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Boyle JM, Kuryba A, Blake HA, van der Meulen J, Fearnhead NS, Braun MS, Walker K. Inequalities in the recovery of colorectal cancer services during the COVID-19 pandemic: a national population-based study. Colorectal Dis 2024; 26:486-496. [PMID: 38302858 DOI: 10.1111/codi.16887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 01/11/2024] [Indexed: 02/03/2024]
Abstract
AIM Evidence is lacking on whether there were inequalities in the recovery of colorectal cancer (CRC) services within the English National Health Service (NHS) following the COVID-19 pandemic. The aim of this study was to evaluate recovery according to patient age and socioeconomic status. METHOD Using routinely collected data, CRC patients diagnosed and treated in the English NHS were identified for two timeframes: the 'initial pandemic period' (April-June 2020) and the 'pandemic period' (April 2020-March 2022). Poisson models evaluated changes in numbers of diagnoses, major resections, adjuvant chemotherapy and neoadjuvant radiotherapy use for each timeframe, relative to the equivalent pre-pandemic timeframe (April-June 2019 and April 2018-March 2020, respectively), stratified by age and socioeconomic status. Tumour stage at presentation was evaluated over time. RESULTS Substantial deficits in diagnoses, major resections and adjuvant chemotherapy were identified in the initial pandemic period, whilst the use of neoadjuvant radiotherapy increased. Overall, these deficits recovered. Patients outside screening age, and in the most deprived group, had greater deficits in diagnoses and major resections. There was no evidence of stage migration by June 2021. CONCLUSIONS CRC services showed recovery to baseline during the pandemic. However, evident inequalities must be addressed in ongoing recovery efforts. Long-term outcomes will fully establish the impact of the pandemic on CRC patients.
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Affiliation(s)
- Jemma M Boyle
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
- Clinical Effectiveness Unit, Royal College of Surgeons of England, London, UK
| | - Angela Kuryba
- Clinical Effectiveness Unit, Royal College of Surgeons of England, London, UK
| | - Helen A Blake
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
- Clinical Effectiveness Unit, Royal College of Surgeons of England, London, UK
| | - Jan van der Meulen
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
- Clinical Effectiveness Unit, Royal College of Surgeons of England, London, UK
| | - Nicola S Fearnhead
- Department of Colorectal Surgery, Cambridge University Hospitals, Cambridge, UK
| | - Michael S Braun
- Department of Oncology, The Christie NHS Foundation Trust, Manchester, UK
- School of Medical Sciences, University of Manchester, Manchester, UK
| | - Kate Walker
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
- Clinical Effectiveness Unit, Royal College of Surgeons of England, London, UK
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Medina‐Prado L, Sala‐Miquel N, Aicart‐Ramos M, López‐Cardona J, Ponce‐Romero M, Ortíz O, Pellisé M, Aguilera L, Díez‐Redondo P, Núñez‐Rodríguez H, Seoane A, Domper‐Arnal M, Borao‐Laguna C, González‐Bernardo Ó, Suárez A, Muñoz‐Tornero M, Bustamante‐Balén M, Soutullo‐Castiñeiras C, Balleste‐Peris B, Esteban P, Jiménez‐Gómez M, Albert M, Lucas J, Valdivieso‐Cortázar E, López‐Serrano A, Solano M, Tejedor‐Tejada J, Trelles M, Zapater P, Jover R. Effect of the SARS-CoV-2 pandemic on colorectal cancer diagnosis and prognosis. Cancer Med 2024; 13:e6923. [PMID: 38491824 PMCID: PMC10943366 DOI: 10.1002/cam4.6923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 10/23/2023] [Accepted: 12/21/2023] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND AND STUDY AIMS Our aim was to determine the impact of the SARS-CoV-2 pandemic on the diagnosis and prognosis of colorectal cancer (CRC). PATIENTS AND METHODS This prospective cohort study included individuals diagnosed with CRC between March 13, 2019 and June 20, 2021 across 21 Spanish hospitals. Two time periods were compared: prepandemic (from March 13, 2019 to March 13, 2020) and pandemic (from March 14, 2020 to June 20, 2021, lockdown period and 1 year after lockdown). RESULTS We observed a 46.9% decrease in the number of CRC diagnoses (95% confidence interval (CI): 45.1%-48.7%) during the lockdown and 29.7% decrease (95% CI: 28.1%-31.4%) in the year after the lockdown. The proportion of patients diagnosed at stage I significantly decreased during the pandemic (21.7% vs. 19.0%; p = 0.025). Centers that applied universal preprocedure SARS-CoV-2 PCR testing experienced a higher reduction in the number of colonoscopies performed during the pandemic post-lockdown (34.0% reduction; 95% CI: 33.6%-34.4% vs. 13.7; 95% CI: 13.4%-13.9%) and in the number of CRCs diagnosed (34.1% reduction; 95% CI: 31.4%-36.8% vs. 26.7%; 95% CI: 24.6%-28.8%). Curative treatment was received by 87.5% of patients diagnosed with rectal cancer prepandemic and 80.7% of patients during the pandemic post-lockdown period (p = 0.002). CONCLUSIONS The COVID-19 pandemic has led to a decrease in the number of diagnosed CRC cases and in the proportion of stage I CRC. The reduction in the number of colonoscopies and CRC diagnoses was higher in centers that applied universal SARS-CoV-2 PCR screening before colonoscopy. In addition, the COVID-19 pandemic has affected curative treatment of rectal cancers.
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Affiliation(s)
- Lucía Medina‐Prado
- Servicio de Medicina Digestiva, Hospital General Universitario Dr. Balmis, Instituto de Investigación Sanitaria ISABIAL, Departamento de Medicina ClínicaUniversidad Miguel HernándezAlicanteSpain
| | - Noelia Sala‐Miquel
- Servicio de Medicina Digestiva, Hospital General Universitario Dr. Balmis, Instituto de Investigación Sanitaria ISABIAL, Departamento de Medicina ClínicaUniversidad Miguel HernándezAlicanteSpain
| | | | | | | | | | | | - Lara Aguilera
- Hospital Vall d'Hebron. Gastroenterology department vall d'Hebron Research InstituteBarcelonaSpain
| | | | | | - Agustín Seoane
- Hospital del Mar Medical Research Institute (IMIM), Gastroenterology departmentBarcelonaSpain
| | - María‐José Domper‐Arnal
- Hospital Clínico Universitario Lozano Blesa. Instituto de investigación sanitaria de Aragón (IIS Aragón)ZaragozaSpain
| | - Cristina Borao‐Laguna
- Hospital Clínico Universitario Lozano Blesa. Instituto de investigación sanitaria de Aragón (IIS Aragón)ZaragozaSpain
| | | | - Adolfo Suárez
- Hospital Universitario Central de AsturiasOviedoSpain
| | | | | | | | | | - Pilar Esteban
- Hospital Morales Meseguer. Instituto Murciano de Investigación Biosanitaria (IMIB)MuricaSpain
| | | | - Marc Albert
- Hospital Universitari de Girona Doctor Josep TruetaGironaSpain
| | - Javier Lucas
- Hospital Universitario Fundación AlcorcónAlcorconSpain
| | | | | | | | | | | | - Pedro Zapater
- Servicio de Medicina Digestiva, Hospital General Universitario Dr. Balmis, Instituto de Investigación Sanitaria ISABIAL, Departamento de Medicina ClínicaUniversidad Miguel HernándezAlicanteSpain
| | - Rodrigo Jover
- Servicio de Medicina Digestiva, Hospital General Universitario Dr. Balmis, Instituto de Investigación Sanitaria ISABIAL, Departamento de Medicina ClínicaUniversidad Miguel HernándezAlicanteSpain
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Murphy A, Lawlor A, Kirby A, Drummond FJ. A pragmatic dialogue amongst stakeholders on the impact of COVID-19 on Irish cancer patients and healthcare services and lessons learned. Support Care Cancer 2023; 32:19. [PMID: 38091145 DOI: 10.1007/s00520-023-08227-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 12/01/2023] [Indexed: 12/18/2023]
Abstract
PURPOSE COVID-19 disrupted cancer care services in Ireland, from screening and diagnostics to treatments, possibly impacting physical health outcomes owing to delayed diagnosis and treatment changes. This study explores how cancer care and patients in Ireland were affected by COVID-19 from the perspective of Irish policy, clinical and patient stakeholders using a qualitative approach. The findings could inform future strategic and implementation plans for the current challenges faced and lessons learned will be identified. METHODS A thematic analysis of a multi-stakeholder online workshop representing policy and clinical and patient stakeholders was completed. RESULTS The pandemic exasperated prior challenges including under-resourced services, access barriers, staff shortages and lack of interoperability in information technology (IT) systems. Overall, the measures implemented protected cancer patients from COVID-19; however, some groups were more vulnerable, with apparent demographic and socio-economic inequalities. Many hard-fought gains from the previous decade, in terms of cancer screening, diagnosis and survivorship, were eroded. As we transition to the peri-COVID-19 period, staff burnout, poor IT infrastructure and lack of good quality data must be addressed to minimise further disruptions and restore and enhance cancer services. CONCLUSIONS Overall, innovations and measures adopted during the pandemic protected cancer patients; however, some groups were particularly vulnerable, and inequalities may have widened further. Only proven effective and efficient innovations introduced during the pandemic should be retained and enhanced. Good quality data is needed to inform such decisions when choosing amongst them.
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Affiliation(s)
- Aileen Murphy
- Department of Economics, Cork University Business School, University College Cork, Cork, T12 CY82, Ireland.
| | - Amy Lawlor
- Department of Economics, Cork University Business School, University College Cork, Cork, T12 CY82, Ireland
| | - Ann Kirby
- Department of Economics, Cork University Business School, University College Cork, Cork, T12 CY82, Ireland
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Braicu V, Fulger L, Nelluri A, Maganti RK, Shetty USA, Verdes G, Brebu D, Dumitru C, Toma AO, Rosca O, Duta C. Three-Year Analysis of the Rectal Cancer Care Trajectory after the COVID-19 Pandemic. Diseases 2023; 11:181. [PMID: 38131987 PMCID: PMC10742543 DOI: 10.3390/diseases11040181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/07/2023] [Accepted: 12/09/2023] [Indexed: 12/23/2023] Open
Abstract
The global pandemic period from 2020 to 2022 caused important alterations in oncology care. This study aimed to describe the trends and variations in patient characteristics, comorbidities, and treatment approaches during this time in Romania. We conducted a retrospective database search to identify patients with rectal cancer who underwent surgical intervention between 2020 and 2022 and the year 2019, which served as a pre-pandemic period control. This study included 164 patients, with a yearly increase of approximately 10% in surgical interventions noted from 2020 (1709 interventions) to 2022 (2118 interventions), but an overall 34.4% decrease compared with the pre-pandemic period. Notable shifts were observed in the type of surgeries performed, with laparoscopic procedures doubling from 2020 (25%) to 2022 (47.5%), confirming the decrease in emergency presentations during the last year of the COVID-19 pandemic and a recovery to normality with planned, elective interventions. Elective interventions increased significantly in 2022 (79.7%) compared with the previous years (p = 0.043), with a concurrent rise in neoadjuvant therapy uptake in 2022 (35.6%). However, significant alterations in the TNM staging, from 12.5% stage IV cases in 2020 to 25.4% in 2022 (p = 0.039), indicated an increased diagnosis of advanced stages of rectal cancer as the years progressed. There was a significant difference in albumin levels over the years (p = 0.019) and in the American Society of Anesthesiology (ASA) scores (from 6.2% ASA stage IV in 2020 to 16.9% in 2022), denoting an increase in case complexity (p = 0.043). This study reveals a trend of increasing surgical interventions and the prevalence of more advanced stages of rectal cancer during the pandemic years. Despite the subtle fluctuations in various patient characteristics and treatment approaches, notable shifts were documented in the severity at diagnosis and surgery types, pointing toward more advanced disease presentations and changes in surgical strategies over the period studied. Nevertheless, the trends in ICU admission rates and mortality did not alter significantly during the pandemic period.
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Affiliation(s)
- Vlad Braicu
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (V.B.); (C.D.)
- Department of General Surgery, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (L.F.); (G.V.); (D.B.)
| | - Lazar Fulger
- Department of General Surgery, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (L.F.); (G.V.); (D.B.)
| | - Aditya Nelluri
- School of General Medicine, Sri Siddhartha Medical College, Tumakuru 572107, India;
| | - Ram Kiran Maganti
- School of General Medicine, Sri Devaraj Urs Academy of Higher Education and Research, Kolar 563101, India;
| | | | - Gabriel Verdes
- Department of General Surgery, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (L.F.); (G.V.); (D.B.)
| | - Dan Brebu
- Department of General Surgery, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (L.F.); (G.V.); (D.B.)
| | - Catalin Dumitru
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Ana-Olivia Toma
- Department of Dermatology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Ovidiu Rosca
- Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Ciprian Duta
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (V.B.); (C.D.)
- Department of General Surgery, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (L.F.); (G.V.); (D.B.)
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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O Connor R, Landes D, Harris R. Trends and inequalities in realised access to NHS primary care dental services in England before, during and throughout recovery from the COVID-19 pandemic. Br Dent J 2023:10.1038/s41415-023-6032-1. [PMID: 37438477 DOI: 10.1038/s41415-023-6032-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/14/2023] [Accepted: 03/03/2023] [Indexed: 07/14/2023]
Abstract
Introduction The COVID-19 pandemic triggered unprecedented disruption to NHS dental services in England. This work describes changes in realised access to NHS primary care dental services between 2019 and 2022, with a particular focus on geographic and deprivation-based inequalities.Methods Data from the NHS Business Services Authority and Office for National Statistics were combined to calculate the proportion of resident populations utilising NHS primary care dental services. These data were compared over multiple six-monthly time periods between 2019 and 2022, across several levels of geography and by quintiles of area-level deprivation.Results The proportion of the England population utilising services fell substantially after the start of the COVID-19 pandemic, recovering to 75-80% of pre-pandemic levels in the first half of 2022. Substantial geographic variation was observed in the pre-pandemic time points and re-emerged as the recovery period progressed. Deprivation-based inequalities in service use were persistently present, although these were consistently greater in child than adult populations. While inequalities for children increased in the initial post-pandemic period, this pattern returned almost to pre-pandemic levels by 2022.Conclusions Socioeconomic inequalities and geographic variations in the use of NHS primary care dental services, seen before the COVID-19 pandemic, have re-emerged afterwards.
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Affiliation(s)
- Rhiannon O Connor
- Speciality Trainee in Dental Public Health, NHS England North East and Yorkshire, United Kingdom.
| | - David Landes
- Consultant in Dental Public Health, NHS England North East and Yorkshire, United Kingdom
| | - Rebecca Harris
- Professor of Dental Public Health, Institute of Population Health, University of Liverpool, United Kingdom
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Demaerel PG, Leloup A, Brochez L, Van Eycken L, Garmyn M. Impact of the COVID-19 Pandemic on the Incidence and Thickness of Cutaneous Melanoma in Belgium. Biomedicines 2023; 11:1645. [PMID: 37371740 DOI: 10.3390/biomedicines11061645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 05/29/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
(1) Background: COVID-19 had a major impact on cancer diagnostics and treatment. Delays in diagnosis of cutaneous melanoma were particularly feared, given the impact on survival and morbidity that comes with advanced stages. Moreover, its incidence in Belgium has been rapidly increasing in recent decades. This Belgian population-level study quantifies the pandemic effect on the number of melanoma diagnoses and Breslow thickness in 2020 and 2021. (2) Methods: In using an automated algorithm, the number of cutaneous melanoma diagnoses and Breslow thickness were extracted from all pathology protocols from 2017-2021 by the Belgian Cancer Registry. Monthly variations, as well as year-to-year differences, were studied. (3) Results: Annual incidence of cutaneous melanoma fell by 1% in 2020, compared to 2019, mainly due to a diagnostic deficit in March, April, and May 2020. An 8% incidence increase occurred in 2021, primarily reflecting an increase in the number of the thinnest melanomas (≤1 mm). Both the mean and median Breslow thicknesses were higher in spring 2020, resulting from an underrepresentation of thinner tumors. However, no particulars stood out on a full-year basis in either 2020 or 2021. (4) Conclusions: Considering the expected incidence increase, we estimate almost 210 melanoma diagnoses were missed in Belgium in 2020, corresponding to 6% of the expected number. This deficit occurred mainly during the first COVID-19 wave. Despite some rebound, the 2021 total was still 3% short of the expected number, leaving around 325 diagnoses remaining pending in 2020 and 2021, corresponding to a two-year deficit of 4.35%. Fortunately, mainly thin melanomas were missed, without any detectable shift toward thicker tumors later in 2020 and or 2021.
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Affiliation(s)
| | | | - Lieve Brochez
- Department of Dermatology, Ghent University Hospital, 9000 Ghent, Belgium
| | | | - Marjan Garmyn
- Department of Dermatology, University Hospitals Leuven, 3000 Leuven, Belgium
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Bright D, Hillier S, Song J, Huws DW, Greene G, Hodgson K, Akbari A, Griffiths R, Davies AR, Gjini A. Inequalities in colorectal cancer screening uptake in Wales: an examination of the impact of the temporary suspension of the screening programme during the COVID-19 pandemic. BMC Public Health 2023; 23:546. [PMID: 36949447 PMCID: PMC10031708 DOI: 10.1186/s12889-023-15345-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 02/28/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND Response to the early stages of the COVID-19 pandemic resulted in the temporary disruption of cancer screening in the UK, and strong public messaging to stay safe and to protect NHS capacity. Following reintroduction in services, we explored the impact on inequalities in uptake of the Bowel Screening Wales (BSW) programme to identify groups who may benefit from tailored interventions. METHODS Records within the BSW were linked to electronic health records (EHR) and administrative data within the Secured Anonymised Information Linkage (SAIL) Databank. Ethnic group was obtained from a linked data method available within SAIL. We examined uptake for the first 3 months of invitations (August to October) following the reintroduction of BSW programme in 2020, compared to the same period in the preceding 3 years. Uptake was measured across a 6 month follow-up period. Logistic models were conducted to analyse variations in uptake by sex, age group, income deprivation quintile, urban/rural location, ethnic group, and clinically extremely vulnerable (CEV) status in each period; and to compare uptake within sociodemographic groups between different periods. RESULTS Uptake during August to October 2020 (period 2020/21; 60.4%) declined compared to the same period in 2019/20 (62.7%) but remained above the 60% Welsh standard. Variation by sex, age, income deprivation, and ethnic groups was observed in all periods studied. Compared to the pre-pandemic period in 2019/20, uptake declined for most demographic groups, except for older individuals (70-74 years) and those in the most income deprived group. Uptake continues to be lower in males, younger individuals, people living in the most income deprived areas and those of Asian and unknown ethnic backgrounds. CONCLUSION Our findings are encouraging with overall uptake achieving the 60% Welsh standard during the first three months after the programme restarted in 2020 despite the disruption. Inequalities did not worsen after the programme resumed activities but variations in CRC screening in Wales associated with sex, age, deprivation and ethnic group remain. This needs to be considered in targeting strategies to improve uptake and informed choice in CRC screening to avoid exacerbating disparities in CRC outcomes as screening services recover from the pandemic.
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Affiliation(s)
- Diana Bright
- Research and Evaluation Division, Knowledge and Research Directorate, Public Health Data, Public Health Wales, Floor 5, Number 2 Capital Quarter, Tyndall Street, Cardiff, CF10 4BZ, UK.
| | - Sharon Hillier
- Health Protection and Screening Services Directorate. Public Health Wales, Cardiff, Wales
| | - Jiao Song
- Communicable Disease Surveillance Centre. Public Health Wales, Cardiff, Wales
| | - Dyfed W Huws
- Research and Evaluation Division, Knowledge and Research Directorate, Public Health Data, Public Health Wales, Floor 5, Number 2 Capital Quarter, Tyndall Street, Cardiff, CF10 4BZ, UK
- Population Data Science, Faculty of Medicine, Health & Life Science, Swansea University Medical School, Swansea University, Swansea, Wales
| | - Giles Greene
- Research and Evaluation Division, Knowledge and Research Directorate, Public Health Data, Public Health Wales, Floor 5, Number 2 Capital Quarter, Tyndall Street, Cardiff, CF10 4BZ, UK
| | - Karen Hodgson
- Research and Evaluation Division, Knowledge and Research Directorate, Public Health Data, Public Health Wales, Floor 5, Number 2 Capital Quarter, Tyndall Street, Cardiff, CF10 4BZ, UK
| | - Ashley Akbari
- Population Data Science, Faculty of Medicine, Health & Life Science, Swansea University Medical School, Swansea University, Swansea, Wales
| | - Rowena Griffiths
- Population Data Science, Faculty of Medicine, Health & Life Science, Swansea University Medical School, Swansea University, Swansea, Wales
| | - Alisha R Davies
- Research and Evaluation Division, Knowledge and Research Directorate, Public Health Data, Public Health Wales, Floor 5, Number 2 Capital Quarter, Tyndall Street, Cardiff, CF10 4BZ, UK
| | - Ardiana Gjini
- Health Protection and Screening Services Directorate. Public Health Wales, Cardiff, Wales
- Cardiff University, Cardiff, UK
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Nguyen NP, Karlsson UL, Lehrman D, Mazibuko T, Saghatelyan T, Thariat J, Baumert BG, Vinh-Hung V, Gorobets O, Giap H, Singh S, Chi A, Alessandrini G, Ahluwalia A, Durosinmi-Etti F, Zegarra Cárdenas J, Diabate K, Oboite J, Oboite E, Mehmood T, Vuong T, Kim L, Page BR. Impact of COVID-19 pandemic on older cancer patients: Proposed solution by the International Geriatric Radiotherapy Group. Front Oncol 2023; 13:1091329. [PMID: 36959795 PMCID: PMC10027708 DOI: 10.3389/fonc.2023.1091329] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 01/18/2023] [Indexed: 03/09/2023] Open
Abstract
Older cancer patients are disproportionally affected by the Coronavirus 19 (COVID-19) pandemic. A higher rate of death among the elderly and the potential for long-term disability have led to fear of contracting the virus in these patients. This fear can, paradoxically, cause delay in diagnosis and treatment that may lead to a poor outcome that could have been prevented. Thus, physicians should devise a policy that both supports the needs of older patients during cancer treatment, and serves to help them overcome their fear so they seek out to cancer diagnosis and treatment early. A combination of telemedicine and a holistic approach, involving prayers for older cancer patients with a high level of spirituality, may improve vaccination rates as well as quality of life during treatment. Collaboration between health care workers, social workers, faith-based leaders, and cancer survivors may be crucial to achieve this goal. Social media may be an important component, providing a means of sending the positive message to older cancer patients that chronological age is not an impediment to treatment.
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Affiliation(s)
- Nam Phong Nguyen
- Department of Radiation Oncology, Howard University, Washington, DC, United States
| | - Ulf Lennart Karlsson
- Department of Radiation Oncology, International Geriatric Radiotherapy Group, Washington, DC, United States
| | - David Lehrman
- Department of Radiation Oncology, Howard University, Washington, DC, United States
| | - Thandeka Mazibuko
- Department of Radiation Oncology, Howard University, Washington, DC, United States
| | - Tatul Saghatelyan
- Department of Radiation Oncology, National Center of Oncology, Yerevan, Armenia
| | - Juliette Thariat
- Department of Radiation Oncology, Francois Baclesse Cancer Center, Cain, France
| | - Brigitta G. Baumert
- Institute of Radiation Oncology, Cantonal Hospital Graubuenden, Chur, Switzerland
| | - Vincent Vinh-Hung
- Department of Radiation Oncology, Centre Hospitalier de La Polynesie Francaise, Tahiti, French Polynesia
| | - Olena Gorobets
- Department of Oral Surgery, Centre Hospitalier Universitaire de Martinique, Martinique, France
| | - Huan Giap
- Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC, United States
| | - Sankalp Singh
- Department of Radiation Oncology, Army Hospital (Research & Referral), New Delhi, India
| | - Alexander Chi
- Department of Radiation Oncology, Beijing Chest Hospital, Beijing, China
| | | | - Abhinav Ahluwalia
- Department of Radiation Oncology, Advanced Care Oncology Center, Dubai, United Arab Emirates
| | | | - Jorge Zegarra Cárdenas
- Division of Medical Oncology, Regional Institute of Neoplastic Disease, Concepcion, Peru
| | | | - Joan Oboite
- Department of Radiation Oncology, Howard University, Washington, DC, United States
| | - Eromosele Oboite
- Department of Radiation Oncology, Howard University, Washington, DC, United States
| | - Tahir Mehmood
- Department of Radiation Oncology, Northampton General Hospital, Northampton, United Kingdom
| | - Te Vuong
- Department of Radiation Oncology, McGill University, Montreal, QC, Canada
| | - Lyndon Kim
- Division of Neuro-Oncology, Mount Sinai Hospital, New York, NY, United States
| | - Brandi R. Page
- Department of Radiation Oncology, Johns Hopkins University, Baltimore, MD, United States
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10
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Mangone L, Marinelli F, Bisceglia I, Filice A, De Leonibus L, Rapicetta C, Paci M. The Influence of COVID-19 on New Lung Cancer Diagnoses, by Stage and Treatment, in Northern Italy. Biology 2023; 12:biology12030390. [PMID: 36979081 PMCID: PMC10045495 DOI: 10.3390/biology12030390] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/20/2023] [Accepted: 02/24/2023] [Indexed: 03/05/2023]
Abstract
The COVID-19 pandemic has had a significant impact on new cancer diagnoses. This study aims to evaluate the implications of the lockdown period on new lung cancer diagnoses in northern Italy. We compared 2020 with 2019 cancer registry data, reporting the variations by age, stage, and treatments. In 2020, 303 lung cancer cases were registered, 21 fewer than in 2019. Cases fell in men (−31 patients, 9.6%) but not in women (+10 patients, +3.1%). A significant drop in stage I from 19.8% to 12.9% (p < 0.05) and an increase in stage III (12.7% vs. 19.1%; p < 0.05) was observed. Histological confirmation dropped (70.1% vs. 60.1%; p < 0.05) while cytology increased (12% vs. 20.8%; p < 0.01). Surgery declined (28.7% vs. 21.5%; p < 0.05) but increased in stage III (19.5% vs. 25.9%; p = 0.46), while chemotherapy increased (17.6% vs. 34.3%; p < 0.01) for all stages. During the pandemic, new lung cancer diagnoses dropped only in men. The reorganization of health services has ensured a decrease in surgical interventions (due to the unavailability of operating rooms) counterbalanced by an increase in chemotherapy.
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Affiliation(s)
- Lucia Mangone
- Epidemiology Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy
- Correspondence:
| | - Francesco Marinelli
- Epidemiology Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy
| | - Isabella Bisceglia
- Epidemiology Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy
| | - Angelina Filice
- Nuclear Medicine Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy
| | - Lisa De Leonibus
- Thoracic Surgery Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy
| | - Cristian Rapicetta
- Thoracic Surgery Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy
| | - Massimiliano Paci
- Thoracic Surgery Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy
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11
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Feeney L, Hamilton A, Lavery A, O’Neill C, Walls G, Taylor K, Turkington RC. Real world outcomes in cancer patients with COVID-19 infection: Northern Ireland experience. Ulster Med J 2023; 92:29-37. [PMID: 36762131 PMCID: PMC9899036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Background Cancer has been assumed to be associated with a high-risk of morbidity and mortality from COVID-19. Protective measures have incorporated modifications in cancer treatments. There are conflicting data about the impact of COVID-19 infection and outcomes in cancer patients. We aim to describe the impact of demographic and clinical characteristics on COVID-19 outcomes in patients with cancer in Northern Ireland reported within the UK Coronavirus Cancer Monitoring Project (UKCCMP). Method Prospective data collection including demographics, cancer stage and type, treatment and outcomes occurred for all Northern Irish patients enrolled in the UKCCMP. The primary endpoint was all-cause mortality. Descriptive statistics and logistic regression analysis were performed using SPSSv25. Results Between March 2020 and March 2021, 110 cases were registered. Median age was 63 years (range 27 to 87). Seventy patients (63.6%) were >60 years and 59 (53.8%) were females. Co-morbidities were reported in 83 patients (72.7%). Most patients had metastatic disease (64, 58.2%). Sixty-seven patients (60.9%) received anticancer treatment in the 4 weeks prior to COVID-19 infection. Of those patients, 35 (52.2%) received chemotherapy. Thirty-nine patients (58.2%) continued treatment as planned; 24 (36.9%) stopped treatment due to SARS-CoV-2 infection. The majority of patients were asymptomatic or experienced mild symptoms (67, 60.9%). Fifty-one (46.3%%) were admitted to hospital for COVID-19. Risk of severe/critical COVID-19 disease was significantly associated with age (OR 1.07 [95% CI 1.03-1.11); p=0.004), pre-existing hypertension (OR 3.29 [95% CI 1.42-7.62]; p=0.02) and thoracic primary malignancy (OR 4.41 [95% CI 1.52-12.74]; p=0.042). Twenty-nine patients (26.3%) died of whom 15 (57.7%) died of COVID-19 and 13 (44.8%) died due to cancer. Risk of death was significantly associated with age (OR 1.05 [95% CI 1.01-1.09]; p=0.014), male sex (OR 3.76 [95% CI 1.51-9.34]; p=0.008) and thoracic primary malignancy (OR 5.35 [95% CI 1.88-15.25]; p=0.014). When corrected for age, gender and co-morbidities, chemotherapy within the past 4 weeks was not significantly associated with mortality (OR 0.65 [95% CI 0.20-2.11]; p=0.476). Conclusion Age and thoracic cancer diagnosis correlated with survival. Comparison of performance during the pandemic with national benchmarks can inform how regional services should be adapted in preparation for future healthcare crises.
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Affiliation(s)
- Laura Feeney
- Patrick G Johnston Centre for Cancer Research, Queens University Belfast, Belfast, UK,Northern Ireland Cancer Centre, Belfast, UK,Correspondence to: Laura Feeney,
| | - Ashleigh Hamilton
- Northern Ireland Cancer Centre, Belfast, UK,Centre For Public Health, Queens University Belfast, Belfast, UK
| | - Anita Lavery
- Patrick G Johnston Centre for Cancer Research, Queens University Belfast, Belfast, UK,Northern Ireland Cancer Centre, Belfast, UK
| | - Conor O’Neill
- Patrick G Johnston Centre for Cancer Research, Queens University Belfast, Belfast, UK,Centre For Public Health, Queens University Belfast, Belfast, UK
| | - Gerard Walls
- Patrick G Johnston Centre for Cancer Research, Queens University Belfast, Belfast, UK,Northern Ireland Cancer Centre, Belfast, UK
| | | | - Richard C Turkington
- Patrick G Johnston Centre for Cancer Research, Queens University Belfast, Belfast, UK,Northern Ireland Cancer Centre, Belfast, UK
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12
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Zagar T, Tomsic S, Zadnik V, Bric N, Birk M, Vurzer B, Mihor A, Lokar K, Oblak I. Impact of the COVID-19 epidemic on cancer burden and cancer care in Slovenia: a follow-up study. Radiol Oncol 2022; 56:488-500. [PMID: 36503711 DOI: 10.2478/raon-2022-0050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 10/30/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND In Slovenia, cancer care services were exempt from government decrees for COVID-19 containment. Nevertheless, cancer control can be impacted also by access to other health services and changes in health-seeking behaviour. In this follow up study, we explored changes in cancer burden and cancer care beyond the first months after the onset of the COVID-19 epidemic. MATERIALS AND METHODS We analysed routinely collected data for the period January 2019 through July 2022 from three sources: (1) pathohistological and clinical practice cancer notifications from two major cancer centres in Ljubljana and Maribor (source: Slovenian Cancer Registry); (2) referrals issued for oncological services (source: e-referral system); and (3) outpatient appointments and diagnostic imaging performed (source: administrative data of the Institute of Oncology Ljubljana - IOL). Additionally, changes in certain clinical and demographic characteristics in patients diagnosed and treated during the epidemic were analysed using the Hospital-Based Cancer Registry of the IOL (period 2015-2021). RESULTS After a drop in referrals to follow-up cancer appointments in April 2020, in June-August 2020, there was an increase in referrals, but it did not make-up for the drop in the first wave; the numbers in 2021 and 2022 were even lower than 2020. Referrals to first cancer care appointments and genetic testing and counselling increased in 2021 compared to 2019 and in 2022 increased further by more than a quarter. First and follow-up outpatient appointments and cancer diagnostic imaging at the IOL dropped after the onset of the epidemic in March 2020 but were as high as expected according to 2019 baseline already in 2021. Some deficits remain for follow-up outpatients' appointments in surgical and radiotherapy departments. There were more CT, MRI and PET scans performed during the COVID-19 period than before. New cancer diagnoses dropped in all observed years 2020, 2021 and until July 2022 by 6%, 3% and 8%, respectively, varying substantially by cancer type. The largest drop was seen in the 50-64 age group (almost 14% in 2020 and 16% in 2021), while for patients older than 80 years, the numbers were above expected according to the 2015-2019 average (4% in 2020, 8% in 2021). CONCLUSIONS Our results show a varying effect of COVID-19 epidemic in Slovenia for different types of cancers and at different stages on the patient care pathway - it is probably a mixture of changes in health-seeking behaviour and systemic changes due to modifications in healthcare organisation on account of COVID-19. A general drop in new cancer cases reflects disruptions in the pre-diagnostic phase and could have profound long-term consequences on cancer burden indicators.
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13
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Trama A, Bernasconi A, Botta L, Di Cosimo S, Miceli R, Claps M, Badenchini F, Lillini R, Rubino M, Lasalvia P. COVID-19 outbreak in Lombardy: Impact on reducing solid cancer diagnoses in 2020. Int J Cancer 2022; 151:1502-1511. [PMID: 35704342 PMCID: PMC9350168 DOI: 10.1002/ijc.34168] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/16/2022] [Accepted: 06/08/2022] [Indexed: 12/15/2022]
Abstract
Our aim was to analyse, on a population level, the year-long decline in cancer diagnoses in the region of Lombardy (Italy), and to characterise the tumours with the greatest reduction in diagnosis by patient age, sex and tumour stage at diagnosis. We used the health care utilisation databases of the Lombardy region to identify cancer patients' characteristics (eg, sex, age) and cancer-related information (eg, cancer site, stage at diagnosis). The frequency of new cancer diagnoses in 2019 and 2020 were compared in terms of percentage differences in undiagnosed cases. We observed two peaks in the decline in cancer diagnoses: March to May 2020 (-37%) and October to December 2020 (-19%). The decline persisted over the course of 2020 and was higher in males and patients aged 74+. Diagnoses of all four common cancers analysed (female breast, lung, colorectal and prostate) remained below pre-pandemic levels. For breast and colorectal cancers, the decline in diagnoses was high in the age groups targeted by population-based screening programmes. We observed a reduction in localised stage cancer diagnoses for all four cancers. Our data confirm that timely monitoring of cancer diagnoses and interventions to prevent disruption of routine diagnostic services are needed to mitigate the impact of emergencies on cancer patients.
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Affiliation(s)
- Annalisa Trama
- Evaluative Epidemiology Unit, Department of ResearchFondazione IRCCS Istituto Nazionale dei TumoriMilan
| | - Alice Bernasconi
- Evaluative Epidemiology Unit, Department of ResearchFondazione IRCCS Istituto Nazionale dei TumoriMilan
| | - Laura Botta
- Evaluative Epidemiology Unit, Department of ResearchFondazione IRCCS Istituto Nazionale dei TumoriMilan
| | - Serena Di Cosimo
- Biomarkers Unit, Department of Applied Research and Technological DevelopmentFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Rosalba Miceli
- Clinical Epidemiology and Trial Organization Unit, Department of Applied Research and Technological DevelopmentFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Melanie Claps
- Medical Oncology 1 Unit, Department of Medical Oncology and HematologyFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Fabio Badenchini
- Prostate Cancer Program, Scientific DirectorateFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Roberto Lillini
- Analytical Epidemiology & Health Impact Unit, Department of ResearchFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Massimiliano Rubino
- Scientific Library “Umberto Veronesi,” Scientific Directorate, Fondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Paolo Lasalvia
- Evaluative Epidemiology Unit, Department of ResearchFondazione IRCCS Istituto Nazionale dei TumoriMilan
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14
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Abstract
PURPOSE OF REVIEW Cancer screening disruption due to COVID-19 may have a significant impact on patients, healthcare practitioners, and healthcare systems. In this present review, we aim to offer a comprehensive view of the effect of the COVID-19 pandemic on cancer screening programs worldwide. RECENT FINDINGS The present review comprised 33 publications. During the COVID-19 pandemic, the rates of cancer screening investigations were drastically reduced worldwide. Screening rates plummeted for all types of cancer, all ages, and racial/ethnic groups. Reductions in screening percentages were higher in several underserved racial groups. Cancer screening was suspended for at least 30 days in 13 countries. SUMMARY Screenings for all types of cancer fell sharply. In the chain of cancer management, delays in any step are liable to change the outcome of the next step. Further long-term research will be needed to fully comprehend the impact of the pandemic on cancer services and patient outcomes.
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Affiliation(s)
| | | | - Hamid Salehiniya
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Ibrahim Alkatout
- University Hospitals Schleswig-Holstein, Campus Kiel, Kiel School of Gynaecological Endoscopy, Kiel, Germany
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15
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Mitchell H, Alford BS, O'Hare S, O'Callaghan E, Fox C, Gavin AT. Impact of the COVID-19 pandemic on emergency hospital cancer admissions in a UK region. BMC Cancer 2022; 22:850. [PMID: 35927617 PMCID: PMC9351130 DOI: 10.1186/s12885-022-09932-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 07/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The pandemic disrupted society and health services through lockdowns and resource reallocation to care for COVID-19 patients. Reductions in numbers of cancer patients having surgery, being diagnosed pathologically or via 2-week wait, and screening programs pauses have been described. The effect on emergency presentation, which represents an acute episode with poor outcomes, has not been investigated. This study explored the pandemic's impact on emergency hospital admissions for cancer patients in a UK region. METHODS Hospital discharge data for cancer patients in Northern Ireland, which included route to admission, were analysed for the pandemic era in 2020 compared to averages for March to December 2017-2019, focusing on volume and route of emergency admissions by demography and tumour site. FINDINGS Compared with the pre-pandemic era, the number of cancer emergency admissions fell by 12·3% in 2020. Emergency admissions for cancer were significantly reduced when COVID-19 levels were highest (- 18·5% in April and - 16.8% in October). Females (- 15·8%), urban residents (- 13·2%), and age groups 0 to 49 and 65-74 years old (- 17%) experienced the largest decreases as did those with haematological (- 14·7%), brain and CNS (- 27·9%), and lung cancers(- 14·3%). Significant reductions in referrals from outpatient departments (- 51%) and primary care (- 43%) (p < 0·001) were counterbalanced by admissions from other routes including confirmed or suspected COVID-19 infection (increase 83·6%). INTERPRETATION Reductions in emergency admissions, and pathologically diagnosed cancers, as reported by the Northern Ireland Cancer Registry (NICR), indicate undiagnosed patients in the community which has implications for future workloads and survival. Data suggest undiagnosed cases may be higher for haematological, brain and CNS, and lung cancers and among females. Efforts should be made to encourage people with symptoms to present for diagnosis or reassurance. FUNDING The NICR is funded by the Public Health Agency of Northern Ireland. This work was supported by Macmillan Cancer Support and uses data collected by health services as part of their care and support functions.
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Affiliation(s)
- Helen Mitchell
- Northern Ireland Cancer Registry, Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland.
| | - Ben S Alford
- Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland
| | - Simon O'Hare
- Northern Ireland Cancer Registry, Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland.,Macmillan Cancer Support, London, England
| | - Eamon O'Callaghan
- Northern Ireland Cancer Registry, Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland
| | - Colin Fox
- Northern Ireland Cancer Registry, Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland
| | - Anna T Gavin
- Northern Ireland Cancer Registry, Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland
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16
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Mangone L, Mancuso P, Braghiroli MB, Bisceglia I, Campari C, Caroli S, Marino M, Caldarella A, Giorgi Rossi P, Pinto C. Prompt Resumption of Screening Programme Reduced the Impact of COVID-19 on New Breast Cancer Diagnoses in Northern Italy. Cancers (Basel) 2022; 14:3029. [PMID: 35740694 DOI: 10.3390/cancers14123029] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/14/2022] [Accepted: 06/17/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary The aim of this study was to compare 2020 tumours with 2019 tumours by age, stage and treatment in four different periods. In 2020 there was no decrease of invasive tumours nor in situ (513 vs. 493 and 76 vs. 73, respectively), while there was a significant decrease in surgery and an increase in neoadjuvant chemotherapy (p = 0.016). During the Italian lockdown period (March–May), we observed a decrease in all ages and a significant one among people aged 75+ [IRR 0.45 (95% CI 0.25–0.79)], but in the last period there was a significant increase among people of the screening age range of 45–74 [IRR 1.48 (95% CI 1.11–1.98)]. Screening activities were suspended from March to May, but over the summer and the autumn the backlog was eliminated. This suggests that a prompt resumption of programmed screening may have limited the impact of the pandemic on the delay of breast cancer diagnoses. Abstract The aim of this study is to evaluate the real impact of COVID-19 during the entire 2020 period, compared with 2019. The data comes from a Cancer Registry in Northern Italy and we compared clinical and treatment characteristics of breast cancer by age, stage, treatment, and status screening. In 2020 there was no decrease in invasive tumours nor in in situ (513 vs. 493 and 76 vs. 73, respectively), while there was a significant decrease in surgery and increase in neoadjuvant chemotherapy (p = 0.016). In the screening range (aged 45–74), no change in stage and grading was observed. In the four periods examined there was an increase in new diagnoses during pre-lockdown, a decrease in tumours especially at age 75+ [IRR 0.45; 95%CI 0.25–0.79] during lockdown, a recovery of new diagnoses in women 45+ in the low incidence period while in the last period there was a significant increase only for ages 45–74 [IRR 1.48; 95% CI 1.11–1.98]. Screening activities were suspended from March to May, but over the summer and autumn the backlog was addressed. This suggests that a prompt resumption of programmed screening may have limited the impact of the pandemic on the delay of breast cancer diagnoses.
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17
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Exarchakou A, Kipourou DK, Belot A, Rachet B. Socio-economic inequalities in cancer survival: how do they translate into Number of Life-Years Lost? Br J Cancer 2022; 126:1490-1498. [PMID: 35149855 PMCID: PMC9090931 DOI: 10.1038/s41416-022-01720-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 01/15/2022] [Accepted: 01/26/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND We aimed to investigate the impact of socio-economic inequalities in cancer survival in England on the Number of Life-Years Lost (NLYL) due to cancer. METHODS We analysed 1.2 million patients diagnosed with one of the 23 most common cancers (92.3% of all incident cancers in England) between 2010 and 2014. Socio-economic deprivation of patients was based on the income domain of the English Index of Deprivation. We estimated the NLYL due to cancer within 3 years since diagnosis for each cancer and stratified by sex, age and deprivation, using a non-parametric approach. The relative survival framework enables us to disentangle death from cancer and death from other causes without the information on the cause of death. RESULTS The largest socio-economic inequalities were seen mostly in adults <45 years with poor-prognosis cancers. In this age group, the most deprived patients with lung, pancreatic and oesophageal cancer lost up to 6 additional months within 3 years since diagnosis than the least deprived. For most moderate/good prognosis cancers, the socio-economic inequalities widened with age. CONCLUSIONS More deprived patients and particularly the young with more lethal cancers, lose systematically more life-years than the less deprived. To reduce these inequalities, cancer policies should systematically encompass the inequities component.
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Affiliation(s)
- Aimilia Exarchakou
- Inequalities in Cancer Outcomes Network (ICON), Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Dimitra-Kleio Kipourou
- Inequalities in Cancer Outcomes Network (ICON), Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Aurélien Belot
- Inequalities in Cancer Outcomes Network (ICON), Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Bernard Rachet
- Inequalities in Cancer Outcomes Network (ICON), Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
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18
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Ng JS, Hamilton DG. Assessing the impact of the COVID-19 pandemic on breast cancer screening and diagnosis rates: A rapid review and meta-analysis. J Med Screen 2022; 29:209-218. [PMID: 35593115 DOI: 10.1177/09691413221101807] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The ongoing COVID-19 pandemic has caused an indefinite delay to cancer screening programs worldwide. This study aims to explore the impact on breast cancer screening outcomes such as mammography and diagnosis rates. METHODS We searched Ovid MEDLINE, Ovid Embase, medRxiv and bioRxiv between January 2020 to October 2021 to identify studies that reported on the rates of screening mammography and breast cancer diagnosis before and during the pandemic. The effects of 'lockdown' measures, age and ethnicity on outcomes were also examined. All studies were assessed for risk of bias using the Newcastle-Ottawa Scale (NOS). Rate ratios were calculated for all outcomes and pooled using standard inverse-variance random effects meta-analysis. RESULTS We identified 994 articles, of which 7 registry-based and 24 non-registry-based retrospective cohort studies, including data on 4,860,786 and 629,823 patients respectively across 18 different countries, were identified. Overall, breast cancer screening and diagnosis rates dropped by an estimated 41-53% and 18-29% respectively between 2019 and 2020. No differences in mammogram screening rates depending on patient age or ethnicity were observed. However, countries that implemented lockdown measures were associated with a significantly greater reduction in mammogram and diagnosis rates between 2019 and 2020 in comparison to those that did not. CONCLUSION The pandemic has caused a substantial reduction in the screening and diagnosis of breast cancer, with reductions more pronounced in countries under lockdown restrictions. It is early yet to know if delayed screening during the pandemic translates into higher breast cancer mortality.
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Affiliation(s)
- Jay Shen Ng
- Melbourne Medical School, Faculty of Medicine, Dentistry & Health Sciences, 569586The University of Melbourne, Melbourne, Australia.,Department of Medicine, Malacca General Hospital, Ministry of Health, Malaysia
| | - Daniel G Hamilton
- Melbourne Medical School, Faculty of Medicine, Dentistry & Health Sciences, 569586The University of Melbourne, Melbourne, Australia.,MetaMelb Research Group, School of BioSciences, 2281The University of Melbourne, Melbourne, Australia
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19
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Elek P, Fadgyas-freyler P, Váradi B, Mayer B, Zemplényi A, Csanádi M. Effects of lower screening activity during the COVID-19 pandemic on breast cancer patient pathways: Evidence from the age cut-off of organized screening. Health Policy 2022. [PMID: 35690504 PMCID: PMC9130317 DOI: 10.1016/j.healthpol.2022.05.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/28/2022] [Accepted: 05/22/2022] [Indexed: 11/23/2022]
Abstract
We examined the effects of the COVID-19 pandemic on the screening, diagnosis and treatment of breast cancer in Hungary based on administrative data until June 2021, covering three pandemic waves. After correcting for trend and seasonality, the number of mammography examinations decreased by 68% in 2020q2, was around its usual level in 2020q3 and was reduced by 20–35% throughout 2020q4-2021q2. The reduction was caused by a combination of supply-side (temporary suspensions of screening) and demand-side (lower screening participation during the pandemic waves) factors. The number of new breast cancer diagnoses and mastectomy surgeries responded with a lag, and were below their usual level by 15-30% in all quarters between 2020q2 and 2021q2, apart from 2020q4, when there was no significant difference. Using a regression discontinuity framework, we found that the partial mastectomy rate (indicative of early diagnosis) dropped more substantially in 2020q2 in the 61–65 years old age group that was just below the age cut-off of organized screening than in the 66–70 years old age group, and this difference was partially offset in 2021q1. We suggest that policymakers need to motivate the target population (by providing both information and incentives) to catch up on missed screenings.
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20
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Ribes J, Pareja L, Sanz X, Mosteiro S, Escribà JM, Esteban L, Gálvez J, Osca G, Rodenas P, Pérez-Sust P, Borràs JM. Cancer diagnosis in Catalonia (Spain) after two years of COVID-19 pandemic: an incomplete recovery. ESMO Open 2022; 7:100486. [PMID: 35714476 PMCID: PMC9197337 DOI: 10.1016/j.esmoop.2022.100486] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 12/01/2022] Open
Affiliation(s)
- J Ribes
- Catalan Pathology Registry, Catalan Cancer Plan, Department of Health of Catalonia, Barcelona, Spain; Department of Clinical Sciences, University of Barcelona (UB), Barcelona, Spain; Hospital Cancer Registry Unit, Catalan Institute of Oncology, Barcelona, Spain.
| | - L Pareja
- Hospital Cancer Registry Unit, Catalan Institute of Oncology, Barcelona, Spain
| | - X Sanz
- Catalan Pathology Registry, Catalan Cancer Plan, Department of Health of Catalonia, Barcelona, Spain
| | - S Mosteiro
- Hospital Cancer Registry Unit, Catalan Institute of Oncology, Barcelona, Spain
| | - J M Escribà
- Department of Clinical Sciences, University of Barcelona (UB), Barcelona, Spain; Hospital Cancer Registry Unit, Catalan Institute of Oncology, Barcelona, Spain
| | - L Esteban
- Catalan Pathology Registry, Catalan Cancer Plan, Department of Health of Catalonia, Barcelona, Spain
| | - J Gálvez
- Hospital Cancer Registry Unit, Catalan Institute of Oncology, Barcelona, Spain
| | - G Osca
- Hospital Cancer Registry Unit, Catalan Institute of Oncology, Barcelona, Spain
| | - P Rodenas
- Catalan Electronic Health Record, EHealth Office, Health/Catalan Health Service, Department of Health of Catalonia, Barcelona, Spain
| | - P Pérez-Sust
- CatSalut Information Systems and Health Department ICT Unit, Barcelona, Spain
| | - J M Borràs
- Catalan Pathology Registry, Catalan Cancer Plan, Department of Health of Catalonia, Barcelona, Spain; Department of Clinical Sciences, University of Barcelona (UB), Barcelona, Spain
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21
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Neamtiu L, Martos C, Giusti F, Negrao Carvalho R, Randi G, Dimitrova N, Flego M, Dyba T, Bettio M, Gavin A, Visser O. Impact of the first wave of the COVID-19 pandemic on cancer registration and cancer care: a European survey. Eur J Public Health 2021; 32:311-315. [PMID: 34935934 PMCID: PMC8975538 DOI: 10.1093/eurpub/ckab214] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background The coronavirus disease COVID-19 pandemic posed a number of challenges to the oncology community, particularly the diagnosis and care of cancer patients while ensuring safety from the virus for both patients and professionals: minimization of visits to the hospital, cancellation of the screening programmes and the difficulties in the management and operation of cancer registries (CRs) while working remotely. This article describes the effects in the medium term of the first wave of the COVID-19 pandemic on cancer registration in Europe, focusing on changes in cancer detection and treatment, possible reduction of CR resources and difficulties in the access to data sources. Methods A questionnaire was distributed in June 2020 to the directors of 108 CRs from 34 countries affiliated to the European Network of Cancer Registries, providing a 37% response rate. Results The results of the survey showed that cancer-screening programmes were mostly stopped or slowed down in the majority of regions covered by the respondent CRs. Cancer diagnostics and treatments were severely disrupted. The cancer registration process was also disrupted, due to changes in the work modalities for the personnel, as well as to the difficulties in accessing sources and/or receiving the notifications. In some CRs, staff was allocated to different activities related to controlling the pandemic. Several CRs reported that they were investigating the impact of COVID-19 on cancer care via dedicated studies. Conclusions A careful analysis will be necessary for proper interpretation of temporal and geographical variations of the 2020 cancer burden indicators.
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Affiliation(s)
- Luciana Neamtiu
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Carmen Martos
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | | | | | - Giorgia Randi
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Nadya Dimitrova
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Manuela Flego
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Tadeusz Dyba
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Manola Bettio
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Anna Gavin
- Northern Ireland Cancer Registry, Queens University, Belfast, United Kingdom
| | - Otto Visser
- Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, the Netherlands
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22
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Sanvisens A, Puigdemont M, Rubió-casadevall J, Vidal-vila A, López-bonet E, Martín-romero F, Marcos-gragera R. Differences in the Impact of COVID-19 on Pathology Laboratories and Cancer Diagnosis in Girona. IJERPH 2021; 18:13269. [PMID: 34948878 PMCID: PMC8701849 DOI: 10.3390/ijerph182413269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 12/10/2021] [Accepted: 12/13/2021] [Indexed: 12/18/2022]
Abstract
Introduction: The recent COVID-19 pandemic has compromised socio-health care, with consequences for the diagnosis and follow-up of other pathologies. The aim of this study was to evaluate the impact of COVID-19 on cancer diagnosis in Girona, Spain. Methodology: Observational study of samples received in two pathology laboratories during 2019–2020 (tertiary hospital in Girona and county hospital in Figueres). Date, sample type, and location and morphology were available. Samples were recoded to determine malignancy and grouped by location. Comparisons were made by calendar year and period of exposure to COVID-19. Results: 102,360 samples were included: 80,517 from Girona and 21,843 from Figueres. The reduction in activity in the pathology laboratories in 2020 compared to the previous year was 25.4% in Girona and 27.5% in Figueres. The reduction in cancer diagnoses in 2020 compared to 2019 was 6.8% in Girona and 21% in Figueres. In both laboratories, a decrease was observed in the diagnoses of neoplasms of the lip, oral cavity and pharynx, larynx, colon, rectum and anus, kidney and urinary system, melanoma, and central nervous system. A statistically significant higher probability of a sample received in the pathology laboratory displaying malignancy during COVID-19 was found (Girona: OR = 1.28, 95% CI: 1.23–1.34; Figueres: OR = 1.10, 95% CI: 1.01–1.20) with respect to the COVID-19-free period. Conclusions: The COVID-19 pandemic has resulted in a reduction in cancer diagnoses by pathology departments that varies according to tumor location and type of hospital. Despite this, the optimization of care resources and the recovery effort have partially reduced the impact of the pandemic in certain neoplasms.
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23
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Zi H, He SH, Leng XY, Xu XF, Huang Q, Weng H, Zhu C, Li LY, Gu JM, Li XH, Ming DJ, Li XD, Yuan S, Wang XH, He DL, Zeng XT. Global, regional, and national burden of kidney, bladder, and prostate cancers and their attributable risk factors, 1990-2019. Mil Med Res 2021; 8:60. [PMID: 34819142 PMCID: PMC8611255 DOI: 10.1186/s40779-021-00354-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 11/01/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The burden of kidney, bladder, and prostate cancers has changed in recent decades. This study aims to investigate the global and regional burden of, and attributable risk factors for genitourinary cancers during the past 30 years. METHODS We extracted data of kidney, bladder, and prostate cancers from the Global Burden of Disease 2019 database, including incidence, mortality, disability-adjusted life-years (DALYs), and attributable risk factors from 1990 to 2019. Estimated annual percentage changes (EAPC) were calculated to assess the changes in age-standardized incidence rate, age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR). The associations between cancers burden and socio-demographic index (SDI) were also analyzed. RESULTS Compared with 1990, the global incident cases in 2019 were higher by 154.78%, 123.34%, and 169.11% for kidney, bladder, and prostate cancers, respectively. During the 30-year study period, there was a downward trend in ASMR and ASDR for bladder cancer (EAPC = - 0.68 and - 0.83, respectively) and prostate cancer (EAPC = - 0.75 and - 0.71, respectively), but an upward trend for kidney cancer (EAPC = 0.35 and 0.12, respectively). Regions and countries with higher SDI had higher incidence, mortality, and DALYs for all three types of cancers. The burden of bladder and prostate cancers was mainly distributed among older men, whereas the burden of kidney cancer increased among middle-aged men. Smoking related mortality and DALYs decreased, but high body mass index (BMI) and high fasting plasma glucose (FPG) related mortality and DALYs increased among kidney, bladder, and prostate cancers during the study period. CONCLUSIONS Kidney, bladder, and prostate cancers remain major global public health challenges, but with distinct trend for different disease entity across different regions and socioeconomic status. More proactive intervention strategies, at both the administrative and academic levels, based on the dynamic changes, are needed.
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Affiliation(s)
- Hao Zi
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.,Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Shao-Hua He
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.,Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.,Precision Medicine Centre, The Second People's Hospital of Huaihua, Huaihua, 418000, China
| | - Xie-Yuan Leng
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.,The First School of Clinical Medicine, Anhui Medical University, Hefei, 230000, China
| | - Xiao-Feng Xu
- Department of Urology, Xianyang Central Hospital, Xianyang, 712000, China.,Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Qiao Huang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Hong Weng
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.,Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Cong Zhu
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.,Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Lu-Yao Li
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.,Institutes of Evidence-Based Medicine and Knowledge Translation, Henan University, Kaifeng, 475000, China
| | - Jia-Min Gu
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.,Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Xu-Hui Li
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Dao-Jing Ming
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.,Institutes of Evidence-Based Medicine and Knowledge Translation, Henan University, Kaifeng, 475000, China
| | - Xiao-Dong Li
- Institutes of Evidence-Based Medicine and Knowledge Translation, Henan University, Kaifeng, 475000, China.,Department of Urology, Huaihe Hospital of Henan University, Kaifeng, 475000, China
| | - Shuai Yuan
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.
| | - Xing-Huan Wang
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China. .,Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China. .,Institute of Urology, Wuhan University, Wuhan, 430071, China.
| | - Da-Lin He
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China.
| | - Xian-Tao Zeng
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China. .,Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China. .,Institute of Urology, Wuhan University, Wuhan, 430071, China.
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24
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Mangesius J, Arnold CR, Seppi T, Mangesius S, Brüggl M, Eichberger P, Ganswindt U. Impact of COVID-19 on Radiation Oncology, an Austrian Experience. Curr Oncol 2021; 28:4776-4785. [PMID: 34898552 PMCID: PMC8628691 DOI: 10.3390/curroncol28060404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 10/29/2021] [Accepted: 11/11/2021] [Indexed: 11/25/2022] Open
Abstract
The COVID-19 pandemic has an unprecedented impact on cancer treatment worldwide. We aimed to evaluate the effects of the pandemic on the radiation treatment of patients in order to provide data for future management of such crises. We compared the number of performed radiotherapy sessions of the pandemic period from February 2020 until May 2021 with those of 2018 and 2019 for reference. At our department, no referred patients had to be rejected or postponed, nor any significant changes in fractionation schedules implemented. Nevertheless, there was a substantial drop in overall radiotherapy sessions in 2020 following the first incidence wave of up to −25% (in June) in comparison to previous years. For breast cancer, a maximum decline of sessions of −45% (July) was recorded. Only a short drop of prostate cancer sessions (max −35%, May) followed by a rebound (+42%, July) was observed. Over the investigated period, a loss of 4.4% of expected patients never recovered. The severe impact of COVID-19 on cancer treatment, likely caused by retarded diagnosis and delayed interdisciplinary co-treatment, is reflected in a lower count of radiotherapy sessions. Radiation oncology is a crucial cornerstone in upholding both curative treatment options and treatment capacity during a pandemic.
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Affiliation(s)
- Julian Mangesius
- Department of Radiation Oncology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (C.R.A.); (T.S.); (M.B.); (P.E.); (U.G.)
- Correspondence:
| | - Christoph Reinhold Arnold
- Department of Radiation Oncology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (C.R.A.); (T.S.); (M.B.); (P.E.); (U.G.)
| | - Thomas Seppi
- Department of Radiation Oncology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (C.R.A.); (T.S.); (M.B.); (P.E.); (U.G.)
| | - Stephanie Mangesius
- Department of Neuroradiology, Medical University of Innsbruck, 6020 Innsbruck, Austria;
| | - Mario Brüggl
- Department of Radiation Oncology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (C.R.A.); (T.S.); (M.B.); (P.E.); (U.G.)
| | - Paul Eichberger
- Department of Radiation Oncology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (C.R.A.); (T.S.); (M.B.); (P.E.); (U.G.)
| | - Ute Ganswindt
- Department of Radiation Oncology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (C.R.A.); (T.S.); (M.B.); (P.E.); (U.G.)
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25
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Rolfo C, Meshulami N, Russo A, Krammer F, García-Sastre A, Mack PC, Gomez JE, Bhardwaj N, Benyounes A, Sirera R, Moore A, Rohs N, Henschke CI, Yankelevitz D, King J, Shyr Y, Bunn PA, Minna JD, Hirsch FR. Lung Cancer and Severe Acute Respiratory Syndrome Coronavirus 2 Infection: Identifying Important Knowledge Gaps for Investigation. J Thorac Oncol 2021; 17:214-227. [PMID: 34774792 PMCID: PMC8579698 DOI: 10.1016/j.jtho.2021.11.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/30/2021] [Accepted: 11/01/2021] [Indexed: 12/12/2022]
Abstract
Patients with lung cancer are especially vulnerable to coronavirus disease 2019 (COVID-19) with a greater than sevenfold higher rate of becoming infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) COVID-19, a greater than threefold higher hospitalization rate with high complication rates, and an estimated case fatality rate of more than 30%. The reasons for the increased vulnerability are not known. In addition, beyond the direct impact of the pandemic on morbidity and mortality among patients with lung cancer, COVID-19, with its disruption of patient care, has also resulted in substantial impact on lung cancer screening and treatment/management.COVID-19 vaccines are safe and effective in people with lung cancer. On the basis of the available data, patients with lung cancer should continue their course of cancer treatment and get vaccinated against the SARS-CoV-2 virus. For unknown reasons, some patients with lung cancer mount poor antibody responses to vaccination. Thus, boosting vaccination seems urgently indicated in this subgroup of vulnerable patients with lung cancer. Nevertheless, many unanswered questions regarding vaccination in this population remain, including the magnitude, quality, and duration of antibody response and the role of innate and acquired cellular immunities for clinical protection. Additional important knowledge gaps also remain, including the following: how can we best protect patients with lung cancer from developing COVID-19, including managing care in patient with lung cancer and the home environment of patients with lung cancer; are there clinical/treatment demographics and tumor molecular demographics that affect severity of COVID-19 disease in patients with lung cancer; does anticancer treatment affect antibody production and protection; does SARS-CoV-2 infection affect the development/progression of lung cancer; and are special measures and vaccine strategies needed for patients with lung cancer as viral variants of concern emerge.
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Affiliation(s)
- Christian Rolfo
- Center of Excellence for Thoracic Oncology, The Tisch Cancer Institute, Icahn School of Medicine, at Mount Sinai, New York, New York
| | - Noy Meshulami
- Center of Excellence for Thoracic Oncology, The Tisch Cancer Institute, Icahn School of Medicine, at Mount Sinai, New York, New York
| | - Alessandro Russo
- Medical Oncology Unit, Azienda Ospedaliera Papardo (A.O. Papardo), Messina, Italy
| | - Florian Krammer
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Adolfo García-Sastre
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Philip C Mack
- Center of Excellence for Thoracic Oncology, The Tisch Cancer Institute, Icahn School of Medicine, at Mount Sinai, New York, New York
| | - Jorge E Gomez
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Nina Bhardwaj
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Amin Benyounes
- Thoracic Oncology, Inova Schar Cancer Institute, Fairfax, Virginia
| | - Rafael Sirera
- Unidad Mixta TRIAL, Centro Investigación Príncipe Felipe-Fundación Investigación, Hospital General Universitario de Valencia, Valencia, Spain; Centro de Investigación Biomédica en Red Cáncer, CIBERONC, Madrid, Spain; Department of Biotechnology, Universitat Politècnica de València, Valencia, Spain
| | - Amy Moore
- LUNGevity Foundation, Bethesda, Maryland
| | - Nicholas Rohs
- Center of Excellence for Thoracic Oncology, The Tisch Cancer Institute, Icahn School of Medicine, at Mount Sinai, New York, New York
| | | | - David Yankelevitz
- Department of Radiology, Mount Sinai Health System, New York, New York
| | - Jennifer King
- GO(2) Foundation for Lung Cancer, Washington, District of Columbia
| | - Yu Shyr
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Paul A Bunn
- Division of Medical Oncology, University of Colorado Cancer Center, Aurora, Colorado
| | - John D Minna
- Division of Hematology and Oncology, Department of Internal Medicine, The Hamon Center for Therapeutic Oncology Research, University of Texas Southwestern Medical Center, Dallas, Texas; Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Fred R Hirsch
- Center of Excellence for Thoracic Oncology, The Tisch Cancer Institute, Icahn School of Medicine, at Mount Sinai, New York, New York.
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