japan
- Department of Infection Prevention and Control, Tokyo Medical University Hospital, Japan
| | - Tomoko Takamiya
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Japan
| | - Noritoshi Fukushima
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Japan
| | - Hiroyuki Kikuchi
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Japan
| | - Toshio Hayashi
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Japan
| | - Shiho Amagasa
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Japan
- Teikyo University Graduate School of Public Health, Japan
| | - Shigeru Inoue
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Japan
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11
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Maddocks W, Stringer J. Retrospective evaluation of the Complementary Health and Wellbeing (CHW) service delivered at the Christie NHS trust UK. Complement Ther Clin Pract 2024; 57:101869. [PMID: 38852531 DOI: 10.1016/j.ctcp.2024.101869] [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: 01/21/2024] [Revised: 06/03/2024] [Accepted: 06/06/2024] [Indexed: 06/11/2024]
Abstract
INTRODUCTION The Complementary Health and Wellbeing service has been offering integrative therapies to cancer patients at The Christie Hospital NHS Trust since 1997 and has not undergone an external service evaluation in that time. It is considered a pioneering service. METHOD An external academic was invited to undertake a service evaluation based on information and experiences since the implementation of services changes as the result of the COVID 19 pandemic. Service users and therapists were interviewed along with review of quality control data and documentation. RESULTS Eighteen staff and eight patients were interviewed showing a high functioning and valuable service, offering a range of services to meet the needs of both inoutpatient and outpatient services. All staff are qualified and passionate, with a significant number of research outputs. However, the service is at capacity, and must rethink some delivery to ensure long term sustainability. Services offered include acupuncture, aromatherapy, massage, talking therapies and motivational behavioural changes. There is a high degree of patient satisfaction as the therapies help them manage their life affecting side effects, however accessing or being aware of the service before treatment commenced was a concern for patients. DISCUSSION The Complementary Health and Wellbeing Service is well resourced, with all staff paid employees of the NHS trust funded via a charitable part of the trust. There is a self-funding education unit to provide staff training with participants coming from around the world. The therapists are expert practitioners who have undergone specialist training to work in this unique environment, however capacity to meet the needs of the service is limited, and there are gaps in the way patient evaluations are collected, which needs to be addressed for long term viability and future benchmarking. The changes to service to adapt to COVID-19 have become embedded within the service.
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Affiliation(s)
| | - Jacqui Stringer
- The Christie NHS Trust, Manchester, UK; Division of Cancer Sciences, University of Manchester.
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12
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Wichmann B, Moreira Wichmann R. Using machine learning to estimate health spillover effects. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2024; 25:717-730. [PMID: 37543994 DOI: 10.1007/s10198-023-01621-7] [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: 11/11/2022] [Accepted: 07/17/2023] [Indexed: 08/08/2023]
Abstract
We develop a nonparametric model to study health spillover effects of policy interventions. We use double/debiased machine learning to estimate the model using data from 74 hospitals in Rio de Janeiro, Brazil, and examine cross-patient spillover effects during the COVID-19 pandemic. The pandemic forced hospitals to develop new protocols to offer intensive care to both COVID and non-COVID patients. Our results show that the need to care for COVID patients affects health outcomes of non-COVID patients. Controlling for a number of confounders, we find that mortality rates and length of stay of non-COVID ICU patients increase when hospitals simultaneously offer intensive care to both types of patients. Policy simulations suggest that an increase in the number of ICU beds can counter morbidity spillover, but it is unlikely to be a feasible approach to counter mortality spillover.
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Affiliation(s)
- Bruno Wichmann
- Department of Resource Economics and Environmental Sociology, College of Natural and Applied Sciences, University of Alberta, 503 General Services Building, Edmonton, T6G-2H1, AB, Canada.
| | - Roberta Moreira Wichmann
- World Bank, SCES Trecho 03, Lote 05, Ed. Polo 8, S/N, Brasília, DF, CEP 70200-003, Brazil
- Brazilian Institute of Education, Development and Research IDP, Economics Graduate Program, SGAS Quadra 607 - Modulo 49 - Via L2 Sul, Brasília, DF, CEP 70.200-670, Brazil
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13
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Sebastian M, Eberhardt WEE, von der Heyde E, Dörfel S, Wiegand J, Schiefer C, Losem C, Jänicke M, Fleitz A, Zacharias S, Kaiser-Osterhues A, Hipper A, Dietel C, Bleckmann A, Benkelmann R, Boesche M, Grah C, Müller A, Griesinger F, Thomas M. Patient-reported outcomes in advanced NSCLC before and during the COVID-19 pandemic: Real-world data from the German prospective CRISP Registry (AIO-TRK-0315). Int J Cancer 2024; 154:1967-1978. [PMID: 38329180 DOI: 10.1002/ijc.34868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 12/19/2023] [Accepted: 12/20/2023] [Indexed: 02/09/2024]
Abstract
Patients with lung cancer under treatment have been associated with a high risk of COVID-19 infection and potentially worse outcome, but real-world data on patient-reported outcomes (PROs) are rare. We assess patients' characteristics and PROs before and during the COVID-19 pandemic in an advanced non-small cell lung cancer (NSCLC) cohort in Germany. Patients with locally advanced or metastatic NSCLC from the prospective, multicentre, observational CRISP Registry (NCT02622581) were categorised as pre-pandemic (March 2019 to Feb 2020, n = 1621) and pandemic (March 2020 to Feb 2021, n = 1317). From baseline to month 15, patients' health-related quality of life (HRQoL) was assessed by FACT-L, anxiety and depression by PHQ-4. Association of pandemic status with time to deterioration (TTD) in QoL scales adjusted for potential covariates was estimated using Cox modelling. PROs were documented for 1166 patients (72%) in the pre-pandemic, 979 (74%) in the pandemic group. Almost 60% of patients were male, median age was 66 years, comorbidities occurred in 85%. Regarding HRQoL, mean-change-from-baseline plots hardly differed between both samples. Approximately 15%-21% of patients reported anxiety, about 19%-27% signs of depression. For the pandemic group, TTD was slightly, but statistically significantly, worse for the physical well-being-FACT-G subscale (HR 1.15 [95%CI 1.02-1.30]) and the anxiety-GAD-2 subscale (HR 1.14 [95%CI 1.01-1.29]). These prospectively collected real-world data provide valuable insights into PROs before and during the COVID-19 pandemic in advanced NSCLC. For the patients, the pandemic seemed to be less of a burden than the disease itself, as there was a considerable proportion of patients with anxiety and depression in both groups.
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Grants
- The CRISP project is supported by grants from Amgen Ltd, AstraZeneca GmbH, Boehringer Ingelheim Pharma GmbH & Co. KG, Bristol-Myers Squibb GmbH & Co. KGaA, Celgene GmbH, Janssen-Cilag GmbH, Lilly Deutschland GmbH, MSD Sharp & Dohme GmbH, Novartis Pharma GmbH, Pfizer Pharma GmbH, Roche Pharma AG, and Takeda Pharma Vertriebs GmbH & Co. KG. None of the funders had any role in study design, data collection and analysis, interpretation of results, decision to publish, or preparation of the manuscript
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Affiliation(s)
- Martin Sebastian
- Department of Medicine II, Hematology/Oncology, University Hospital Frankfurt, Frankfurt, Germany
- German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt, Germany
- Frankfurt Cancer Institute, Goethe University Frankfurt, Frankfurt, Germany
| | - Wilfried E E Eberhardt
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Essen, Germany
- Division of Thoracic Oncology, West German Cancer Center, University Medicine Essen-Ruhrlandklinik, Essen, Germany
| | | | | | - Jörg Wiegand
- Gemeinschaftspraxis für Hämatologie & Onkologie, Moers, Germany
| | | | | | - Martina Jänicke
- Clinical Epidemiology and Health Economics, iOMEDICO, Freiburg i. Br, Germany
| | - Annette Fleitz
- Clinical Epidemiology and Health Economics, iOMEDICO, Freiburg i. Br, Germany
| | | | | | | | | | - Annalen Bleckmann
- Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster, Münster, Germany
| | - Robin Benkelmann
- Innere Medizin/Hämatoonkologie/Gastroenterologie/Palliativmedizin, I. Med. Klinik, Konstanz, Germany
| | - Michael Boesche
- Pneumologie, Klinik für Innere Medizin B, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Christian Grah
- Pneumologie-Lungenkrebszentrum, Gemeinschaftskrankenhaus Havelhöhe, Berlin, Germany
| | - Annette Müller
- Marienhof Koblenz, Katholisches Klinikum Koblenz Montabaur, Koblenz, Germany
| | - Frank Griesinger
- Department of Hematology and Oncology, University Department Internal Medicine-Oncology, Pius-Hospital, University Medicine Oldenburg, Oldenburg, Germany
| | - Michael Thomas
- Department of Thoracic Oncology, Thoraxklinik, University Hospital Heidelberg and Translational, Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Heidelberg, Germany
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14
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Dobson CM, Deane J, Osborne B, Araújo‐Soares V, Rees CJ, Angell L, Sharp L. 'I Do It All Alone': The Burdens and Benefits of Being Diagnosed With, and Treated for, Colorectal Cancer During the Covid-19 Pandemic. Health Expect 2024; 27:e14110. [PMID: 38872460 PMCID: PMC11176574 DOI: 10.1111/hex.14110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/26/2024] [Accepted: 05/24/2024] [Indexed: 06/15/2024] Open
Abstract
INTRODUCTION The Covid-19 pandemic dramatically altered the way cancer care services were accessed and delivered, including for colorectal cancer (CRC). In the United Kingdom, patients were discouraged from presenting in primary care, many consultations took place remotely, investigative procedures and screening programmes were temporarily suspended, and fewer operations and treatments were delivered. People had to face the practical consequences of having cancer during a pandemic and navigate never before seen pathways, often alone. We examined the experience of being diagnosed and treated for CRC during the pandemic, and the implications of this on people's cancer journeys. METHODS Semi-structured interviews were undertaken with people diagnosed with CRC during the Covid-19 pandemic (January 2020-May 2021), in the North East of England. An iterative topic guide was used during interviews, which took place remotely (telephone or Zoom), were audio recorded, pseudo-anonymised and transcribed. Initial transcripts were independently coded by two researchers, and a code 'bank' developed for application across transcripts. Development of themes and overarching analytical constructs was undertaken collaboratively by the research team. RESULTS Interviews were conducted with 19 participants, analysed and four key themes identified: (1) The relative threats of Covid-19 and Cancer were not comparable, with cancer seen as posing a far greater risk than Covid-19; (2) Remote consultations were problematic, affecting patients' abilities to build rapport and trust with clinicians, assess nonverbal communication, and feel able to disclose, comprehend and retain information; (3) Stoma follow-up care was seen to be lacking, with long wait times for stoma reversal experienced by some; Finally, (4) Being alone during consultations negatively impacted some peoples' abilities to absorb information, and left them without the support of loved ones at an emotionally vulnerable time. However, some participants preferred being alone at certain points in their pathways, including receiving a diagnosis, and most frequently when receiving in-patient treatment. CONCLUSION Being alone brought unexpected benefits, absolving people from undertaking emotions work for others, and instead focus on their recovery, however, remote consultations negatively impacted patients' experiences. This study highlights the complex benefits and burdens of pandemic-located cancer journeys, including how these shifted at different points across cancer pathways. PATIENT OR PUBLIC CONTRIBUTION Lorraine Angell, a cancer survivor, has been central to this study from idea conception, contributing to: development of study focus and design; securing funding; production of patient-facing materials; development of interview topic guides; analysis and interpretation of data; and drafting of key findings and manuscripts.
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Affiliation(s)
- Christina M. Dobson
- Population Health Sciences InstituteNewcastle UniversityNewcastle‐upon‐TyneUK
| | - Jennifer Deane
- Population Health Sciences InstituteNewcastle UniversityNewcastle‐upon‐TyneUK
| | - Beth Osborne
- Population Health Sciences InstituteNewcastle UniversityNewcastle‐upon‐TyneUK
| | - Vera Araújo‐Soares
- Center for Preventive Medicine and Digital Health (CPD), Medical Faculty MannheimHeidelberg UniversityMannheimGermany
| | - Colin J. Rees
- Population Health Sciences InstituteNewcastle UniversityNewcastle‐upon‐TyneUK
| | | | - Linda Sharp
- Population Health Sciences InstituteNewcastle UniversityNewcastle‐upon‐TyneUK
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15
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Mazzola S, Vittorietti M, Fruscione S, De Bella DD, Savatteri A, Belluzzo M, Ginevra D, Gioia A, Costanza D, Castellone MD, Costantino C, Zarcone M, Ravazzolo B, Graziano G, Mannino R, Amodio R, Di Marco V, Vitale F, Mazzucco W. Factors Associated with Primary Liver Cancer Survival in a Southern Italian Setting in a Changing Epidemiological Scenario. Cancers (Basel) 2024; 16:2046. [PMID: 38893166 PMCID: PMC11171362 DOI: 10.3390/cancers16112046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 05/01/2024] [Accepted: 05/01/2024] [Indexed: 06/21/2024] Open
Abstract
A retrospective observational study utilising cancer incidence data from a population-based registry investigated determinants affecting primary liver cancer survival in a southern Italian region with high hepatitis viral infection rates and obesity prevalence. Among 2687 patients diagnosed between 2006 and 2019 (65.3% male), a flexible hazard-based regression model revealed factors influencing 5-year survival rates. High deprivation levels [HR = 1.41 (95%CI = 1.15-1.76); p < 0.001], poor access to care [HR = 1.99 (95%IC = 1.70-2.35); p < 0.0001], age between 65 and 75 [HR = 1.48 (95%IC = 1.09-2.01); p < 0.05] or >75 [HR = 2.21 (95%CI = 1.62-3.01); p < 0.0001] and residing in non-urban areas [HR = 1.35 (95%CI = 1.08-1.69); p < 0.01] were associated with poorer survival estimates. While deprivation appeared to be a risk factor for primary liver cancer patients residing within the urban area, the geographic distance from specialised treatment centres emerged as a potential determinant of lower survival estimates for residents in the non-urban areas. After balancing the groups of easy and poor access to care using a propensity score approach, poor access to care and a lower socioeconomic status resulted in potentially having a negative impact on primary liver cancer survival, particularly among urban residents. We emphasise the need to interoperate cancer registries with other data sources and to deploy innovative digital solutions to improve cancer prevention.
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Affiliation(s)
- Sergio Mazzola
- Clinical Epidemiology and Cancer Registry Unit, Azienda Ospedaliera Universitaria Policlinico di Palermo, 90127 Palermo, Italy; (S.M.); (C.C.); (M.Z.); (B.R.); (G.G.); (R.M.); (R.A.); (F.V.); (W.M.)
| | | | - Santo Fruscione
- PROMISE Department, University of Palermo, 90127 Palermo, Italy; (D.D.D.B.); (A.S.); (M.B.); (D.G.); (A.G.); (D.C.); (V.D.M.)
| | - Daniele Domenico De Bella
- PROMISE Department, University of Palermo, 90127 Palermo, Italy; (D.D.D.B.); (A.S.); (M.B.); (D.G.); (A.G.); (D.C.); (V.D.M.)
| | - Alessandra Savatteri
- PROMISE Department, University of Palermo, 90127 Palermo, Italy; (D.D.D.B.); (A.S.); (M.B.); (D.G.); (A.G.); (D.C.); (V.D.M.)
| | - Miriam Belluzzo
- PROMISE Department, University of Palermo, 90127 Palermo, Italy; (D.D.D.B.); (A.S.); (M.B.); (D.G.); (A.G.); (D.C.); (V.D.M.)
| | - Daniela Ginevra
- PROMISE Department, University of Palermo, 90127 Palermo, Italy; (D.D.D.B.); (A.S.); (M.B.); (D.G.); (A.G.); (D.C.); (V.D.M.)
| | - Alice Gioia
- PROMISE Department, University of Palermo, 90127 Palermo, Italy; (D.D.D.B.); (A.S.); (M.B.); (D.G.); (A.G.); (D.C.); (V.D.M.)
| | - Davide Costanza
- PROMISE Department, University of Palermo, 90127 Palermo, Italy; (D.D.D.B.); (A.S.); (M.B.); (D.G.); (A.G.); (D.C.); (V.D.M.)
| | | | - Claudio Costantino
- Clinical Epidemiology and Cancer Registry Unit, Azienda Ospedaliera Universitaria Policlinico di Palermo, 90127 Palermo, Italy; (S.M.); (C.C.); (M.Z.); (B.R.); (G.G.); (R.M.); (R.A.); (F.V.); (W.M.)
- PROMISE Department, University of Palermo, 90127 Palermo, Italy; (D.D.D.B.); (A.S.); (M.B.); (D.G.); (A.G.); (D.C.); (V.D.M.)
| | - Maurizio Zarcone
- Clinical Epidemiology and Cancer Registry Unit, Azienda Ospedaliera Universitaria Policlinico di Palermo, 90127 Palermo, Italy; (S.M.); (C.C.); (M.Z.); (B.R.); (G.G.); (R.M.); (R.A.); (F.V.); (W.M.)
| | - Barbara Ravazzolo
- Clinical Epidemiology and Cancer Registry Unit, Azienda Ospedaliera Universitaria Policlinico di Palermo, 90127 Palermo, Italy; (S.M.); (C.C.); (M.Z.); (B.R.); (G.G.); (R.M.); (R.A.); (F.V.); (W.M.)
| | - Giorgio Graziano
- Clinical Epidemiology and Cancer Registry Unit, Azienda Ospedaliera Universitaria Policlinico di Palermo, 90127 Palermo, Italy; (S.M.); (C.C.); (M.Z.); (B.R.); (G.G.); (R.M.); (R.A.); (F.V.); (W.M.)
| | - Rita Mannino
- Clinical Epidemiology and Cancer Registry Unit, Azienda Ospedaliera Universitaria Policlinico di Palermo, 90127 Palermo, Italy; (S.M.); (C.C.); (M.Z.); (B.R.); (G.G.); (R.M.); (R.A.); (F.V.); (W.M.)
| | - Rosalba Amodio
- Clinical Epidemiology and Cancer Registry Unit, Azienda Ospedaliera Universitaria Policlinico di Palermo, 90127 Palermo, Italy; (S.M.); (C.C.); (M.Z.); (B.R.); (G.G.); (R.M.); (R.A.); (F.V.); (W.M.)
| | - Vito Di Marco
- PROMISE Department, University of Palermo, 90127 Palermo, Italy; (D.D.D.B.); (A.S.); (M.B.); (D.G.); (A.G.); (D.C.); (V.D.M.)
| | - Francesco Vitale
- Clinical Epidemiology and Cancer Registry Unit, Azienda Ospedaliera Universitaria Policlinico di Palermo, 90127 Palermo, Italy; (S.M.); (C.C.); (M.Z.); (B.R.); (G.G.); (R.M.); (R.A.); (F.V.); (W.M.)
- PROMISE Department, University of Palermo, 90127 Palermo, Italy; (D.D.D.B.); (A.S.); (M.B.); (D.G.); (A.G.); (D.C.); (V.D.M.)
| | - Walter Mazzucco
- Clinical Epidemiology and Cancer Registry Unit, Azienda Ospedaliera Universitaria Policlinico di Palermo, 90127 Palermo, Italy; (S.M.); (C.C.); (M.Z.); (B.R.); (G.G.); (R.M.); (R.A.); (F.V.); (W.M.)
- PROMISE Department, University of Palermo, 90127 Palermo, Italy; (D.D.D.B.); (A.S.); (M.B.); (D.G.); (A.G.); (D.C.); (V.D.M.)
- College of Medicine, University of Cincinnati, Cincinnati, OH 45221, USA
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16
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Powis M, Sutradhar R, Singh S, Alibhai S, Hack S, Baiad A, Chen K, Li H, Mohmand Z, Krzyzanowska MK. The Impact of the Pandemic on the Quality of Colorectal and Anal Cancer Care, and 2-Year Clinical Outcomes. Curr Oncol 2024; 31:2328-2340. [PMID: 38668076 PMCID: PMC11048770 DOI: 10.3390/curroncol31040173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 04/11/2024] [Accepted: 04/17/2024] [Indexed: 04/28/2024] Open
Abstract
We undertook a retrospective study to compare the quality of care delivered to a cohort of newly diagnosed adults with colon, rectal or anal cancer during the early phase of COVID-19 (02/20-12/20) relative to the same period in the year prior (the comparator cohort), and examine the impact of the pandemic on 2-year disease progression and all-cause mortality. We observed poorer performance on a number of quality measures, such as approximately three times as many patients in the COVID-19 cohort experienced 30-day post-surgical readmission (10.5% vs. 3.6%; SD:0.27). Despite these differences, we observed no statistically significant adjusted associations between COVID-19 and time to either all-cause mortality (HR: 0.88, 95% CI: 0.61-1.27, p = 0.50) or disease progression (HR: 1.16, 95% CI: 0.82-1.64, p = 0.41). However, there was a substantial reduction in new patient consults during the early phase of COVID-19 (12.2% decrease), which appeared to disproportionally impact patients who traditionally experience sociodemographic disparities in access to care, given that the COVID-19 cohort skewed younger and there were fewer patients from neighborhoods with the highest Housing and Dwelling, ands Age and Labour Force marginalization quintiles. Future work is needed to understand the more downstream effects of COVID-19 related changes on cancer care to inform planning for future disruptions in care.
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Affiliation(s)
- Melanie Powis
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5S 1A1, Canada; (R.S.); (S.S.); (M.K.K.)
- Cancer Quality Laboratory (CQuaL), Princess Margaret Cancer Centre, Toronto, ON M5G 1X6, Canada
| | - Rinku Sutradhar
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5S 1A1, Canada; (R.S.); (S.S.); (M.K.K.)
- Institute for Clinical Evaluative Sciences (ICES), Toronto, ON M4N 3M5, Canada
| | - Simron Singh
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5S 1A1, Canada; (R.S.); (S.S.); (M.K.K.)
- Division of Medical Oncology and Hematology, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada
- Department of Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada; (K.C.); (Z.M.)
| | - Shabbir Alibhai
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5S 1A1, Canada; (R.S.); (S.S.); (M.K.K.)
- Department of Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada; (K.C.); (Z.M.)
- Department of Medicine, University Health Network, Toronto, ON M5G 2C4, Canada
| | - Saidah Hack
- Cancer Quality Laboratory (CQuaL), Princess Margaret Cancer Centre, Toronto, ON M5G 1X6, Canada
| | - Abed Baiad
- Department of Medicine, McGill University, Montreal, QC H3A 0G4, Canada;
| | - Kevin Chen
- Department of Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada; (K.C.); (Z.M.)
| | - Huaqi Li
- Department of Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada; (K.C.); (Z.M.)
| | - Zuhal Mohmand
- Department of Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada; (K.C.); (Z.M.)
| | - Monika K. Krzyzanowska
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5S 1A1, Canada; (R.S.); (S.S.); (M.K.K.)
- Cancer Quality Laboratory (CQuaL), Princess Margaret Cancer Centre, Toronto, ON M5G 1X6, Canada
- Institute for Clinical Evaluative Sciences (ICES), Toronto, ON M4N 3M5, Canada
- Department of Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada; (K.C.); (Z.M.)
- Department of Medicine, University Health Network, Toronto, ON M5G 2C4, Canada
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Cioffi G, Waite KA, Price M, Neff C, Kruchko C, Ostrom QT, Barnholtz-Sloan JS. The impact of COVID-19 on 2020 monthly incidence trends of primary brain and other CNS tumors. Neuro Oncol 2024; 26:764-774. [PMID: 38167948 PMCID: PMC10995517 DOI: 10.1093/neuonc/noad235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND To mitigate disease spread, restrictions implemented in the United States surrounding the COVID-19 pandemic created an environment that led to delays in cancer diagnosis. The data needed to accurately analyze the impact of the pandemic on brain and CNS tumor incidence has not been available until now. Utilizing incidence data from the Central Brain Tumor Registry of the United States (CBTRUS) we analyzed the impact of the COVID-19 pandemic on primary brain and other CNS tumor incidence for the first year of the pandemic. METHODS Monthly age-adjusted incidence rates and incidence trends for 2019 and 2020 were determined for age at diagnosis, sex, race, ethnicity, diagnostic confirmation, behavior, tumor histopathology, and county-level urbanization. Monthly incidence rate ratios comparing 2020 and 2019 were evaluated for the same factors. RESULTS Overall, there was a notable decrease in incidence rates in March-May 2020 when compared to 2019. These decreases were driven by nonmalignant tumors, with a 50% incidence decrease between March 2020 and 2019. Individuals who were Black had a larger incidence decrease in early 2020 than individuals who were White. Radiographically confirmed tumors saw larger incidence decreases than histologically confirmed tumors. There were no changes in monthly incidence of glioblastoma in 2020 compared to 2019. CONCLUSIONS These data provide evidence that disruptions in medical care, such as governmental and health care mandates, in response to the COVID-19 pandemic resulted in an overall decreased incidence of primary brain tumors in early 2020.
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Affiliation(s)
- Gino Cioffi
- Trans Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
| | - Kristin A Waite
- Trans Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
| | - Mackenzie Price
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
- Department of Neurosurgery, Duke University School of Medicine, Durham, North Carolina, USA
| | - Corey Neff
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
- Department of Neurosurgery, Duke University School of Medicine, Durham, North Carolina, USA
| | - Carol Kruchko
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
| | - Quinn T Ostrom
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
- Department of Neurosurgery, Duke University School of Medicine, Durham, North Carolina, USA
- The Preston Robert Tisch Brain Tumor Center, Duke University School of Medicine, Durham, North Carolina, USA
| | - Jill S Barnholtz-Sloan
- Trans Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
- Center for Biomedical Informatics and Information Technology, National Cancer Institute, Bethesda, Maryland, USA
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18
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Powell AC, Long JW, Bhatnagar AK, Loy BA, Mirhadi AJ. Use of Radiation Therapy for the Treatment of Breast Cancer in 2019 Versus 2020. Adv Radiat Oncol 2024; 9:101435. [PMID: 38778830 PMCID: PMC11110029 DOI: 10.1016/j.adro.2023.101435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 12/18/2023] [Indexed: 05/25/2024] Open
Abstract
Purpose The COVID-19 pandemic disrupted medical care. Little is known about how radiation therapy (RT) ordering behavior changed during the pandemic. This study examined (1) whether there was a change in the rate at which orders for lumpectomy were followed by orders for RT and (2) whether there was a change in the percentage of RT orders for hypofractionated (HF) RT rather than conventionally fractionated (CF) RT. Methods and Materials Prior authorization order data from 2019 and 2020, pertaining to patients with commercial and Medicare Advantage health plans, were reviewed to determine whether patients had an order for RT in the 90 days after lumpectomy and if it was for CF or HF RT. Univariate analyses were conducted using χ2 tests, and adjusted analyses were conducted using multivariate logistic regression, controlling for patient age, urbanicity, local median income, region, if the lumpectomy facility was academic, and if the lumpectomy facility was a hospital. Results In 2019, 47.7% of included lumpectomy orders (2200/4610) were followed by an RT order within 90 days, in contrast to 45.6% (1944/4263) in 2020 (P = .048). Of the RT orders meeting this study's definition of CF or HF, 75.3% of orders placed in 2019 (1387/1843) and 79.0% of orders placed in 2020 (1261/1597) were for HF (P = .011). Adjusted analysis found patients receiving a lumpectomy order in the first quarter of 2020 had significantly reduced odds (odds ratio, 0.84; 95% CI, 0.71-0.99) of receiving an order for RT after lumpectomy, relative to those with orders placed in the first quarter of 2019. Adjusted analysis likewise found significant evidence of increased use of HF RT during the pandemic. Conclusions In the population examined, physicians were less likely to order RT after lumpectomy in 2020 than in 2019, and if they did, were more likely to order HF RT.
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Affiliation(s)
- Adam C. Powell
- HealthHelp, Houston, Texas
- Payer+Provider Syndicate, Newton, Massachusetts
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19
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Smith M, Korenblum C, Mosher PJ, Gupta AA, Avery J. The Future of Adolescent and Young Adult Supportive Care: Looking Beyond the COVID-19 Pandemic. J Adolesc Young Adult Oncol 2024; 13:239-241. [PMID: 37930835 DOI: 10.1089/jayao.2023.0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023] Open
Affiliation(s)
- Marlie Smith
- Adolescent and Young Adult Program, Department of Supportive Care, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Chana Korenblum
- Adolescent and Young Adult Program, Department of Supportive Care, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
- Division of Adolescent Medicine, Department of Pediatrics, SickKids Hospital, Toronto, Canada
| | - Pamela J Mosher
- Adolescent and Young Adult Program, Department of Supportive Care, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
| | - Abha A Gupta
- Adolescent and Young Adult Program, Department of Supportive Care, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Center, University of Toronto, Toronto, Canada
| | - Jonathan Avery
- Adolescent and Young Adult Program, Department of Supportive Care, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
- School of Nursing, University of British Columbia, Vancouver, Canada
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20
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Cafaro A, Foca F, Nanni O, Chiumente M, Coppola M, Baldo P, Orzetti S, Enrico F, Ladisa V, Lerose R, Nardulli P, Maiolino P, Gradellini F, Gasbarro AR, Carrucciu G, Provasi R, Cappelletto PC, Pasqualini A, Vecchia S, Veraldi M, De Francesco AE, Crinò L, Delmonte A, Masini C. A real-world retrospective, observational study of first-line pembrolizumab plus chemotherapy for metastatic non-squamous non-small cell lung cancer with PD-L1 tumor proportion score < 50% (PEMBROREAL). Front Oncol 2024; 14:1351995. [PMID: 38601759 PMCID: PMC11004281 DOI: 10.3389/fonc.2024.1351995] [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: 12/07/2023] [Accepted: 03/05/2024] [Indexed: 04/12/2024] Open
Abstract
Introduction The phase III Keynote-189 trial established a first-line treatment combining pembrolizumab with pemetrexed and platinum as a standard treatment for patients with stage IV non-small cell lung cancer (NSCLC) without known EGFR and ALK driver mutations and independent of programmed cell death ligand 1 (PD-L1) expression. However, in Italy, eligibility for the National Health Service payment program is limited to patients with PD-L1 <50%. The PEMBROREAL study assesses the real-world effectiveness and safety of pembrolizumab in patients eligible for the National Health Service payment program. Methods PEMBROREAL is a retrospective, observational study on patients with NSCLC who started pembrolizumab combined with pemetrexed and platinum within the reimbursability time window, considered as December 2019 to December 2020. The primary endpoints were to assess progression-free survival (PFS) and overall survival (OS; using the Kaplan-Meier method), response to therapy, and tolerability. Results Until February 2022, 279 patients (median follow-up: 19.7 months) have been observed. The median PFS was 8.0 months (95% confidence interval: 6.5-9.2). OS was not reached, but we can estimate a 12- to 24-month survival rate for the combined treatment: 66.1% and 52.5%, respectively. PD-L1 expression and Eastern Cooperative Group (ECOG) Performance Status were both associated with PFS and OS. Overall, only 44.4% of patients reported an adverse event, whereas toxicity led to a 5.4% discontinuation rate. Conclusion The results of the PEMBROREAL study have shown that the combined treatment of pembrolizumab with pemetrexed and platinum is effective for metastatic non-squamous NSCLC, even for patients with PD-L1 levels below 50%, despite the differences in patient demographics and pathological features compared to the Keynote-189 study. The adverse events reported during the study were more typical of chemotherapy treatment rather than immunotherapy, and physicians were able to manage them easily.
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Affiliation(s)
- Alessandro Cafaro
- Pharmacy Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Flavia Foca
- Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Oriana Nanni
- Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Marco Chiumente
- Scientific Direction, Società Italiana di Farmacia Clinica e Terapia (SIFaCT), Turin, Italy
| | - Marina Coppola
- Pharmacy Unit, IRCCS Istituto Oncologico Veneto (IOV), Padova, Italy
| | - Paolo Baldo
- Pharmacy Unit, CRO Aviano IRCCS, National Cancer Institute, Aviano, Italy
| | - Sabrina Orzetti
- Pharmacy Unit, CRO Aviano IRCCS, National Cancer Institute, Aviano, Italy
| | - Fiorenza Enrico
- Hospital Pharmacy, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy
| | - Vito Ladisa
- Hospital Pharmacy, IRCCS National Cancer Institute Foundation, Milan, Italy
| | - Rosa Lerose
- Hospital Pharmacy, IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, PZ, Italy
| | - Patrizia Nardulli
- Pharmacy Unit, National Cancer Research Center Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Piera Maiolino
- Pharmacy Unit, Istituto Nazionale Tumori “Fondazione G. Pascale”, IRCCS, Naples, Italy
| | | | | | | | - Riccardo Provasi
- Pharmacy Unit, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | | | | | - Stefano Vecchia
- Pharmacy Unit, Hospital Guglielmo da Saliceto, Piacenza, Italy
| | - Marianna Veraldi
- Protesic and Pharmaceutical Assistance sector n. 3, Department of Health Protection and Health Service Calabria Region, Catanzaro, Italy
| | | | - Lucio Crinò
- Thoracic Oncology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Angelo Delmonte
- Thoracic Oncology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Carla Masini
- Pharmacy Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
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21
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Mukherjee A, Shammas N, Xu L, Cannavale KL, Gilfillan AD, Szamreta EA, Monberg M, Hodeib M, Chao CR. Impact of the Coronavirus Disease 2019 pandemic on neoadjuvant chemotherapy use in patients diagnosed with epithelial type ovarian cancer. Front Oncol 2024; 14:1290719. [PMID: 38601762 PMCID: PMC11005450 DOI: 10.3389/fonc.2024.1290719] [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: 09/07/2023] [Accepted: 03/13/2024] [Indexed: 04/12/2024] Open
Abstract
Introduction The Coronavirus Disease 2019 (COVID-19) pandemic posed critical challenges in providing care to ovarian cancer (OC) patients, including delays in OC diagnosis and treatment initiation. To accommodate for delays in OC surgery, the Society of Gynecologic Oncology (SGO) recommended preferential use of neoadjuvant chemotherapy during the pandemic. The purpose of this study was to assess the association of the COVID-19 pandemic with neoadjuvant chemotherapy use in patients diagnosed with OC. Methods This retrospective cohort study included patients diagnosed with stage II-IV ovarian cancer of epithelial subtype between 01/01/2017-06/30/2021 at Kaiser Permanente Southern California (KPSC), a large integrated healthcare system in the United States. Ovarian cancer patients diagnosed between 2017-2020 were identified from KPSC's Surveillance, Epidemiology, and End Results (SEER)-affiliated cancer registry. Patients diagnosed in 2021 were identified from the electronic medical records (EMR) using ICD-10 diagnosis codes, followed by medical chart review to validate diagnosis and extract information on histology and stage at diagnosis. March 4, 2020 was used as the cut-off to define pre-pandemic and pandemic periods. Patients diagnosed with COVID-19 between OC diagnosis and treatment completion were excluded. Data on neoadjuvant chemotherapy use were extracted from the cancer registry and EMR, supplemented by chart review. Modified Poisson regression was used to evaluate the association of the pandemic with neoadjuvant chemotherapy use. Results Of 566 OC patients, 160 (28.3%) were diagnosed in the pandemic period. Patients diagnosed in the pandemic period were slightly younger (mean age 62.7 vs 64.9 years, p=0.07) and had a higher burden of Charlson comorbidities (p=0.05) than patients diagnosed in pre-pandemic period. No differences in time to treatment initiation were observed by pandemic periods. Neoadjuvant chemotherapy use was documented in 58.7% patients during the pandemic period compared to 47.3% in pre-pandemic period (p=0.01). After adjusting for covariates, patients diagnosed in the pandemic period were 29% more likely to receive neoadjuvant chemotherapy than patients diagnosed in pre-pandemic period [RR(95%CI): 1.29(1.12-1.49)]. Discussions Ovarian cancer patients diagnosed in the COVID-19 pandemic were more likely to receive neoadjuvant chemotherapy than patients diagnosed before the pandemic. Future research on patient outcomes and trends in the post-pandemic period are warranted.
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Affiliation(s)
- Amrita Mukherjee
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States
| | - Natalie Shammas
- Obstetrics and Gynecology, Adventist Health White Memorial Medical Center, Los Angeles, CA, United States
| | - Lanfang Xu
- Data Reporting and Analytics, MedHealth Statistical Consulting Inc., Solon, OH, United States
| | - Kimberly L. Cannavale
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States
| | - Alec D. Gilfillan
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States
| | - Elizabeth A. Szamreta
- Center for Observational and Real-World Evidence (CORE), Merck & Co., Inc., Rahway, NJ, United States
| | - Matthew Monberg
- Center for Observational and Real-World Evidence (CORE), Merck & Co., Inc., Rahway, NJ, United States
| | - Melissa Hodeib
- Gynecology Oncology, Kaiser Permanente Southern California, Riverside, CA, United States
| | - Chun R. Chao
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States
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22
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van Hagen CCE, Huiberts AJ, Mutubuki EN, de Melker HE, Vos ERA, van de Wijgert JHHM, van den Hof S, Knol MJ, van Hoek AJ. Health-related quality of life during the COVID-19 pandemic: The impact of restrictive measures using data from two Dutch population-based cohort studies. PLoS One 2024; 19:e0300324. [PMID: 38498510 PMCID: PMC10947685 DOI: 10.1371/journal.pone.0300324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 02/23/2024] [Indexed: 03/20/2024] Open
Abstract
OBJECTIVES We describe health-related quality of life during the COVID-19 pandemic in the general Dutch population and correlations with restrictive measures. METHODS Data were obtained from 18-85 year-old participants of two population-based cohort studies (February 2021-July 2022): PIENTER Corona (n = 8,019) and VASCO (n = 45,413). Per cohort, mean scores of mental and physical health and health utility from the SF-12 were calculated by age group, sex and presence of a medical risk condition. Spearman correlations with stringency of measures were calculated. RESULTS Both cohorts showed comparable results. Participants <30 years had lowest health utility and mental health score, and highest physical health score. Health utility and mental health score increased with age (up to 79 years), while physical health score decreased with age. Women and participants with a medical risk condition scored lower than their counterparts. Fluctuations were small over time but most pronounced among participants <60 years, and correlated weakly, but mostly positively with measure stringency. CONCLUSIONS During the Dutch COVID-19 epidemic, health utility and mental health scores were lower and fluctuated strongest among young adults compared to older adults. In our study population, age, sex and presence of a medical risk condition seemed to have more impact on health scores than stringency of COVID-19 non-pharmaceutical interventions.
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Affiliation(s)
- Cheyenne C. E. van Hagen
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Anne J. Huiberts
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Elizabeth N. Mutubuki
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Hester E. de Melker
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Eric R. A. Vos
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Janneke H. H. M. van de Wijgert
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (UMCU), Utrecht, the Netherlands
| | - Susan van den Hof
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Mirjam J. Knol
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Albert Jan van Hoek
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
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23
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İzci Güllü E, Akin L, Gökler ME, Aydin M. Increased Severity of Presentation Signs in Children with Newly Diagnosed Type 1 Diabetes during the COVID-19 Pandemic: A Tertiary Center Experience. ANNALS OF NUTRITION & METABOLISM 2024; 80:161-170. [PMID: 38479369 DOI: 10.1159/000538322] [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: 12/22/2023] [Accepted: 03/11/2024] [Indexed: 06/06/2024]
Abstract
INTRODUCTION Diabetic ketoacidosis (DKA) is an important complication of type 1 diabetes mellitus (T1DM) which is worsened when the diagnosis of T1DM is delayed. The aim of this study was to evaluate the presentation patterns, severity, autoantibody status, and seasonal variability of newly diagnosed T1DM patients during the pandemic period of 2 years compared to those in the pre-pandemic period. METHODS In this single tertiary center retrospective cohort study, newly diagnosed T1DM patients were grouped as pre-pandemic and pandemic period. Age, gender, the month of diagnosis, hemoglobin A1c, venous blood gas parameters, duration of symptoms, glutamic-acid-decarboxylase-antibody (anti-GAD), islet-cell antibody (ICA), and insulin autoantibody levels were recorded. The data obtained were compared between the groups. RESULTS Number of patients presenting with DKA was significantly higher during the pandemic period (92 [65.7%] vs. 62 [40.8%] patients, p < 0.001). In terms of clinical severity of DKA, pH, and HCO3 levels were lower during the pandemic period (p < 0.001), while the number of patients presenting with severe DKA was significantly higher during the pandemic period (41 [44.6%] vs. 17 [27.4%] patients, p = 0.031). ICA positivity was significantly higher in patients admitted during the pandemic period (47 [36.4%] vs. 21 patients [16.9%], p < 0.001), especially in the second year of the pandemic (p < 0.001). Anti-GAD-ICA co-positivity was significantly higher in patients admitted during the pandemic period and also in second year of the pandemic (p < 0.001). CONCLUSION DKA rates increased in newly diagnosed T1DM cases during the pandemic. Despite the relaxation of bans, the second year of the pandemic also saw increased rates of DKA and severe DKA compared to the pre-pandemic period. The significantly increased ICA positivity in the pandemic may support the effects of COVID-19 on autoimmune T1DM.
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Affiliation(s)
- Elif İzci Güllü
- Ondokuz Mayıs University Faculty of Medicine, Department of Pediatric Endocrinology, Samsun, Turkey
- University of Health Sciences, Samsun Training and Research Hospital, Department of Pediatric Endocrinology, Samsun, Turkey
| | - Leyla Akin
- Ondokuz Mayıs University Faculty of Medicine, Department of Pediatric Endocrinology, Samsun, Turkey
| | - Mehmet Enes Gökler
- Ankara Yıldırım Beyazıt University Faculty of Medicine, Department of Public Health, Ankara, Turkey
| | - Murat Aydin
- Ondokuz Mayıs University Faculty of Medicine, Department of Pediatric Endocrinology, Samsun, Turkey
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24
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Parikh S, Zhang Y, Sherwani Z, Kumar R, Ohri N, Jan I, Vergalasova I, Jabbour S, Hathout L. Impact of the COVID-19 pandemic on brachytherapy and cancer patient outcomes: A systematic review. Brachytherapy 2024; 23:141-148. [PMID: 38307787 DOI: 10.1016/j.brachy.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 11/15/2023] [Accepted: 11/27/2023] [Indexed: 02/04/2024]
Abstract
PURPOSE/OBJECTIVE(S) To assess the impact of the COVID-19 pandemic on the use of brachytherapy in patients with gynecologic and prostate cancers including treatment delays, increased burden of mortality, and associated clinical outcomes. MATERIALS/METHODS A comprehensive search of PubMed, Cochrane Library, CINAHL, Scopus, and Web of Science was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases were searched for studies published through September 2023 using MeSH terms and keywords related to "COVID and brachytherapy." Inclusion criteria included all studies reporting on the impact of COVID-19 on treatment delay, treatment omission, recurrence rates, and clinical outcomes in patients requiring brachytherapy for prostate or gynecologic cancers from December 2019 to September 2023. Data were extracted by two independent reviewers (LH, IV). RESULTS Of the 292 screened records, 10 studies (9 retrospective, 1 prospective single-arm exploratory noninferiority) were included. Hypofractioned regimens were the preferred approach in radiation treatment (RT) centers, with 6 of 10 studies noting shift towards hypofractionation. For cervical cancer, intracavitary brachytherapy was limited to 3-4 fractions, reducing personnel and patient exposure. Treatment delays influenced by COVID-19 ranged between 19% and 53% and treatment omissions ranged between 2% and 28%. These disruptions arose from factors such as patient fear of contracting COVID-19, COVID-19 infection, barriers to accessing care, and operating room closures. Three studies reported on a single-application (SA) rather than a multiple application (MA) approach for cervical cancer. They reported excellent local control, shorter overall treatment time at the expense of higher grade ≥2 vaginal, genitourinary, and gastrointestinal events. For cervical cancer patients, overall treatment time (OTT) was significantly impacted by COVID-19 as reported by 2 studies from India. OTT > 60 days occurred in 40-53% of patients. CONCLUSION This is the first systematic review to assess the impact of the COVID-19 pandemic on brachytherapy in patients with gynecologic and prostate cancers. Although many expert consensus recommendations have been published during the pandemic regarding radiation therapy, few studies evaluated its clinical impact on brachytherapy delivery and patient outcomes. The COVID-19 pandemic resulted in treatment delays, omissions in brachytherapy, and further adoption of hypofractionated regimens. Early results demonstrate that despite increased toxicities, local control rates with hypofractionated treatment are similar to standard fractionation. The impact of the pandemic on gynecologic and prostate cancers is yet to be determined as well as the long-term outcomes on patients treated during the lockdown period.
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Affiliation(s)
- Shreel Parikh
- Department of Radiation Oncology, Rutgers Cancer Institute, Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Yingting Zhang
- Robert Wood Johnson Library of the Health Sciences, Rutgers, The State University of New Jersey, New Brunswick, NJ
| | - Zohaib Sherwani
- Department of Radiation Oncology, Rutgers Cancer Institute, Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Ritesh Kumar
- Department of Radiation Oncology, Rutgers Cancer Institute, Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Nisha Ohri
- Department of Radiation Oncology, Rutgers Cancer Institute, Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Imraan Jan
- Department of Radiation Oncology, Rutgers Cancer Institute, Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Irina Vergalasova
- Department of Radiation Oncology, Rutgers Cancer Institute, Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Salma Jabbour
- Department of Radiation Oncology, Rutgers Cancer Institute, Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Lara Hathout
- Department of Radiation Oncology, Rutgers Cancer Institute, Robert Wood Johnson Medical School, New Brunswick, NJ.
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25
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Rahman MM, Wang L, Rahman MM, Chen Y, Zhang W, Wang J, Lee LP, Wan Y. Rapid in situ mutation detection in extracellular vesicle-DNA. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.02.26.582068. [PMID: 38464277 PMCID: PMC10925088 DOI: 10.1101/2024.02.26.582068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
A PCR- and sequencing-free mutation detection assay facilitates cancer diagnosis and reduces over-reliance on specialized equipment. This benefit was highlighted during the pandemic when high demand for viral nucleic acid testing often sidelined mutation analysis. This shift led to substantial challenges for patients on targeted therapy in tracking mutations. Here, we report a 30-minute DNA mutation detection technique using Cas12a-loaded liposomes in a microplate reader, a fundamental laboratory tool. CRISPR-Cas12a complex and fluorescence-quenching (FQ) probes are introduced into tumor-derived extracellular vesicles (EV) through membrane fusion. When CRISPR-RNA hybridizes with the DNA target, activated Cas12a can trans-cleave FQ probes, resulting in fluorescence signals for the quantification of DNA mutation. Future advancements in multiplex and high-throughput mutation detection using this assay will streamline self-diagnosis and treatment monitoring at home.
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Affiliation(s)
- Md Mofizur Rahman
- The Pq Laboratory of BiomeDx/Rx, Department of Biomedical Engineering, Binghamton University, Binghamton, NY, USA
- Department of Pharmacy, Daffodil International University, Dhaka, Bangladesh
| | - Lixue Wang
- The Pq Laboratory of BiomeDx/Rx, Department of Biomedical Engineering, Binghamton University, Binghamton, NY, USA
- Department of Radiotherapy, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Md Motiar Rahman
- Department of Chemistry, Binghamton University, Binghamton, NY, USA
| | - Yundi Chen
- The Pq Laboratory of BiomeDx/Rx, Department of Biomedical Engineering, Binghamton University, Binghamton, NY, USA
| | - Wenlong Zhang
- Twist Bioscience Corporation, San Francisco, CA, USA
| | - Jing Wang
- Department of Hematology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
- Department of Oncology and Hematology, Yizheng Hospital of Nanjing Drum Tower Hospital Group, Yizheng, Jiangsu, China
| | - Luke P Lee
- Harvard Medical School, Harvard University; Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Department of Bioengineering, Department of Electrical Engineering and Computer Science, University of California, Berkeley, Berkeley, CA, USA
- Department of Biophysics, Institute of Quantum Biophysics, Sungkyunkwan University, Suwon, Korea
- Department of Chemistry and Nanoscience, Ewha Womans University, Seoul, Korea
| | - Yuan Wan
- The Pq Laboratory of BiomeDx/Rx, Department of Biomedical Engineering, Binghamton University, Binghamton, NY, USA
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Sim J, Shin J, Lee HJ, Lee Y, Kim YA. Impact of coronavirus disease 2019 on cancer care: How the pandemic has changed cancer utilization and expenditures. PLoS One 2024; 19:e0296808. [PMID: 38329987 PMCID: PMC10852310 DOI: 10.1371/journal.pone.0296808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 12/19/2023] [Indexed: 02/10/2024] Open
Abstract
PURPOSE Since identified in December 2019, the novel coronavirus disease 2019 (COVID-19) has had a global impact on medical resource use and costs for patients with cancer in South Korea. This study aimed to identify the medical use and costs among patients with cancer during the COVID-19 pandemic, to predict these patterns in South Korea in the future. METHODS We conducted a secondary claims data analysis using the National Health Insurance Service database for the calendar period of 2019-2020. Monthly relative percent changes in cancer incidence, medical use, and billing costs for medical care utilization by cancer type were calculated. Then, the medical use and costs after January 2020 were predicted using a time series model with data before the COVID-19 outbreak (2014-2019). RESULTS The incidence of cancer diagnoses has seen a notable decline since the outbreak of the COVID-19 in 2020 as compared to 2019. Despite the impact of COVID-19, there hasn't been a distinct decline in outpatient utilization when compared to inpatient utilization. While medical expenses for both inpatient and outpatient visits have slightly increased, the number of patients treated for cancer has decreased significantly compared to the previous year. In June 2020, overall outpatient costs experienced the highest increase (21.1%), while individual costs showed the most significant decrease (-4.9%) in June 2020. Finally, the number of hospitalisations and outpatient visits increased slightly from June-July in 2020, reducing the difference between the actual and predicted values. The decrease in the number of inpatient hospitalisations (-22~-6%) in 2020 was also high. CONCLUSIONS The overall use of medical services by patients with cancer decreased in 2020 compared with that in the pre-COVID-19 pandemic period. In the future, the government should consider how to recover from the COVID-19 pandemic, and establish permanent health policies for patients with cancer.
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Affiliation(s)
- Jinah Sim
- School of AI Convergence, Hallym University, Chuncheon, Republic of Korea
| | - Jihye Shin
- Department of Research, Health Insurance Review & Assessment Service (HIRA), Wonju, Republic of Korea
| | - Hyun Jeong Lee
- Division of Cancer Control & Policy, National Cancer Center, Gyeonggi, Republic of Korea
| | - Yeonseung Lee
- Division of Cancer Control & Policy, National Cancer Center, Gyeonggi, Republic of Korea
| | - Young Ae Kim
- Division of Cancer Control & Policy, National Cancer Center, Gyeonggi, Republic of Korea
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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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Murphy CC, Tavakkoli A, Wani S, Singal AG. Pandemic-Related Changes in Incidence and Mortality Rates of Gastrointestinal Cancers During 2020. Am J Gastroenterol 2024; 119:382-387. [PMID: 37791616 PMCID: PMC10873074 DOI: 10.14309/ajg.0000000000002526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 09/26/2023] [Indexed: 10/05/2023]
Abstract
INTRODUCTION Coronavirus Disease 2019 disrupted cancer-related care in early 2020. METHODS We used population-based cancer registry data to estimate incidence and mortality rates of gastrointestinal cancers between 2016 and 2020. RESULTS Incidence rates were unchanged from 2016 to 2019 but decreased in 2020, with the largest declines for colorectal cancer (rate ratio [RR] 0.88; 95% confidence interval [CI] 0.87-0.90) and hepatocellular carcinoma (RR 0.85; 95% CI 0.82-0.88). Mortality rates of colorectal cancer (RR 1.06; 95% CI 1.04-1.08) and esophageal adenocarcinoma (RR 1.06; 95% CI 1.00-1.13) increased in 2020. DISCUSSION Incidence and mortality rates of gastrointestinal cancers may increase in the future given pandemic-related delays in 2020.
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Affiliation(s)
- Caitlin C Murphy
- University of Texas Health Science Center at Houston (UTHealth Houston) School of Public Health, Houston, Texas, USA
- University of Texas Southwestern Medical Center, Dallas, Texas, USA
- University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Anna Tavakkoli
- University of Texas Health Science Center at Houston (UTHealth Houston) School of Public Health, Houston, Texas, USA
- University of Texas Southwestern Medical Center, Dallas, Texas, USA
- University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Sachin Wani
- University of Texas Health Science Center at Houston (UTHealth Houston) School of Public Health, Houston, Texas, USA
- University of Texas Southwestern Medical Center, Dallas, Texas, USA
- University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Amit G Singal
- University of Texas Health Science Center at Houston (UTHealth Houston) School of Public Health, Houston, Texas, USA
- University of Texas Southwestern Medical Center, Dallas, Texas, USA
- University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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Otremski H, Dermott J, Page K, Ipp LS, Blanco JS, Studer D, Sigal A, Kim D, Hasler CC, Lebel DE, Widmann RF, Ovadia D. The global impact of the COVID-19 pandemic on pediatric spinal care: A multi-centric study. J Child Orthop 2024; 18:33-39. [PMID: 38348438 PMCID: PMC10859112 DOI: 10.1177/18632521231210356] [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: 06/28/2023] [Accepted: 10/08/2023] [Indexed: 02/15/2024] Open
Abstract
Background The COVID-19 pandemic has affected healthcare worldwide since December 2019. We aimed to identify the effect of the COVID-19 pandemic on outpatient clinic and surgical volumes and peri-operative complications for pediatric spinal deformities patients. Methods In this multi-center retrospective study, outpatient visits (in-person and virtual care) and pediatric spine surgeries volumes in four high-volume pediatric spine centers were compared between March and December 2019 and the same period in 2020. Peri-operative complications were collected and compared in the same periods. Descriptive statistics were calculated, and comparative analyses were performed. Results During the 2020 study period, the outpatient visit (in-person and virtual care) volume decreased during local lockdown periods by 71% for new patients (p < 0.001) and 53% for returning patients (p = 0.03). Overall, for 2020, there was a 20% reduction in new patients (p = 0.001) and 21% decrease in returning patients (p < 0.001). During the pandemic, there was also 20% less overall surgical volume of adolescent idiopathic scoliosis (AIS) patients undergoing primary posterior spinal fusion, with a 70% reduction during lockdown times (p < 0.001). Complication rate and profile were similar between periods. Conclusion There was a significant decrease in outpatient pediatric spine outpatient visits, particularly new patients, which may increase the proportion of pediatric patients with spinal deformities that present late, meeting surgical indication. This, in combination with the reduction in surgical volume of AIS over the first year of the pandemic, could result in an extended waitlist for surgeries during years to come. Complication rate was similar for both periods, suggesting it is safe to continue elective pediatric spine surgery even in a time of a pandemic. Level of evidence level IV.
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Affiliation(s)
- Hila Otremski
- Pediatric Orthopaedic Department, Dana Dwek Children’s Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jennifer Dermott
- The Hospital for Sick Children, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Kira Page
- Department of Pediatric Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Lisa S Ipp
- Department of Pediatric Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
| | - John S Blanco
- Department of Pediatric Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Daniel Studer
- Orthopaedic Department, Children’s Hospital, University of Basel, Basel, Switzerland
| | - Amit Sigal
- Pediatric Orthopaedic Department, Dana Dwek Children’s Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dorothy Kim
- The Hospital for Sick Children, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Carol C Hasler
- Orthopaedic Department, Children’s Hospital, University of Basel, Basel, Switzerland
| | - David E Lebel
- The Hospital for Sick Children, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Roger F Widmann
- Department of Pediatric Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Dror Ovadia
- Pediatric Orthopaedic Department, Dana Dwek Children’s Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Duncan FC, Al Nasrallah N, Nephew L, Han Y, Killion A, Liu H, Al-Hader A, Sears CR. Racial disparities in staging, treatment, and mortality in non-small cell lung cancer. Transl Lung Cancer Res 2024; 13:76-94. [PMID: 38405005 PMCID: PMC10891396 DOI: 10.21037/tlcr-23-407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 01/12/2024] [Indexed: 02/27/2024]
Abstract
Background Black race is associated with advanced stage at diagnosis and increased mortality in non-small cell lung cancer (NSCLC). Most studies focus on race alone, without accounting for social determinants of health (SDOH). We explored the hypothesis that racial disparities in stage at diagnosis and outcomes are associated with SDOH and influence treatment decisions by patients and providers. Methods Patients with NSCLC newly diagnosed at Indiana University Simon Comprehensive Cancer Center (IUSCCC) from January 1, 2000 to May 31, 2015 were studied. Multivariable regression analyses were conducted to examine the impact of SDOH (race, gender, insurance status, and marital status) on diagnosis stage, time to treatment, receipt of and reasons for not receiving guideline concordant treatment, and 5-year overall survival (OS) based on Kaplan-Meier curves. Results A total of 3,349 subjects were included in the study, 12.2% of Black race. Those diagnosed with advanced-stage NSCLC had a significantly higher odds of being male, uninsured, and Black. Five-year OS was lower in those of Black race, male, single, uninsured, Medicare/Medicaid insurance, and advanced stage. Adjusted for multiple variables, individuals with Medicare, Medicare/Medicaid, uninsured, widowed, and advanced stage at diagnosis, were associated with significantly lower OS time. Black, single, widowed, and uninsured individuals were less likely to receive stage appropriate treatment for advanced disease. Those uninsured [odds ratio (OR): 3.876, P<0.001], Medicaid insurance (OR: 3.039, P=0.0017), and of Black race (OR: 1.779, P=0.0377) were less likely to receive curative-intent surgery for early-stage NSCLC because it was not a recommended treatment. Conclusions We found racial, gender, and socioeconomic disparities in NSCLC diagnosis stage, receipt of stage-appropriate treatment, and reasons for guideline discordance in receipt of curative intent surgery for early-stage NSCLC. While insurance type and marital status were associated with worse OS, race alone was not. This suggests racial differences in outcomes may not be associated with race alone, but rather worse SDOH disproportionately affecting Black individuals. Efforts to understand advanced diagnosis and reasons for failure to receive stage-appropriate treatment by vulnerable populations is needed to ensure equitable NSCLC care.
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Affiliation(s)
- Francesca C. Duncan
- Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Nawar Al Nasrallah
- Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Lauren Nephew
- Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Yan Han
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Andrew Killion
- Indiana Clinical and Translational Science Institute, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Hao Liu
- Department of Biostatistics and Epidemiology, Rutgers Cancer Institute of New Jersey, Rutgers School of Public Health, New Brunswick, NJ, USA
| | - Ahmad Al-Hader
- Division of Hematology and Oncology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Catherine R. Sears
- Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Division of Pulmonary Medicine, Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis, IN, USA
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Moria FA, Park CL, Eigl BJ, Macfarlane R, Pavic M, Saleh RR. A Real-World Retrospective Analysis of the Management of Advanced Urothelial Carcinoma in Canada. Curr Oncol 2024; 31:704-722. [PMID: 38392046 PMCID: PMC10887988 DOI: 10.3390/curroncol31020052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 01/16/2024] [Accepted: 01/19/2024] [Indexed: 02/24/2024] Open
Abstract
Locally advanced or metastatic urothelial carcinoma (aUC) presents a significant challenge with high mortality rates. Platinum-based chemotherapy remains the established frontline standard of care, and a switch-maintenance strategy with immunotherapy has now emerged as a new standard for aUC patients without disease progression, following initial platinum therapy. Examining the treatment patterns is imperative, given the evolving therapeutic landscape. In this study, we conducted a retrospective medical chart review of 17 Canadian oncologists treating patients with aUC to assess unmet needs in Canadian aUC patient care. Data from 146 patient charts were analyzed, revealing important clinical insights about the management of aUC. A substantial proportion of patients (53%) presented with de novo metastatic disease, which was possibly influenced by pandemic-related care disruptions. Variability was evident in the cisplatin eligibility criteria, with a majority (70%) of oncologists utilizing a 50 mL/min threshold. Most favored four cycles of platinum-based chemotherapy to spare the bone marrow for future therapies and prevent patient fatigue. Notably, some eligible patients were kept under surveillance rather than receiving maintenance therapy, suggesting a potential gap in awareness regarding evidence-based recommendations. Furthermore, managing treatment-related adverse events was found to be one of the biggest challenges in relation to maintenance immunotherapy. In conclusion, our findings provide the first comprehensive overview of aUC treatment patterns in Canada following the approval of maintenance immunotherapy, offering insights into the decision-making process and underscoring the importance of evidence-based guidelines in aUC patient management.
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Affiliation(s)
- Feras A. Moria
- McGill University Health Center, Montreal, QC H4A 3J1, Canada; (F.A.M.); (C.L.P.)
| | - Changsu L. Park
- McGill University Health Center, Montreal, QC H4A 3J1, Canada; (F.A.M.); (C.L.P.)
| | | | | | - Michel Pavic
- Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada;
| | - Ramy R. Saleh
- McGill University Health Center, Montreal, QC H4A 3J1, Canada; (F.A.M.); (C.L.P.)
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Pflüger P, Lefering R, Dommasch M, Biberthaler P, Kanz KG. [Impact of the COVID-19 pandemic on the care of major trauma patients: analysis from the TraumaRegister DGU®]. UNFALLCHIRURGIE (HEIDELBERG, GERMANY) 2024; 127:62-68. [PMID: 37341734 PMCID: PMC10786995 DOI: 10.1007/s00113-023-01325-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/06/2023] [Indexed: 06/22/2023]
Abstract
BACKGROUND The treatment of major trauma patients requires intensive care capacity, which is a critical resource particularly during the coronavirus disease 2019 (COVID-19) pandemic. Therefore, the aim of this study was to analyze the impact on major trauma care considering the intensive care treatment of COVID-19 positive patients. METHODS Demographic, prehospital, and intensive care treatment data from the TraumaRegister DGU® of the German Trauma Society (DGU) in 2019 and 2020 were analyzed. Only major trauma patients from the state of Bavaria were included. Inpatient treatment data of COVID-19 patients in Bavaria in 2020 were obtained using IVENA eHealth. RESULTS In total, 8307 major trauma patients were treated in the state of Bavaria in the time period investigated. The number of patients in 2020 (n = 4032) compared to 2019 (n = 4275) was not significantly decreased (p = 0.4). Regarding COVID-19 case numbers, maximum values were reached in the months of April and December with more than 800 intensive care unit (ICU) patients per day. In the critical period (> 100 patients with COVID-19 on ICU), a prolonged rescue time was evident (64.8 ± 32.5 vs. 67.4 ± 30.6 min; p = 0.003). The length of stay and ICU treatment of major trauma patients were not negatively affected by the COVID-19 pandemic. CONCLUSION The intensive medical care of major trauma patients could be ensured during the high-incidence phases of the COVID-19 pandemic. The prolonged prehospital rescue times show possible optimization potential of the horizontal integration of prehospital and hospital.
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Affiliation(s)
- Patrick Pflüger
- Klinik und Poliklinik für Unfallchirurgie, Klinikum rechts der Isar, Technische Universität München, München, Deutschland.
| | - Rolf Lefering
- Institut für Forschung in der Operativen Medizin (IFOM), Universität Witten/Herdecke, Witten, Deutschland
| | - Michael Dommasch
- Fakultät für Medizin, Zentrale Interdisziplinäre Notaufnahme, Klinikum rechts der Isar, Technische Universität München, München, Deutschland
| | - Peter Biberthaler
- Klinik und Poliklinik für Unfallchirurgie, Klinikum rechts der Isar, Technische Universität München, München, Deutschland
| | - Karl-Georg Kanz
- Klinik und Poliklinik für Unfallchirurgie, Klinikum rechts der Isar, Technische Universität München, München, Deutschland
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Fefferman M, Kuchta K, Wang C, Nicholson K, Kopkash K, Pesce C, Poli E, Smith TW, Yao K. Rates of newly diagnosed breast cancer at commission on cancer facilities during the early phase of the COVID-19 pandemic. Cancer Med 2024; 13:e6874. [PMID: 38140789 PMCID: PMC10807625 DOI: 10.1002/cam4.6874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 11/02/2023] [Accepted: 12/10/2023] [Indexed: 12/24/2023] Open
Abstract
INTRODUCTION The objective of this study was to examine the impact of the early part of the COVID-19 pandemic on the number of newly diagnosed breast cancer cases at Commission on Cancer (CoC)-accredited facilities relative to the United States (U.S.) population. METHODS We examined the incidence of breast cancer cases at CoC sites using the U.S. Census population as the denominator. Breast cancer incidence was stratified by patient age, race and ethnicity, and geographic location. RESULTS A total of 1,499,806 patients with breast cancer were included. For females, breast cancer cases per 100,000 individuals went from 188 in 2015 to 203 in 2019 and then dropped to 176 in 2020 with a 15.7% decrease from 2019 to 2020. Breast cancer cases per 100,000 males went from 1.7 in 2015 to 1.8 in 2019 and then declined to 1.5 in 2020 with a 21.8% decrease from 2019 to 2020. For both females and males, cases per 100,000 individuals decreased from 2019 to 2020 for almost all age groups. For females, rates dropped from 2019 to 2020 for all races and ethnicities and geographic locations. The largest percent change was seen among Hispanic patients (-18.4%) and patients in the Middle Atlantic division (-18.6%). The stage distribution (0-IV) for female and male patients remained stable from 2018 to 2020. CONCLUSION The first year of the COVID-19 pandemic was associated with a decreased number of newly diagnosed breast cancer cases at Commission on Cancer sites.
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Affiliation(s)
- Marie Fefferman
- Department of SurgeryNorthShore University Health System, Evanston HospitalEvanstonIllinoisUSA
- Department of SurgeryUniversity of Chicago, Pritzker School of MedicineChicagoIllinoisUSA
| | - Kristine Kuchta
- Department of SurgeryNorthShore University Health System, Evanston HospitalEvanstonIllinoisUSA
| | - Chi‐Hsiung Wang
- Department of SurgeryNorthShore University Health System, Evanston HospitalEvanstonIllinoisUSA
| | - Kyra Nicholson
- Department of SurgeryNorthShore University Health System, Evanston HospitalEvanstonIllinoisUSA
- Department of SurgeryUniversity of Chicago, Pritzker School of MedicineChicagoIllinoisUSA
| | - Katherine Kopkash
- Department of SurgeryNorthShore University Health System, Evanston HospitalEvanstonIllinoisUSA
- Department of SurgeryUniversity of Chicago, Pritzker School of MedicineChicagoIllinoisUSA
| | - Catherine Pesce
- Department of SurgeryNorthShore University Health System, Evanston HospitalEvanstonIllinoisUSA
- Department of SurgeryUniversity of Chicago, Pritzker School of MedicineChicagoIllinoisUSA
| | - Elizabeth Poli
- Department of SurgeryNorthShore University Health System, Evanston HospitalEvanstonIllinoisUSA
- Department of SurgeryUniversity of Chicago, Pritzker School of MedicineChicagoIllinoisUSA
| | - Thomas W. Smith
- Department of SurgeryNorthShore University Health System, Evanston HospitalEvanstonIllinoisUSA
- Department of SurgeryUniversity of Chicago, Pritzker School of MedicineChicagoIllinoisUSA
| | - Katharine Yao
- Department of SurgeryNorthShore University Health System, Evanston HospitalEvanstonIllinoisUSA
- Department of SurgeryUniversity of Chicago, Pritzker School of MedicineChicagoIllinoisUSA
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Slotman E, Fransen HP, van Laarhoven HWM, van den Beuken-van Everdingen MHJ, Tjan-Heijnen VCG, Huijben AMT, Jager A, van Zuylen L, Kuip EJM, van der Linden YM, Raijmakers NJH, Siesling S. Reduction in potentially inappropriate end-of-life hospital care for cancer patients during the COVID-19 pandemic: A retrospective population-based study. Palliat Med 2024; 38:140-149. [PMID: 38142283 PMCID: PMC10798006 DOI: 10.1177/02692163231217373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2023]
Abstract
BACKGROUND The COVID-19 pandemic impacted cancer diagnosis and treatment. However, little is known about end-of-life cancer care during the pandemic. AIM To investigate potentially inappropriate end-of-life hospital care for cancer patients before and during the COVID-19 pandemic. DESIGN Retrospective population-based cohort study using data from the Netherlands Cancer Registry and the Dutch National Hospital Care Registration. Potentially inappropriate care in the last month of life (chemotherapy administration, >1 emergency room contact, >1 hospitalization, hospitalization >14 days, intensive care unit admission or hospital death) was compared between four COVID-19 periods and corresponding periods in 2018/2019. PARTICIPANTS A total of 112,919 cancer patients (⩾18 years) who died between January 2018 and May 2021 were included. RESULTS Fewer patients received potentially inappropriate end-of-life care during the COVID-19 pandemic compared to previous years, especially during the first COVID-19 peak (22.4% vs 26.0%). Regression analysis showed lower odds of potentially inappropriate end-of-life care during all COVID-19 periods (between OR 0.81; 95% CI 0.74-0.88 and OR 0.92; 95% CI 0.87-0.97) after adjustment for age, sex and cancer type. For the individual indicators, fewer patients experienced multiple or long hospitalizations, intensive care unit admission or hospital death during the pandemic. CONCLUSIONS Cancer patients received less potentially inappropriate end-of-life care during the COVID-19 pandemic. Because several factors may have contributed, it is unclear whether this reflects better quality care. However, these findings raise important questions about what pandemic-induced changes in care practices can help provide appropriate end-of-life care for future patients in the context of increasing patient numbers and limited resources.
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Affiliation(s)
- Ellis Slotman
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
- Netherlands Association for Palliative Care (PZNL), Utrecht, The Netherlands
- Department of Health Technology and Services Research, University of Twente, Technical Medical Centre, Enschede, The Netherlands
| | - Heidi P Fransen
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
- Netherlands Association for Palliative Care (PZNL), Utrecht, The Netherlands
| | - Hanneke WM van Laarhoven
- Department of Medical Oncology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Cancer Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | | | - Vivianne CG Tjan-Heijnen
- Department of Medical Oncology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Auke MT Huijben
- Department of Internal Medicine, Maasstad Hospital, Rotterdam, The Netherlands
| | - Agnes Jager
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Lia van Zuylen
- Department of Medical Oncology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Evelien JM Kuip
- Department of Medical Oncology and Department of Anesthesiology, Pain and Palliative Care, Radboud Medical Center, Nijmegen, The Netherlands
| | - Yvette M van der Linden
- Centre of Expertise in Palliative Care, Leiden University Medical Centre, Leiden, The Netherlands
- Department of Radiotherapy, Leiden University Medical Centre, Leiden, The Netherlands
| | - Natasja JH Raijmakers
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
- Netherlands Association for Palliative Care (PZNL), Utrecht, The Netherlands
| | - Sabine Siesling
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
- Department of Health Technology and Services Research, University of Twente, Technical Medical Centre, Enschede, The Netherlands
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Ejezie CL, Shegog R, Durand C, Cuccaro P, Savas LS. A Multivariate Probit Regression of the Uptake of Adolescent Vaccines Among Racial/Ethnic Minority Adolescents Before and During the COVID-19 Pandemic. J Adolesc Health 2024; 74:28-35. [PMID: 37804299 DOI: 10.1016/j.jadohealth.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 07/09/2023] [Accepted: 08/04/2023] [Indexed: 10/09/2023]
Abstract
PURPOSE The uptake of adolescent vaccines has improved over the years. However, research of the effects of the COVID-19 pandemic on this uptake among racial/ethnic minority adolescents has been limited. This study was conducted to compare the probability of uptake of the human papillomavirus (HPV); tetanus, diphtheria, and acellular pertussis (Tdap); and quadrivalent meningococcal conjugate (MenACWY) vaccines among racial/ethnic minority adolescents ages 13-17 years in 2019, 2020, and 2021. METHODS Using a cross-sectional design to examine data from the National Immunization Survey-Teen (2019-2021), multivariate probit regression was used to model variation in uptake of these three adolescent vaccines (n = 38,128). The outcome measures were HPV, Tdap, and MenACWY vaccine uptake. RESULTS The probability of uptake of HPV vaccine was higher in 2020 (Coef = 0.09 [95% confidence interval (CI), 0.03-0.16]) and 2021 (Coef = 0.07 [95% CI, 0.00-0.15]) than in 2019. The probability of uptake of MenACWY vaccine was higher in 2020 (Coef = 0.08 [95% CI, 0.02-0.15]) than in 2019. The probability of uptake of recommended vaccines varied among racial/ethnic minorities with non-Hispanic Black adolescents exhibiting higher probability of uptake of HPV vaccine (Coef = 0.10 [95% CI, 0.01-0.19]) than Tdap vaccine. U.S. Census region and insurance status were associated with the uptake of all recommended vaccines. DISCUSSION Progress in the uptake of these recommended vaccines may not have been interrupted by the COVID-19 pandemic. Also, disparities in uptake of the recommended vaccines still exist despite increased uptake during the pandemic. Future research should examine the disparities as well as examine regional differences in the uptake of these three adolescent vaccines.
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Affiliation(s)
- Chinenye Lynette Ejezie
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
| | - Ross Shegog
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas
| | - Casey Durand
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas
| | - Paula Cuccaro
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas
| | - Lara S Savas
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas
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Englum BR, Sahoo S, Mayorga-Carlin M, Hayssen H, Siddiqui T, Turner DJ, Sorkin JD, Lal BK. Growing Deficit in New Cancer Diagnoses 2 Years Into the COVID-19 Pandemic: A National Multicenter Study. Ann Surg Oncol 2023; 30:8509-8518. [PMID: 37695458 PMCID: PMC10939008 DOI: 10.1245/s10434-023-14217-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 08/07/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Large decreases in cancer diagnoses were seen early in the COVID-19 pandemic. However, the evolution of these deficits since the end of 2020 and the advent of widespread vaccination is unknown. METHODS This study examined data from the Veterans Health Administration (VA) from 1 January 2018 through 28 February 2022 and identified patients with screening or diagnostic procedures or new cancer diagnoses for the four most common cancers in the VA health system: prostate, lung, colorectal, and bladder cancers. Monthly procedures and new diagnoses were calculated, and the pre-COVID era (January 2018 to February 2020) was compared with the COVID era (March 2020 to February 2022). RESULTS The study identified 2.5 million patients who underwent a diagnostic or screening procedure related to the four cancers. A new cancer was diagnosed for 317,833 patients. During the first 2 years of the pandemic, VA medical centers performed 13,022 fewer prostate biopsies, 32,348 fewer cystoscopies, and 200,710 fewer colonoscopies than in 2018-2019. These persistent deficits added a cumulative deficit of nearly 19,000 undiagnosed prostate cancers and 3300 to 3700 undiagnosed cancers each for lung, colon, and bladder. Decreased diagnostic and screening procedures correlated with decreased new diagnoses of cancer, particularly cancer of the prostate (R = 0.44) and bladder (R = 0.27). CONCLUSION Disruptions in new diagnoses of four common cancers (prostate, lung, bladder, and colorectal) seen early in the COVID-19 pandemic have persisted for 2 years. Although reductions improved from the early pandemic, new reductions during the Delta and Omicron waves demonstrate the continued impact of the COVID-19 pandemic on cancer care.
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Affiliation(s)
- Brian R Englum
- Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Shalini Sahoo
- Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Minerva Mayorga-Carlin
- Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
- Surgery Service, Veterans Affairs Medical Center, Baltimore, MD, USA
| | - Hilary Hayssen
- Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Tariq Siddiqui
- Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
- Surgery Service, Veterans Affairs Medical Center, Baltimore, MD, USA
| | - Douglas J Turner
- Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
- Surgery Service, Veterans Affairs Medical Center, Baltimore, MD, USA
| | - John D Sorkin
- Geriatrics Research, Education, and Clinical Center, Veterans Affairs Medical Center, Baltimore, MD, USA
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Brajesh K Lal
- Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA.
- Surgery Service, Veterans Affairs Medical Center, Baltimore, MD, USA.
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Kaur B, Yeo YH, Liang J, Luu M, Ayoub W, Kuo A, Trivedi H, Sankar K, Gong J, Hendifar A, Osipov A, Kosari K, Nissen N, Noureddin M, Singal AG, Yang JD. COVID-19 Pandemic Impact on Diagnosis, Stage, and Treatment of Hepatocellular Carcinoma in the United States. GASTRO HEP ADVANCES 2023; 3:230-237. [PMID: 39129956 PMCID: PMC11308067 DOI: 10.1016/j.gastha.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 11/16/2023] [Indexed: 08/13/2024]
Abstract
Background and Aims The change in hepatocellular carcinoma (HCC) care continuum during the coronavirus disease 2019 (COVID-19) pandemic remains unknown at a national level in the United States. We sought to determine the impact of the pandemic on incident HCC cases, clinical characteristics, and treatment in the United States. Methods Using the National Cancer Database, we analyzed incident HCC cases from 2010 to 2020. The incidence rate was calculated using the population data for each year from the census bureau. Joinpoint regression analysis was applied for trend analysis, and a polynomial regression model estimated the number of projected HCC cases in 2020 according to the trend of rates from 2010 to 2019. The distribution of cancer stage and treatment modality were assessed. Results The pandemic led to a significant reduction in reported HCC cases, from 19,597 in 2019 to 16,188 in 2020. The projected number of HCC for 2020 was 19,011, corresponding to a 14.8% reduction in 2020. Extent of reduction in the number of incident HCC cases relative to estimated cases remains consistent in racial and ethnic subgroups. Despite underdiagnosis of HCC in 2020, proportion of patients with early tumor stage (30.5% for Tumour, Node, Metastasis stage 1) and curative treatment receipt (9.1% for surgical resection, 13% for ablation, 4.2% for liver transplant) for HCC remained stable in the first year of the COVID-19 pandemic. Conclusion There was a significant reduction in HCC cases in 2020 compared to pre-COVID years. While tumor stage and proportion of patients receiving curative treatment remained stable, continued follow-up is needed to assess potential changes during subsequent years.
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Affiliation(s)
- Bhupinder Kaur
- Division of Internal Medicine, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California
| | - Yee Hui Yeo
- Division of Internal Medicine, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California
- Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, California
| | - Jeff Liang
- Division of Internal Medicine, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California
| | - Michael Luu
- Biostatistics and Bioinformatics Research Center, Cedars-Sinai Medical Center, Los Angeles, California
| | - Walid Ayoub
- Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, California
| | - Alexander Kuo
- Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, California
| | - Hirsh Trivedi
- Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, California
| | - Kamya Sankar
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Jun Gong
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Andrew Hendifar
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Arsen Osipov
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Kambiz Kosari
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California
- Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California
| | - Nicholas Nissen
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California
- Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California
| | - Mazen Noureddin
- Department of Medicine, Houston Methodist Lynda K. & David M. Underwood Center for Digestive Disorder, Houston, Texas
| | - Amit G. Singal
- Division of Digestive and Liver Diseases, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas
- Department of Population & Data Sciences, UT Southwestern Medical Center, Dallas, Texas
| | - Ju Dong Yang
- Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, California
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California
- Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California
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Alexandrou G, Mantikas KT, Allsopp R, Yapeter CA, Jahin M, Melnick T, Ali S, Coombes RC, Toumazou C, Shaw JA, Kalofonou M. The Evolution of Affordable Technologies in Liquid Biopsy Diagnostics: The Key to Clinical Implementation. Cancers (Basel) 2023; 15:5434. [PMID: 38001698 PMCID: PMC10670715 DOI: 10.3390/cancers15225434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/01/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023] Open
Abstract
Cancer remains a leading cause of death worldwide, despite many advances in diagnosis and treatment. Precision medicine has been a key area of focus, with research providing insights and progress in helping to lower cancer mortality through better patient stratification for therapies and more precise diagnostic techniques. However, unequal access to cancer care is still a global concern, with many patients having limited access to diagnostic tests and treatment regimens. Noninvasive liquid biopsy (LB) technology can determine tumour-specific molecular alterations in peripheral samples. This allows clinicians to infer knowledge at a DNA or cellular level, which can be used to screen individuals with high cancer risk, personalize treatments, monitor treatment response, and detect metastasis early. As scientific understanding of cancer pathology increases, LB technologies that utilize circulating tumour DNA (ctDNA) and circulating tumour cells (CTCs) have evolved over the course of research. These technologies incorporate tumour-specific markers into molecular testing platforms. For clinical translation and maximum patient benefit at a wider scale, the accuracy, accessibility, and affordability of LB tests need to be prioritized and compared with gold standard methodologies in current use. In this review, we highlight the range of technologies in LB diagnostics and discuss the future prospects of LB through the anticipated evolution of current technologies and the integration of emerging and novel ones. This could potentially allow a more cost-effective model of cancer care to be widely adopted.
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Affiliation(s)
- George Alexandrou
- Centre For Bio-Inspired Technology, Department of Electrical & Electronic Engineering, Imperial College London, London SW7 2BT, UK; (K.-T.M.); (C.A.Y.); (M.J.); (T.M.); (C.T.)
| | - Katerina-Theresa Mantikas
- Centre For Bio-Inspired Technology, Department of Electrical & Electronic Engineering, Imperial College London, London SW7 2BT, UK; (K.-T.M.); (C.A.Y.); (M.J.); (T.M.); (C.T.)
| | - Rebecca Allsopp
- Leicester Cancer Research Centre, Department of Genetics and Genome Biology, University of Leicester, Leicester LE2 7LX, UK; (R.A.); (J.A.S.)
| | - Calista Adele Yapeter
- Centre For Bio-Inspired Technology, Department of Electrical & Electronic Engineering, Imperial College London, London SW7 2BT, UK; (K.-T.M.); (C.A.Y.); (M.J.); (T.M.); (C.T.)
| | - Myesha Jahin
- Centre For Bio-Inspired Technology, Department of Electrical & Electronic Engineering, Imperial College London, London SW7 2BT, UK; (K.-T.M.); (C.A.Y.); (M.J.); (T.M.); (C.T.)
| | - Taryn Melnick
- Centre For Bio-Inspired Technology, Department of Electrical & Electronic Engineering, Imperial College London, London SW7 2BT, UK; (K.-T.M.); (C.A.Y.); (M.J.); (T.M.); (C.T.)
| | - Simak Ali
- Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK; (S.A.); (R.C.C.)
| | - R. Charles Coombes
- Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK; (S.A.); (R.C.C.)
| | - Christofer Toumazou
- Centre For Bio-Inspired Technology, Department of Electrical & Electronic Engineering, Imperial College London, London SW7 2BT, UK; (K.-T.M.); (C.A.Y.); (M.J.); (T.M.); (C.T.)
| | - Jacqueline A. Shaw
- Leicester Cancer Research Centre, Department of Genetics and Genome Biology, University of Leicester, Leicester LE2 7LX, UK; (R.A.); (J.A.S.)
| | - Melpomeni Kalofonou
- Centre For Bio-Inspired Technology, Department of Electrical & Electronic Engineering, Imperial College London, London SW7 2BT, UK; (K.-T.M.); (C.A.Y.); (M.J.); (T.M.); (C.T.)
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Sobhani N, Mondani G, Roviello G, Catalano M, Sirico M, D'Angelo A, Scaggiante B, Generali D. Cancer management during the COVID-19 world pandemic. Cancer Immunol Immunother 2023; 72:3427-3444. [PMID: 37642709 DOI: 10.1007/s00262-023-03524-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 08/10/2023] [Indexed: 08/31/2023]
Abstract
Since 2019, the world has been experiencing an outbreak of a novel beta-coronavirus, severe acute respiratory syndrome coronavirus (SARS-CoV)-2. The worldwide spread of this virus has been a severe challenge for public health, and the World Health Organization declared the outbreak a public health emergency of international concern. As of June 8, 2023, the virus' rapid spread had caused over 767 million infections and more than 6.94 million deaths worldwide. Unlike previous SARS-CoV-1 and Middle East respiratory syndrome coronavirus outbreaks, the COVID-19 outbreak has led to a high death rate in infected patients; this has been caused by multiorgan failure, which might be due to the widespread presence of angiotensin-converting enzyme 2 (ACE2) receptors-functional receptors of SARS-CoV-2-in multiple organs. Patients with cancer may be particularly susceptible to COVID-19 because cancer treatments (e.g., chemotherapy, immunotherapy) suppress the immune system. Thus, patients with cancer and COVID-19 may have a poor prognosis. Knowing how to manage the treatment of patients with cancer who may be infected with SARS-CoV-2 is essential. Treatment decisions must be made on a case-by-case basis, and patient stratification is necessary during COVID-19 outbreaks. Here, we review the management of COVID-19 in patients with cancer and focus on the measures that should be adopted for these patients on the basis of the organs or tissues affected by cancer and by the tumor stage.
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Affiliation(s)
- Navid Sobhani
- Department of Medicine, Section of Epidemiology and Population Sciences, Baylor College of Medicine, Houston, TX, 77030, USA.
| | - Giuseppina Mondani
- Royal Infirmary Hospital, Foresterhill Health Campus, Foresterhill Rd, Aberdeen, AB25 2ZN, UK
| | - Giandomenico Roviello
- Department of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Florence, Florence, Italy
| | - Martina Catalano
- Royal Infirmary Hospital, Foresterhill Health Campus, Foresterhill Rd, Aberdeen, AB25 2ZN, UK
| | - Marianna Sirico
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via P. Maroncelli 40, 47014, Meldola, Italy
| | - Alberto D'Angelo
- Department of Biology and Biochemistry, University of Bath, Bath, BA2 7AX, UK
| | - Bruna Scaggiante
- Department of Life Sciences, University of Trieste, 34127, Trieste, Italy
| | - Daniele Generali
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34127, Trieste, Italy
- Multidisciplinary Unit of Breast Pathology and Translational Research, Cremona Hospital, 26100, Cremona, Italy
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Chtourou A, Sanchez PV, Golden T, Chen HS, Schwartz SM, Wu XC, Hernandez BY, Harrison JN, Penberthy L, Negoita S. Impact on the Volume of Pathology Reports Before and During the COVID-19 Pandemic in SEER Cancer Registries. Cancer Epidemiol Biomarkers Prev 2023; 32:1591-1598. [PMID: 37594474 PMCID: PMC10618747 DOI: 10.1158/1055-9965.epi-23-0066] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 05/02/2023] [Accepted: 08/16/2023] [Indexed: 08/19/2023] Open
Abstract
INTRODUCTION Health care procedures including cancer screening and diagnosis were interrupted due to the COVID-19 pandemic. The extent of this impact on cancer care in the United States is not fully understood. We investigated pathology report volume as a reflection of trends in oncology services pre-pandemic and during the pandemic. METHODS Electronic pathology reports were obtained from 11 U.S. central cancer registries from NCI's SEER Program. The reports were sorted by cancer site and document type using a validated algorithm. Joinpoint regression was used to model temporal trends from January 2018 to February 2020, project expected counts from March 2020 to February 2021 and calculate observed-to-expected ratios. Results were stratified by sex, age, cancer site, and report type. RESULTS During the first 3 months of the pandemic, pathology report volume decreased by 25.5% and 17.4% for biopsy and surgery reports, respectively. The 12-month O/E ratio (March 2020-February 2021) was lowest for women (O/E 0.90) and patients 65 years and older (O/E 0.91) and lower for cancers with screening (melanoma skin, O/E 0.86; breast, O/E 0.88; lung O/E 0.89, prostate, O/E 0.90; colorectal, O/E 0.91) when compared with all other cancers combined. CONCLUSIONS These findings indicate a decrease in cancer diagnosis, likely due to the COVID-19 pandemic. This decrease in the number of pathology reports may result in a stage shift causing a subsequent longer-term impact on survival patterns. IMPACT Investigation on the longer-term impact of the pandemic on pathology services is vital to understand if cancer care delivery levels continue to be affected.
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Affiliation(s)
- Amina Chtourou
- Division of Cancer Control and Population Sciences, NCI, Bethesda, Maryland
| | - Pamela V. Sanchez
- Division of Cancer Control and Population Sciences, NCI, Bethesda, Maryland
| | - Todd Golden
- Division of Cancer Control and Population Sciences, NCI, Bethesda, Maryland
| | - Huann-Sheng Chen
- Division of Cancer Control and Population Sciences, NCI, Bethesda, Maryland
| | - Stephen M. Schwartz
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Xiao-Cheng Wu
- Louisiana Tumor Registry, Epidemiology Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Los Angeles
| | | | - Jovanka N. Harrison
- New York State Cancer Registry, New York State Department of Health, Albany, New York
| | - Lynne Penberthy
- Division of Cancer Control and Population Sciences, NCI, Bethesda, Maryland
| | - Serban Negoita
- Division of Cancer Control and Population Sciences, NCI, Bethesda, Maryland
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Lofters AK, Wu F, Frymire E, Kiran T, Vahabi M, Green ME, Glazier RH. Cancer Screening Disparities Before and After the COVID-19 Pandemic. JAMA Netw Open 2023; 6:e2343796. [PMID: 37983033 PMCID: PMC10660460 DOI: 10.1001/jamanetworkopen.2023.43796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 10/08/2023] [Indexed: 11/21/2023] Open
Abstract
Importance Breast, cervical, and colorectal cancer-screening disparities existed prior to the COVID-19 pandemic, and it is unclear whether those have changed since the pandemic. Objective To assess whether changes in screening from before the pandemic to after the pandemic varied for immigrants and for people with limited income. Design, Setting, and Participants This population-based, cross-sectional study, using data from March 31, 2019, and March 31, 2022, included adults in Ontario, Canada, the country's most populous province, with more than 14 million people, almost 30% of whom are immigrants. At both dates, the screening-eligible population for each cancer type was assessed. Exposures Neighborhood income quintile, immigrant status, and primary care model type. Main Outcomes and Measures For each cancer screening type, the main outcome was whether the screening-eligible population was up to date on screening (a binary outcome) on March 31, 2019, and March 31, 2022. Up to date on screening was defined as having had a mammogram in the previous 2 years, a Papanicolaou test in the previous 3 years, and a fecal test in the previous 2 years or a flexible sigmoidoscopy or colonoscopy in the previous 10 years. Results The overall cohort on March 31, 2019, included 1 666 943 women (100%) eligible for breast screening (mean [SD] age, 59.9 [5.1] years), 3 918 225 women (100%) eligible for cervical screening (mean [SD] age, 45.5 [13.2] years), and 3 886 345 people eligible for colorectal screening (51.4% female; mean [SD] age, 61.8 [6.4] years). The proportion of people up to date on screening in Ontario decreased for breast, cervical, and colorectal cancers, with the largest decrease for breast screening (from 61.1% before the pandemic to 51.7% [difference, -9.4 percentage points]) and the smallest decrease for colorectal screening (from 65.9% to 62.0% [difference, -3.9 percentage points]). Preexisting disparities in screening for people living in low-income neighborhoods and for immigrants widened for breast screening and colorectal screening. For breast screening, compared with income quintile 5 (highest), the β estimate for income quintile 1 (lowest) was -1.16 (95% CI, -1.56 to -0.77); for immigrant vs nonimmigrant, the β estimate was -1.51 (95% CI, -1.84 to -1.18). For colorectal screening, compared with income quintile 5, the β estimate for quntile 1 was -1.29 (95% CI, 16 -1.53 to -1.06); for immigrant vs nonimmigrant, the β estimate was -1.41 (95% CI, -1.61 to -1.21). The lowest screening rates both before and after the COVID-19 pandemic were for people who had no identifiable family physician (eg, moving from 11.3% in 2019 to 9.6% in 2022 up to date for breast cancer). In addition, patients of interprofessional, team-based primary care models had significantly smaller reductions in β estimates for breast (2.14 [95% CI, 1.79 to 2.49]), cervical (1.72 [95% CI, 1.46 to 1.98]), and colorectal (2.15 [95% CI, 1.95 to 2.36]) postpandemic screening and higher uptake of screening in general compared with patients of other primary care models. Conclusions and Relevance In this cross-sectional study in Ontario that included 2 time points, widening disparities before compared with after the COVID-19 pandemic were found for breast cancer and colorectal cancer screening based on income and immigrant status, but smaller declines in disparities were found among patients of interprofessional, team-based primary care models than among their counterparts. Policy makers should investigate the value of prioritizing and investing in improving access to team-based primary care for people who are immigrants and/or with limited income.
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Affiliation(s)
- Aisha K. Lofters
- Peter Gilgan Centre for Women’s Cancers, Women’s College Hospital, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- ICES Central, Toronto, Ontario, Canada
- MAP Centre for Urban Health Solutions, St Michael’s Hospital, Toronto, Ontario, Canada
| | | | - Eliot Frymire
- Health Services and Policy Research Institute, Queen’s University, Kingston, Ontario, Canada
- ICES Queen’s, Kingston, Ontario, Canada
| | - Tara Kiran
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- ICES Central, Toronto, Ontario, Canada
- MAP Centre for Urban Health Solutions, St Michael’s Hospital, Toronto, Ontario, Canada
| | - Mandana Vahabi
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Michael E. Green
- Health Services and Policy Research Institute, Queen’s University, Kingston, Ontario, Canada
- ICES Queen’s, Kingston, Ontario, Canada
- Department of Family Medicine, Queen’s University, Kingston, Ontario, Canada
| | - Richard H. Glazier
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- ICES Central, Toronto, Ontario, Canada
- MAP Centre for Urban Health Solutions, St Michael’s Hospital, Toronto, Ontario, Canada
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Chapman GC, Smrz SA, Gordon JC, Lynam SK, Strohl AE, Ferguson LA, Armstrong AJ, Zanotti KM. Gynecologic cancer care in the first year of the COVID-19 pandemic. Gynecol Oncol 2023; 178:138-144. [PMID: 37862793 DOI: 10.1016/j.ygyno.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 09/06/2023] [Accepted: 09/18/2023] [Indexed: 10/22/2023]
Abstract
OBJECTIVE To analyze the impact of the early COVID-19 pandemic on the diagnosis and initiation of treatment for patients with gynecologic cancer. METHODS Patients diagnosed with gynecologic cancer in the National Cancer Database during 2017-2020 were included. For the first aim, incidence rate ratios were calculated to compare gynecologic cancer diagnosis in the first year of the COVID-19 pandemic to the three years prior, and factors associated with a reduction in diagnosis were identified. For the second aim, patients who experienced an 8-week delay in cancer treatment were compared to those who did not. Multivariate logistic regression was used to identify factors associated with treatment delay. Propensity score analysis was utilized to compare the rate of cancer treatment delay in patients who were diagnosed with COVID-19 to those who were not. RESULTS The incidence rate ratio of being diagnosed with gynecologic cancer in 2020 versus 2017-2019 was 0.90 (95%CI 0.90-0.91). Factors associated with increased risk of missed or delayed diagnosis in 2020 included cervical cancer, earlier cancer stage, younger age, lower levels of medical comorbidity, and lack of health insurance. In 2020, factors associated with treatment delay included COVID-19 diagnosis (aOR 1.50, 95%CI 1.35-1.67), in addition to race and ethnicity, insurance type, comorbidity, cancer stage, and primary site. The risk of treatment delay remained significantly elevated in patients diagnosed with COVID-19 after propensity-score matching. CONCLUSIONS Gynecologic cancer diagnosis and timely provision of care were negatively impacted during the first year of the COVID-19 pandemic, with certain subgroups at elevated risk.
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Affiliation(s)
- Graham C Chapman
- University Hospitals Cleveland Medical Center, Case Comprehensive Cancer Center, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology. 11000 Euclid Ave, Cleveland, OH 44106, USA.
| | - Stacy A Smrz
- University Hospitals Cleveland Medical Center, Case Comprehensive Cancer Center, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology. 11000 Euclid Ave, Cleveland, OH 44106, USA
| | - Jennifer C Gordon
- University Hospitals Cleveland Medical Center, Case Comprehensive Cancer Center, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology. 11000 Euclid Ave, Cleveland, OH 44106, USA
| | - Sarah K Lynam
- University Hospitals Cleveland Medical Center, Case Comprehensive Cancer Center, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology. 11000 Euclid Ave, Cleveland, OH 44106, USA
| | - Anna E Strohl
- University Hospitals Cleveland Medical Center, Case Comprehensive Cancer Center, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology. 11000 Euclid Ave, Cleveland, OH 44106, USA
| | - Lindsay A Ferguson
- University Hospitals Cleveland Medical Center, Case Comprehensive Cancer Center, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology. 11000 Euclid Ave, Cleveland, OH 44106, USA
| | - Amy J Armstrong
- University Hospitals Cleveland Medical Center, Case Comprehensive Cancer Center, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology. 11000 Euclid Ave, Cleveland, OH 44106, USA
| | - Kristine M Zanotti
- University Hospitals Cleveland Medical Center, Case Comprehensive Cancer Center, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology. 11000 Euclid Ave, Cleveland, OH 44106, USA
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de Oliveira RP, de Moraes PHR, Drummond-Lage AP. Impact of the SARS-CoV-2 on the journey of high-risk colon cancer patients within the scope of the Unified Health System in Brazil. BMC Health Serv Res 2023; 23:1102. [PMID: 37845707 PMCID: PMC10580526 DOI: 10.1186/s12913-023-10083-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 09/28/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Colon cancer is an important cause of mortality related to cancer. During the COVID-19 pandemic, an important reallotment of assistance resources was necessary to tackle the crisis, directly impacting medical practice all over the globe. OBJECTIVE To assess the impact of the Sars-Cov-2 pandemic on the time between diagnosis and the beginning of systemic treatment in patients diagnosed with high-risk colon neoplasia. METHODS This is a retrospective study based on the analysis of medical records of patients diagnosed with colon neoplasia who required systemic treatment and were treated between March 2019 and March 2022, in a reference Oncology unit of the Brazilian Unified Health System. The study's population was divided into two groups: (I) Pre-COVID-19: diagnoses made between March 2019 and February 2020, (II) COVID-19: diagnoses made between March 2020 and March 2022. RESULTS The sample consisted of 228 patients, 108 (47.97%) of whom were diagnosed during pre-COVID-19 and 118 (52.21%) diagnosed during the two years-period of COVID-19. Regarding the time between colonoscopy and surgery, the time between surgery and first consultation in clinical oncology, and the time between requesting and beginning of systemic treatment, a statistically significant reduction was observed during the COVID-19 period. CONCLUSION A decrease in time between diagnosis and systemic treatment of patients with colorectal cancer during the COVID-19 pandemic was observed. Yet, even with this improvement, the time to begin treatment remains greater than the recommended by the current guidelines, regardless of the time of diagnosis (before or after the pandemic), which negatively impacts the disease outcome.
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Affiliation(s)
- Raquel Pucci de Oliveira
- Faculdade Ciências Médicas de Minas Gerais, Alameda Ezequiel Dias 275, Belo Horizonte, 30.130.110, Brazil
| | | | - Ana Paula Drummond-Lage
- Faculdade Ciências Médicas de Minas Gerais, Alameda Ezequiel Dias 275, Belo Horizonte, 30.130.110, Brazil.
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Tudor C, Sova RA. Mining Google Trends data for nowcasting and forecasting colorectal cancer (CRC) prevalence. PeerJ Comput Sci 2023; 9:e1518. [PMID: 37869464 PMCID: PMC10588692 DOI: 10.7717/peerj-cs.1518] [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: 03/13/2023] [Accepted: 07/14/2023] [Indexed: 10/24/2023]
Abstract
Background Colorectal cancer (CRC) is the third most prevalent and second most lethal form of cancer in the world. Consequently, CRC cancer prevalence projections are essential for assessing the future burden of the disease, planning resource allocation, and developing service delivery strategies, as well as for grasping the shifting environment of cancer risk factors. However, unlike cancer incidence and mortality rates, national and international agencies do not routinely issue projections for cancer prevalence. Moreover, the limited or even nonexistent cancer statistics for large portions of the world, along with the high heterogeneity among world nations, further complicate the task of producing timely and accurate CRC prevalence projections. In this situation, population interest, as shown by Internet searches, can be very important for improving cancer statistics and, in the long run, for helping cancer research. Methods This study aims to model, nowcast and forecast the CRC prevalence at the global level using a three-step framework that incorporates three well-established univariate statistical and machine-learning models. First, data mining is performed to evaluate the relevancy of Google Trends (GT) data as a surrogate for the number of CRC survivors. The results demonstrate that population web-search interest in the term "colonoscopy" is the most reliable indicator to nowcast CRC disease prevalence. Then, various statistical and machine-learning models, including ARIMA, ETS, and FNNAR, are trained and tested using relevant GT time series. Finally, the updated monthly query series spanning 2004-2022 and the best forecasting model in terms of out-of-sample forecasting ability (i.e., the neural network autoregression) are utilized to generate point forecasts up to 2025. Results Results show that the number of people with colorectal cancer will continue to rise over the next 24 months. This in turn emphasizes the urgency for public policies aimed at reducing the population's exposure to the principal modifiable risk factors, such as lifestyle and nutrition. In addition, given the major drop in population interest in CRC during the first wave of the COVID-19 pandemic, the findings suggest that public health authorities should implement measures to increase cancer screening rates during pandemics. This in turn would deliver positive externalities, including the mitigation of the global burden and the enhancement of the quality of official statistics.
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Affiliation(s)
- Cristiana Tudor
- Bucharest University of Economic Studies, Bucharest, Romania
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Donovan CA, Kaufman CS, Thomas KA, Polat AK, Thomas M, Mack B, Gilbert A, Sarantou T. Timeliness of Breast Diagnostic Imaging and Biopsy in Practice: 15 Years of Collecting, Comparing, and Defining Quality Breast Cancer Care. Ann Surg Oncol 2023; 30:6070-6078. [PMID: 37528305 PMCID: PMC10495489 DOI: 10.1245/s10434-023-13905-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 06/23/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND The literature lacks well-established benchmarks for expected time between screening mammogram to diagnostic imaging and then to core needle breast biopsy. METHODS Timeliness of diagnostic imaging workup was evaluated using aggregate data from 2005 to 2019 submitted to The National Quality Measures for Breast Centers (NQMBC). RESULTS A total of 419 breast centers submitted data for 1,805,515 patients on the time from screening mammogram to diagnostic imaging. The overall time was 7 days with 75th, 25th, and 10th percentile values of 5, 10, and 13.5 days, respectively. The average time in business days decreased from 9.1 to 7.1 days (p < 0.001) over the study period with the greatest gains in poorest-performing quartiles. Screening centers and centers in the Midwest had significantly shorter time to diagnostic imaging. Time from diagnostic imaging to core needle biopsy was submitted by 406 facilities representing 386,077 patients. The average time was 6 business days, with 75th, 25th, and 10th percentiles of 4, 9, and 13.7 days, respectively. Time to biopsy improved from a mean of 9.0 to 6.3 days (p < 0.001) with the most improvement in the poorest-performing quartiles. Screening centers, centers in the Midwest, and centers in metropolitan areas had significantly shorter time to biopsy. CONCLUSIONS In a robust dataset, the time from screening mammogram to diagnostic imaging and from diagnostic imaging to biopsy decreased from 2005 to 2019. On average, patients could expect to have diagnostic imaging and biopsies within 1 week of abnormal results. Monitoring and comparing performance with reported data may improve quality in breast care.
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Affiliation(s)
| | - Cary S Kaufman
- Department of Surgery, Bellingham Regional Breast Center, University of Washington, Bellingham, WA, USA
| | - Kari A Thomas
- Pacific Imaging Associates, Legacy Good Samaritan Breast Health Center, Portland, OR, USA
| | | | - Marguerite Thomas
- Oncology Program, Penrose-St Francis Cancer Center, Colorado Springs, CO, USA
| | - Bonnie Mack
- The Breast Center at Portsmouth Regional Hospital, Portsmouth, NH, USA
| | - Ariel Gilbert
- National Consortium of Breast Centers, Warsaw, IN, USA
| | - Terry Sarantou
- Levine Cancer Institute, Atrium Health, Charlotte, NC, USA
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Fornacon-Wood I, Banfill K, Ahmad S, Britten A, Carson C, Dorey N, Hatton M, Hiley C, Thippu Jayaprakash K, Jegannathen A, Kidd AC, Koh P, Panakis N, Peedell C, Peters A, Pope A, Powell C, Stilwell C, Thomas B, Toy E, Wicks K, Wood V, Yahya S, Price G, Faivre-Finn C. Impact of the COVID-19 Pandemic on Outcomes for Patients with Lung Cancer Receiving Curative-intent Radiotherapy in the UK. Clin Oncol (R Coll Radiol) 2023; 35:e593-e600. [PMID: 37507280 DOI: 10.1016/j.clon.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 06/13/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023]
Abstract
AIMS Previous work found that during the first wave of the COVID-19 pandemic, 34% of patients with lung cancer treated with curative-intent radiotherapy in the UK had a change to their centre's usual standard of care treatment (Banfill et al. Clin Oncol 2022;34:19-27). We present the impact of these changes on patient outcomes. MATERIALS AND METHODS The COVID-RT Lung database was a prospective multicentre UK cohort study including patients with stage I-III lung cancer referred for and/or treated with radical radiotherapy between April and October 2020. Data were collected on patient demographics, radiotherapy and systemic treatments, toxicity, relapse and death. Multivariable Cox and logistic regression were used to assess the impact of having a change to radiotherapy on survival, distant relapse and grade ≥3 acute toxicity. The impact of omitting chemotherapy on survival and relapse was assessed using multivariable Cox regression. RESULTS Patient and follow-up forms were available for 1280 patients. Seven hundred and sixty-five (59.8%) patients were aged over 70 years and 603 (47.1%) were female. The median follow-up was 213 days (119, 376). Patients with stage I-II non-small cell lung cancer (NSCLC) who had a change to their radiotherapy had no significant increase in distant relapse (P = 0.859) or death (P = 0.884); however, they did have increased odds of grade ≥3 acute toxicity (P = 0.0348). Patients with stage III NSCLC who had a change to their radiotherapy had no significant increase in distant relapse (P = 0.216) or death (P = 0.789); however, they did have increased odds of grade ≥3 acute toxicity (P < 0.001). Patients with stage III NSCLC who had their chemotherapy omitted had no significant increase in distant relapse (P = 0.0827) or death (P = 0.0661). CONCLUSION This study suggests that changes to radiotherapy and chemotherapy made in response to the COVID-19 pandemic did not significantly affect distant relapse or survival. Changes to radiotherapy, namely increased hypofractionation, led to increased odds of grade ≥3 acute toxicity. These results are important, as hypofractionated treatments can help to reduce hospital attendances in the context of potential future emergency situations.
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Affiliation(s)
| | - K Banfill
- University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK
| | - S Ahmad
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - A Britten
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - C Carson
- The Northern Ireland Cancer Centre, Belfast, UK
| | - N Dorey
- Torbay and South Devon NHS Foundation Trust, Torquay, UK
| | - M Hatton
- Weston Park Hospital, Sheffield, UK
| | - C Hiley
- University College London Hospitals, London, UK
| | - K Thippu Jayaprakash
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - A Jegannathen
- University Hospitals North Midlands, Stoke on Trent, UK
| | | | - P Koh
- Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - N Panakis
- Oxford University Hospitals NHS Trust, Oxford, UK
| | - C Peedell
- The James Cook University Hospital, Middlesborough, UK
| | - A Peters
- Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - A Pope
- Clatterbridge Cancer Centre, Liverpool, UK
| | - C Powell
- Velindre Cancer Centre, Cardiff, UK
| | | | - B Thomas
- Swansea Bay University Hospital, Swansea, UK
| | - E Toy
- Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - K Wicks
- University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK
| | - V Wood
- University Hospitals Southampton NHS Foundation Trust, Southampton, UK
| | - S Yahya
- University Hospitals Birmingham, Birmingham, UK
| | - G Price
- University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK
| | - C Faivre-Finn
- University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK
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Gremke N, Griewing S, Bausch E, Alymova S, Wagner U, Kostev K, Kalder M. Therapy delay due to COVID-19 pandemic among European women with breast cancer: prevalence and associated factors. J Cancer Res Clin Oncol 2023; 149:11749-11757. [PMID: 37405476 PMCID: PMC10465653 DOI: 10.1007/s00432-023-05065-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 06/29/2023] [Indexed: 07/06/2023]
Abstract
PURPOSE This study investigates the impact of the COVID-19 pandemic on breast cancer (BC) care, analyzing treatment delays and factors associated with them. METHODS This retrospective cross-sectional study analyzed data from the Oncology Dynamics (OD) database. Surveys of 26,933 women with BC performed between January 2021 and December 2022 in Germany, France, Italy, the United Kingdom, and Spain were examined. The study focused on determining the prevalence of treatment delays due to the COVID-19 pandemic, considering factors such as country, age group, treating facility, hormone receptor status, tumor stage, site of metastases, and Eastern Cooperative Oncology Group (ECOG) status. Baseline and clinical characteristics were compared for patients with and without therapy delay using chi-squared tests, and a multivariable logistic regression analysis was conducted to explore the association between demographic and clinical variables and therapy delay. RESULTS The present study found that most therapy delays lasted less than 3 months (2.4%). Factors associated with higher risk of delay included being bedridden (OR 3.62; 95% CI 2.51-5.21), receiving neoadjuvant therapy (OR 1.79; 95% CI 1.43-2.24) compared to adjuvant therapy, being treated in Italy (OR 1.58; 95% CI 1.17-2.15) compared to Germany or treatment in general hospitals and non-academic cancer facilities (OR 1.66, 95% CI 1.13-2.44 and OR 1.54; 95% CI 1.14-2.09, respectively) compared to treatment by office-based physicians. CONCLUSION Addressing factors associated with therapy delays, such as patient performance status, treatment settings, and geographic location, can help guide strategies for improved BC care delivery in the future.
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Affiliation(s)
- Niklas Gremke
- Department of Gynecology and Obstetrics, University Hospital Marburg, Philipps-University Marburg, Baldingerstraße, 35043, Marburg, Germany.
- Institute of Molecular Oncology, Philipps-University Marburg, Hans-Meerwein-Straße 3, 35043, Marburg, Germany.
| | - Sebastian Griewing
- Department of Gynecology and Obstetrics, University Hospital Marburg, Philipps-University Marburg, Baldingerstraße, 35043, Marburg, Germany
| | - Elena Bausch
- Real World Solutions, IQVIA, Unterschweinstiege 2-14, 60549, Frankfurt, Germany
| | - Svetlana Alymova
- Real World Solutions, IQVIA, Unterschweinstiege 2-14, 60549, Frankfurt, Germany
| | - Uwe Wagner
- Department of Gynecology and Obstetrics, University Hospital Marburg, Philipps-University Marburg, Baldingerstraße, 35043, Marburg, Germany
| | - Karel Kostev
- IQVIA, Unterschweinstiege 2-14, 60549, Frankfurt, Germany
| | - Matthias Kalder
- Department of Gynecology and Obstetrics, University Hospital Marburg, Philipps-University Marburg, Baldingerstraße, 35043, Marburg, Germany
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Mostafavi Zadeh SM, Tajik F, Gheytanchi E, Kiani J, Ghods R, Madjd Z. COVID-19 pandemic impact on screening and diagnosis of prostate cancer: a systematic review. BMJ Support Palliat Care 2023:spcare-2023-004310. [PMID: 37748857 DOI: 10.1136/spcare-2023-004310] [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: 04/04/2023] [Accepted: 09/06/2023] [Indexed: 09/27/2023]
Abstract
INTRODUCTION The healthcare level has been greatly affected by the COVID-19 pandemic compared with before the outbreak. This study aimed to review the impact of COVID-19 on the screening and diagnosis of prostate cancer (PCa). METHOD The current study was designed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020. The keywords used to perform the search strategy were COVID-19 and prostate neoplasms. The four primary electronic databases comprising PubMed/MEDLINE, Web of Science, Scopus and Embase were searched until 1 September 2022. After screening and selecting studies through the EndNote software, data were extracted from each included study by two independent authors. All studies were evaluated according to Newcastle-Ottawa Scale quality assessment tool. RESULTS As a result, 40 studies were included, categorised into two subjects. The majority of studies indicated a significant decrease in screening prostate-specific antibody tests during the COVID-19 pandemic compared with the pre-pandemic period, leading to delays in cancer diagnosis. The decrease in the number of diagnosed cases with low/intermediate stages to some extent was more than those with advanced stages. The PCa screening and diagnosis reduction ranged from nearly 0% to 78% and from 4.1% to 71.7%, respectively. CONCLUSION Our findings showed that during the COVID-19 lockdown, delays in PCa screening tests and diagnoses led to the negative health effects on patients with PCa. Thus, it is highly recommended performing regular cancer screening to reduce the impact of the COVID-19 lockdown. PROSPERO REGISTRATION NUMBER CRD42021291656.
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Affiliation(s)
- Seyed Mostafa Mostafavi Zadeh
- Oncopathology Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Molecular Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Tajik
- Oncopathology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Elmira Gheytanchi
- Oncopathology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Jafar Kiani
- Oncopathology Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Molecular Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Roya Ghods
- Oncopathology Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Molecular Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Madjd
- Oncopathology Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Molecular Medicine, Iran University of Medical Sciences, Tehran, Iran
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Bogaert B, Kozlakidis Z, Caboux E, Péron J, Saintingy P. What went right during the COVID crisis: The capabilities of local actors and lasting innovations in oncology care and research. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002366. [PMID: 37747872 PMCID: PMC10519589 DOI: 10.1371/journal.pgph.0002366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 08/16/2023] [Indexed: 09/27/2023]
Abstract
This article will elaborate how oncology care and research was adapted during the COVID pandemic in the Metropole of Lyon (France), including the lasting innovations that came out of the crisis. The research method involved 22 semi-structured qualitative interviews of healthcare professionals, managers, and researchers in the Lyon, France region coming from both public and private academic hospitals. The interviews took place from February 2021-December 2022 in order to assess the long-term adaptations and innovations in cancer care organization in the post-COVID era. The main results show adaptations and innovations in 1) new processes and resources to facilitate disciplinary and interdisciplinary work; 2) harmonization and streamlining of patient journeys. In the discussion section, we will mobilize the capabilities approach, an interdisciplinary social sciences approach that focuses on the capabilities of persons to be and to do, to elaborate the conditions by which local actors were able to be agile, to adapt and to innovate in spite of the healthcare emergency and in coherence with their professional and personal values.
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Affiliation(s)
- Brenda Bogaert
- Department of Social Sciences and Humanities, Centre Léon Bérard, Lyon, France and Institut des Humanités en Médecine, UNIL/CHUV, Lausanne, Switzerland
| | - Zisis Kozlakidis
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Elodie Caboux
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Julien Péron
- Department of Medical Oncology and Research Center on Healthcare Performance (RESHAPE) INSERM U1290, Hospices Civils de Lyon, Pierre-Benite, France
| | - Pierre Saintingy
- Department of Medical Oncology, Centre Léon Bérard and Claude Bernard Lyon 1 University, INSERM 1052, CNRS 5286, Cancer Research Center of Lyon, Lyon, France
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Piletska N. International survey of cytopathology training during the pandemic: Water under the bridge? Cytopathology 2023; 34:433-441. [PMID: 37377122 DOI: 10.1111/cyt.13262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 04/16/2023] [Accepted: 06/03/2023] [Indexed: 06/29/2023]
Abstract
The purpose of this study was to assess the impact of the COVID-19 pandemic on cytopathology training at an international level. An anonymous online questionnaire was distributed by members of the international cytopathological community to medical practitioners in cytopathology. The survey explored perceived changes in cytology workload and workflow during the pandemic, and its effect on both non-cervical and cervical cytology reporting and teaching. A total of 82 responses were received from seven countries. Approximately half of the respondents reported a decrease in the number and range of cytology cases during the pandemic. Nearly half (47%) saw a reduction in the opportunity to co-report with consultants/attendings, and 72% of the respondents reported that their consultants/attendings were working remotely during the pandemic. Another 34% of the respondents were redeployed for 3 weeks to 1 year, with 96% stating that this period was only partially compensated for during their training, if at all. The pandemic negatively affected the opportunity to report cervical cytology, perform fine needle aspirations, and participate in multidisciplinary team meetings. Most respondents (69%) saw a decrease in the amount and quality (52%) of face-to-face departmental cytology teaching, whereas remote departmental teaching improved in amount (54%) and quality (49%). Almost half (49%) reported that cytology teaching in the regional, national, and international settings increased in both amount and quality. The pandemic catalysed many changes in cytopathology training, affecting the trainees' exposure to cases, the use of remote reporting, consultant/attending working practices, redeployment, and local as well as external teaching.
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Affiliation(s)
- Nataliya Piletska
- North West London Pathology hosted at Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK
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