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Barclay NL, Pineda Moncusí M, Jödicke AM, Prieto-Alhambra D, Raventós B, Newby D, Delmestri A, Man WY, Chen X, Català M. The impact of the UK COVID-19 lockdown on the screening, diagnostics and incidence of breast, colorectal, lung and prostate cancer in the UK: a population-based cohort study. Front Oncol 2024; 14:1370862. [PMID: 38601756 PMCID: PMC11004443 DOI: 10.3389/fonc.2024.1370862] [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: 01/15/2024] [Accepted: 03/14/2024] [Indexed: 04/12/2024] Open
Abstract
Introduction The COVID-19 pandemic had collateral effects on many health systems. Cancer screening and diagnostic tests were postponed, resulting in delays in diagnosis and treatment. This study assessed the impact of the pandemic on screening, diagnostics and incidence of breast, colorectal, lung, and prostate cancer; and whether rates returned to pre-pandemic levels by December, 2021. Methods This is a cohort study of electronic health records from the United Kingdom (UK) primary care Clinical Practice Research Datalink (CPRD) GOLD database. The study included individuals registered with CPRD GOLD between January, 2017 and December, 2021, with at least 365 days of clinical history. The study focused on screening, diagnostic tests, referrals and diagnoses of first-ever breast, colorectal, lung, and prostate cancer. Incidence rates (IR) were stratified by age, sex, and region, and incidence rate ratios (IRR) were calculated to compare rates during and after lockdown with rates before lockdown. Forecasted rates were estimated using negative binomial regression models. Results Among 5,191,650 eligible participants, the first lockdown resulted in reduced screening and diagnostic tests for all cancers, which remained dramatically reduced across the whole observation period for almost all tests investigated. There were significant IRR reductions in breast (0.69 [95% CI: 0.63-0.74]), colorectal (0.74 [95% CI: 0.67-0.81]), and prostate (0.71 [95% CI: 0.66-0.78]) cancer diagnoses. IRR reductions for lung cancer were non-significant (0.92 [95% CI: 0.84-1.01]). Extrapolating to the entire UK population, an estimated 18,000 breast, 13,000 colorectal, 10,000 lung, and 21,000 prostate cancer diagnoses were missed from March, 2020 to December, 2021. Discussion The UK COVID-19 lockdown had a substantial impact on cancer screening, diagnostic tests, referrals, and diagnoses. Incidence rates remained significantly lower than pre-pandemic levels for breast and prostate cancers and associated tests by December, 2021. Delays in diagnosis are likely to have adverse consequences on cancer stage, treatment initiation, mortality rates, and years of life lost. Urgent strategies are needed to identify undiagnosed cases and address the long-term implications of delayed diagnoses.
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Affiliation(s)
- Nicola L. Barclay
- Pharmaco− and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom
| | - Marta Pineda Moncusí
- Pharmaco− and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom
| | - Annika M. Jödicke
- Pharmaco− and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom
| | - Daniel Prieto-Alhambra
- Pharmaco− and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom
- Department of Medical Informatics, Erasmus Medical Center University, Rotterdam, Netherlands
| | - Berta Raventós
- Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Danielle Newby
- Pharmaco− and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom
| | - Antonella Delmestri
- Pharmaco− and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom
| | - Wai Yi Man
- Pharmaco− and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom
| | - Xihang Chen
- Pharmaco− and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom
| | - Marti Català
- Pharmaco− and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom
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Wong SL, Johnston E, Rossell N, Malogolowkin M, Rios L, Gómez García W, Antillon-Klussmann F, Fu L, Fuentes-Alabi S, Quintero Delgado K, Ortiz Morales D, Rodriguez-Loza C, Apesoa-Varano EC, Friedrich P, Alvarez E. The Effect of COVID-19 on Oncology Care for Adolescents and Young Adults in Latin America. J Adolesc Young Adult Oncol 2024. [PMID: 38502817 DOI: 10.1089/jayao.2023.0140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024] Open
Abstract
Children with cancer in low- and middle-income countries were disproportionately impacted by the COVID-19 pandemic, but little is known about how adolescents and young adults (AYAs) with cancer were affected. Sixty-seven physicians and nonphysician providers were interviewed about their experiences caring for AYAs with cancer in Latin America. Quotes related to the COVID-19 pandemic were identified and grouped into themes. Barriers from the COVID-19 pandemic included limited space, restrictions on travel, reduced funding, limited staff, limited services, and changes to treatment. However, improvements to care that arose from the COVID-19 pandemic included better access to distance learning and telemedicine.
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Affiliation(s)
- Samantha L Wong
- School of Medicine, University of California Davis, Sacramento, California, USA
| | - Emily Johnston
- Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Institute for Cancer Outcomes and Survivorship, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Nuria Rossell
- Independent Medical Anthropology Researcher, San Salvador, El Salvador
| | - Marcio Malogolowkin
- Division of Pediatric Hematology and Oncology, Davis School of Medicine, University of California, Sacramento, California, USA
| | - Ligia Rios
- Department of Pediatrics, Unidad de Oncología Pediátrica y del Adolescente, Hospital Nacional Edgardo Rebagliati Martins, Lima, Perú
| | - Wendy Gómez García
- Department of Oncology, Dr. Robert Reid Cabral Children's Hospital, Santo Domingo, Dominican Republic
- National Cancer Institute, INCART, Santo Domingo, Dominican Republic
| | - Federico Antillon-Klussmann
- Department of Hematology/Oncology, Unidad Nacional de Oncología Pediátrica, Guatemala City, Guatemala
- School of Medicine, Francisco Marroquín University, Guatemala City, Guatemala
| | - Ligia Fu
- Department of Pediatrics, Hospital Escuela, Tegucigalpa, Honduras
| | - Soad Fuentes-Alabi
- Department of Pediatric Oncology, National Program for Childhood Cancer, Ayudame a Vivir Foundation/National Children's Hospital Benjamin Bloom, San Salvador, El Salvador
| | - Karina Quintero Delgado
- Department of Pediatrics, Hospital del Niño Dr. José Renán Esquivel, Oncología, Panama City, Panama
| | | | - Carolina Rodriguez-Loza
- Department of Pediatric Oncology, National Program for Childhood Cancer, Ayudame a Vivir Foundation/National Children's Hospital Benjamin Bloom, San Salvador, El Salvador
| | | | - Paola Friedrich
- St. Jude Children's Research Hospital, Global Pediatric Medicine, Memphis, Tennessee, USA
| | - Elysia Alvarez
- Division of Pediatric Hematology and Oncology, Davis School of Medicine, University of California, Sacramento, California, USA
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Zucchetti G, Quarello P, Ferrari A, Silva M, Mercolini F, Sciarra P, Guido A, Peruzzi L, Colavero P, Montanaro M, Taormina R, Micheletti MV, Solari F, Perillo T, Paioli A, Canepa M, Migliozzi C, Zuliani L, Solfa V, Bertolotti M, Fagioli F. How Did Adolescents With Cancer Experience the COVID-19 Pandemic? A Report From Italian Pediatric Hematology Oncology Association Centers. J Pediatr Hematol Oncol 2023; 45:e683-e688. [PMID: 37314864 DOI: 10.1097/mph.0000000000002689] [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: 10/31/2022] [Accepted: 04/04/2023] [Indexed: 06/16/2023]
Abstract
PURPOSE This study set out to evaluate the psychosocial effects of coronavirus disease 2019 (COVID-19) among adolescents with cancer, and whether these effects are significantly different among adolescents who were undergoing therapy or had completed it. MATERIALS AND METHODS The AIEOP Adolescents Working Group and the AIEOP Psychosocial Working Group adapted a questionnaire, which was completed by 214 adolescent cancer patients ( Mage =16.3 y, range: 15 to 19 y old) treated at 16 AIEOP centers in the North (38%), South (31%), and Center (31%) of Italy. RESULTS The results highlighted that fear of the virus is equally distributed among adolescent cancer patients, with patients being particularly concerned about their parents and families. The adolescents reported that had no difficulty in following individual safety measures: they used personal protective equipment and they were attentive to their own health and adhering to the rules imposed by doctors and the wider community. There are very few, limited differences between adolescents undergoing treatment (active group) and those who have completed treatment (follow-up group). The reminder of their own therapy experience triggered by the use of personal protective equipment, and the more common refusal to follow some restrictions were the only 2 behaviors by which the follow-up group differed significantly from the adolescents in the active group. CONCLUSIONS Adolescents with cancer seem to have coped well with the pandemic: although they were very afraid of the virus for themselves and their families, and had to limit their social contact, they did comply with the restrictions. Their experience of cancer probably also had a positive effect in cultivating adolescents who are more responsible and resilient in emergency situations such as the pandemic.
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Affiliation(s)
- Giulia Zucchetti
- Paediatric Oncology Division, Regina Margherita Children's Hospital, A.O.U. City of Health and Science of Turin
- Department of Public Health and Paediatric Sciences, University of Turin, Turin
| | - Paola Quarello
- Paediatric Oncology Division, Regina Margherita Children's Hospital, A.O.U. City of Health and Science of Turin
- Department of Public Health and Paediatric Sciences, University of Turin, Turin
| | - Andrea Ferrari
- Paediatric Oncology Unit, National Cancer Institute of Milan
| | - Matteo Silva
- Paediatric Oncology Unit, National Cancer Institute of Milan
| | - Federico Mercolini
- Paediatric Oncology Unit, Department of Pediatrics, Hospital of Bolzano, Bolzano
| | - Pierpaolo Sciarra
- Paediatric Haemato-Oncology Unit, Hematology Department, General Hospital of Pescara, Pescara
| | | | - Laura Peruzzi
- Paediatric Oncology Unit, A. Gemelli University Polyclinic
| | | | | | - Rino Taormina
- Paediatric Hematology and Oncology Department, ARNAS Civico, G. Di Cristina and Benfratelli Hospitals, Palermo
| | - Maria V Micheletti
- Paediatric Hematology Oncology, Bone Marrow Transplant, A.O.U of Pisa, Pisa
| | - Federica Solari
- Department of Paediatrics, University-Hospital of Parma, Parma
| | - Teresa Perillo
- Department of Pediatrics, Paediatric Hematology-Oncology Division, University of Bari, Bari
| | - Anna Paioli
- Department of Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies, IRCCS Rizzoli Orthopaedic Institute, Bologna
| | - Monica Canepa
- Department of Paediatric Hematology/Oncology-Bone Marrow Transplant Unit-Infectious Diseases, G. Gaslini Children's Research Institute, Genova
| | | | | | - Valentina Solfa
- Paediatric Hematology Oncology Unit, Department of Mother and Child, Verona, Italy
| | - Marina Bertolotti
- Paediatric Oncology Division, Regina Margherita Children's Hospital, A.O.U. City of Health and Science of Turin
- Department of Public Health and Paediatric Sciences, University of Turin, Turin
| | - Franca Fagioli
- Paediatric Oncology Division, Regina Margherita Children's Hospital, A.O.U. City of Health and Science of Turin
- Department of Public Health and Paediatric Sciences, University of Turin, Turin
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Katato GK, Sitaula P, Gupte A, Al-Antary ET. The Impact of COVID-19 on Pediatric Malignancy Diagnosis and Treatment: Never the Same but Lessons Learned. Vaccines (Basel) 2023; 11:vaccines11030667. [PMID: 36992251 DOI: 10.3390/vaccines11030667] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/07/2023] [Accepted: 03/08/2023] [Indexed: 03/18/2023] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic affected the pediatric oncology population globally. Over the course of 2 years, increasing reports have been made to better understand this entity and its pathologic complications on these patients. The pandemic has allowed healthcare providers, hospital systems, and leading oncologic societies to quickly adapt and formulate new guidelines for the effective understanding, management, and treatment of patients with pediatric malignancy.
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Affiliation(s)
- Ghadir K Katato
- Division of Hematology/Oncology, Children's Hospital of Michigan, Detroit, MI 48201, USA
- Department of Pediatrics, Central Michigan University College of Medicine, Mt Clemons, MI 48603, USA
| | - Prasiksha Sitaula
- Division of Hematology/Oncology, Children's Hospital of Michigan, Detroit, MI 48201, USA
- Department of Pediatrics, Central Michigan University College of Medicine, Mt Clemons, MI 48603, USA
| | - Avanti Gupte
- Division of Hematology/Oncology, Children's Hospital of Michigan, Detroit, MI 48201, USA
- Department of Pediatrics, Central Michigan University College of Medicine, Mt Clemons, MI 48603, USA
- Pediatric Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Barbara Ann Karmanos Cancer Center, Children's Hospital of Michigan, Detroit, MI 48201, USA
| | - Eman T Al-Antary
- Division of Hematology/Oncology, Children's Hospital of Michigan, Detroit, MI 48201, USA
- Department of Pediatrics, Central Michigan University College of Medicine, Mt Clemons, MI 48603, USA
- Pediatric Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Barbara Ann Karmanos Cancer Center, Children's Hospital of Michigan, Detroit, MI 48201, USA
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Beydoun HA, Beydoun MA, Alemu BT, Weiss J, Hossain S, Gautam RS, Zonderman AB. Determinants of COVID-19 Outcome as Predictors of Delayed Healthcare Services among Adults ≥50 Years during the Pandemic: 2006-2020 Health and Retirement Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12059. [PMID: 36231360 PMCID: PMC9566439 DOI: 10.3390/ijerph191912059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/16/2022] [Accepted: 09/21/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The coronavirus disease 19 (COVID-19) was declared a global pandemic on 11 March 2020. To date, a limited number of studies have examined the impact of this pandemic on healthcare-seeking behaviors of older populations. This longitudinal study examined personal characteristics linked to COVID-19 outcomes as predictors of self-reported delayed healthcare services attributed to this pandemic, among U.S. adults, ≥50 years of age. METHODS Secondary analyses were performed using cross-sectional data (1413 participants) and longitudinal data (2881 participants) from Health and Retirement Study (HRS) (2006-2018) linked to the 2020 HRS COVID-19 Project (57% female, mean age: 68 years). Demographic, socioeconomic, lifestyle and health characteristics were evaluated in relation to delayed overall, surgical and non-surgical healthcare services ("Since March 2020, was there any time when you needed medical or dental care, but delayed getting it, or did not get it at all?" and "What type of care did you delay") using logistic regression and Ensemble machine learning for cross-sectional data as well as mixed-effects logistic modeling for longitudinal data. RESULTS Nearly 32.7% delayed healthcare services, 5.8% delayed surgical services and 31.4% delayed non-surgical services. Being female, having a college degree or higher and 1-unit increase in depression score were key predictors of delayed healthcare services. In fully adjusted logistic models, a history of 1 or 2 cardiovascular and/or metabolic conditions (vs. none) was associated with 60-70% greater odds of delays in non-surgical services, with distinct findings for histories of hypertension, cardiovascular disease, diabetes and stroke. Ensemble machine learning predicted surgical better than overall and non-surgical healthcare delays. CONCLUSION Among older adults, sex, education and depressive symptoms are key predictors of delayed healthcare services attributed to the COVID-19 pandemic. Delays in surgical and non-surgical healthcare services may have distinct predictors, with non-surgical delays more frequently observed among individuals with a history of 1 or 2 cardiovascular and/or metabolic conditions.
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Affiliation(s)
- Hind A. Beydoun
- Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, VA 22060, USA
| | - May A. Beydoun
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging Intramural Research Program, Baltimore, MD 21225, USA
| | - Brook T. Alemu
- Health Sciences Program, School of Health Sciences, Western Carolina University, Cullowhee, NC 28723, USA
| | - Jordan Weiss
- Department of Demography, University of California Berkeley, Berkeley, CA 94720, USA
| | - Sharmin Hossain
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging Intramural Research Program, Baltimore, MD 21225, USA
| | - Rana S. Gautam
- Department of Sociology and Human Services, University of North Georgia, Dahlonega, GA 30597, USA
| | - Alan B. Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging Intramural Research Program, Baltimore, MD 21225, USA
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Carroll WL. The new reality is virtual. Pediatr Blood Cancer 2022; 69:e29774. [PMID: 35561068 DOI: 10.1002/pbc.29774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 04/25/2022] [Indexed: 11/07/2022]
Affiliation(s)
- William L Carroll
- Division of Pediatric Hematology-Oncology, Departments of Pediatrics and Pathology, Perlmutter Cancer Center, NYU-Langone Medical Center, New York, New York, USA
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