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Tashkandi E, Al-Abdulwahab A, Basulaiman B, Alsharm A, Al-Hajeili M, Alshadadi F, Halawani L, Al-Mansour M, Alquzi B, Barnawi S, Alghamdi M, Abdelaziz N, Azher R. Mortality and morbidity of curative and palliative anticancer treatments during the COVID-19 pandemic: A multicenter population-based retrospective study. Mol Clin Oncol 2021; 14:82. [PMID: 33758663 PMCID: PMC7947946 DOI: 10.3892/mco.2021.2244] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 02/09/2021] [Indexed: 01/08/2023] Open
Abstract
Administration of effective anticancer treatments should continue during pandemics. However, the outcomes of curative and palliative anticancer treatments during the coronavirus disease (COVID-19) pandemic remain unclear. The present retrospective observational study aimed to determine the 30-day mortality and morbidity of curative and palliative anticancer treatments during the COVID-19 pandemic. Between March 1 and June 30, 2020, all adults (n=2,504) with solid and hematological malignancies irrespective of cancer stage and type of anticancer treatments at five large comprehensive cancer centers in Saudi Arabia were included. The 30-day mortality was 5.1% (n=127) for all patients receiving anticancer treatment, 1.8% (n=24) for curative intent, 8.6% (n=103) for palliative intent and 13.4% (n=12) for COVID-19 cases. The 30-day morbidity was 28.2% (n=705) for all patients, 17.9% (n=234) for curative intent, 39.3% (n=470) for palliative intent and 75% (n=77) for COVID-19 cases. The 30-day mortality was significantly increased with male sex [odds ratio (OR), 2.011; 95% confidence interval (CI), 1.141-3.546; P=0.016], body mass index (BMI) <25 (OR, 1.997; 95% CI, 1.292-3.087; P=0.002), hormone therapy (OR, 6.315; 95% CI, 0.074-2.068; P=0.001) and number of cycles (OR, 2.110; 95% CI, 0.830-0.948; P=0.001), but decreased with Eastern Cooperative Oncology Group performance status (ECOG-PS) of 0-1 (OR, 0.157; 95% CI, 0.098-0.256; P=0.001), stage I-II cancer (OR, 0.254; 95% CI, 0.069-0.934; P=0.039) and curative intent (OR, 0.217; 95% CI, 0.106-0.443; P=0.001). Furthermore, the 30-day morbidity significantly increased with age >65 years (OR, 1.420; 95% CI, 1.075-1.877; P=0.014), BMI <25 (OR, 1.484; 95% CI, 1.194-1.845; P=0.001), chemotherapy (OR, 1.397; 95% CI, 1.089-5.438; P=0.032), hormone therapy (OR, 1.527; 95% CI, 0.211-1.322; P=0.038) and immunotherapy (OR, 1.859; 95% CI, 0.648-4.287; P=0.038), but decreased with ECOG-PS of 0-1 (OR, 0.502; 95% CI, 0.399-0.632; P=0.001), breast cancer (OR, 0.569; 95% CI, 0.387-0.836; P=0.004) and curative intent (OR, 0.410; 95% CI, 0.296-0.586; P=0.001). The mortality risk was lowest with curative treatments. Therefore, such treatments should not be delayed. The morbidity risk doubled with palliative treatments and was highest among COVID-19 cases. Mortality appeared to be driven by male sex, BMI <25, hormonal therapy and number of cycles, while morbidity increased with age >65 years, BMI <25, chemotherapy, hormonal therapy and immunotherapy. Therefore, oncologists should select the most effective anticancer treatments based on the aforementioned factors.
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Affiliation(s)
- Emad Tashkandi
- Department of Medicine, College of Medicine, Umm Al-Qura University, Makkah 21421, Saudi Arabia.,Department of Medical Oncology, Oncology Center, King Abdullah Medical City, Makkah 24246, Saudi Arabia
| | - Amal Al-Abdulwahab
- Department of Medical Oncology, Oncology Center, King Abdullah Medical City, Makkah 24246, Saudi Arabia
| | - Bassam Basulaiman
- Department of Medical Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh 11564, Saudi Arabia
| | - Abdullah Alsharm
- Department of Medical Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh 11564, Saudi Arabia
| | - Marwan Al-Hajeili
- Department of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Faisal Alshadadi
- Department of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Lamis Halawani
- Department of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Mubarak Al-Mansour
- Department of Medical Oncology, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 21423, Saudi Arabia.,Department of Medical Oncology, Princess Noorah Oncology Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs-Western Region, Jeddah 21423, Saudi Arabia
| | - Bushra Alquzi
- Department of Medical Oncology, Princess Noorah Oncology Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs-Western Region, Jeddah 21423, Saudi Arabia
| | - Samar Barnawi
- Department of Medical Oncology, Princess Noorah Oncology Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs-Western Region, Jeddah 21423, Saudi Arabia
| | - Mohammed Alghamdi
- Department of Medical Oncology, College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia
| | - Nashwa Abdelaziz
- Department of Medical Oncology, College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia
| | - Ruqayya Azher
- Community Medicine Department, Umm Al-Qura University, Makkah 21421, Saudi Arabia
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Al-Hajeili M, Abdulwassi HK, Alshadadi F, Alqurashi L, Idriss M, Halawani L. Assessing knowledge on preventive colorectal cancer screening in Saudi Arabia: A cross-sectional study. J Family Med Prim Care 2019; 8:3140-3146. [PMID: 31742133 PMCID: PMC6857381 DOI: 10.4103/jfmpc.jfmpc_508_19] [Citation(s) in RCA: 10] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 08/22/2019] [Accepted: 09/10/2019] [Indexed: 12/25/2022] Open
Abstract
Context According to the Saudi Cancer Registry's 2014 Cancer Incidence Report, colorectal cancer (CRC) is the leading form of malignant cancer among Saudi men and ranks third among women. Raising awareness about CRC risk factors could lead to a significant decline in incidence of disease. Aims To assess CRC awareness and evaluate the main barriers that might prevent individuals' participation in screening. Settings and Design A self-administered survey was conducted over two days as part of a CRC awareness campaign in Jeddah, Saudi Arabia in March, 2018. Methods and Materials The survey addressed issues regarding knowledge of CRC and available screening methods. The survey also examined barriers that might make one reluctant to undergo preventative screening. Stata/SE 15.0 was used for all statistical analyses. Statistical Analyses Continuous variables were described with frequencies and percentages. Stepwise linear regression models were constructed to predict CRC knowledge and barriers. Results Out of 422 participants, 50.2% were men. Most respondents were between 15-35 years old (65.8%). Multivariate analysis revealed that gender was a significant predictor of CRC knowledge. Furthermore, the variables of education and family history of CRC significantly predicted subjects' awareness of colonoscopic screenings. The most common barriers for seeking screening included fear of the procedure, absence of clinical symptoms, and fear of the results. Conclusions Our results highlight deficits in public CRC knowledge and their awareness of preventative measures. These shortcomings were found to be mainly related to education level. Specific barriers affecting screening decisions were also identified; intensive efforts on awareness to overcome these obstacles will be required.
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Affiliation(s)
- Marwan Al-Hajeili
- Department of Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Faisal Alshadadi
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Lujain Alqurashi
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohmmad Idriss
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Lamis Halawani
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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