Impact of COVID-19 pandemic on gastrointestinal cancer diagnosis and resection: An observational study.
COVID
Colon cancer
Endoscopy
Hepatocellular carcinoma
Journal
Clinics and research in hepatology and gastroenterology
ISSN: 2210-741X
Titre abrégé: Clin Res Hepatol Gastroenterol
Pays: France
ID NLM: 101553659
Informations de publication
Date de publication:
03 2022
03 2022
Historique:
received:
27
04
2021
revised:
09
11
2021
accepted:
10
11
2021
pubmed:
26
11
2021
medline:
2
4
2022
entrez:
25
11
2021
Statut:
ppublish
Résumé
The COVID-19 pandemic disrupted routine screening for and treatment of gastrointestinal (GI) cancers. We analyzed changes in GI cancer pathology specimens resulting from diagnostic and therapeutic procedures at a single academic center in an epicenter of the COVID-19 pandemic. Our aim was to determine which cancer types, procedures, and patients were impacted by the pandemic. This was a retrospective, cohort study of patients identified based on carcinoma containing pathologic specimens reviewed in our institution resulting from diagnostic or resection procedures. Pathology and medical records of patients with GI and liver carcinoma and high-grade dysplasia were reviewed from February 1 to April 30 in 2018, 2019 and 2020. We used March 16, 2020 to delineate the pre-COVID-19 and COVID-19 period in 2020. Chi-squared or t-tests, as appropriate, were used to compare these time periods in each year. Mann Kendall test was used to test for trend in volume. ANCOVA was used to compare differences across years. A total of 1028 pathology samples from 949 unique patients were identified during the study period. There was a 57% drop in samples within 2020 (p = 0.01) that was not present in either 2018 or 2019 (p<0.01). In 2020, there were significantly fewer resections compared to biopsies overall in the COVID-19 period (p = 0.01). There were fewer colorectal cancer specimens (p = 0.04) which were procured from older patients (p<0.01) in the 2020 COVID-19 period compared to pre-COVID-19. In our institution, there was a significant drop in diagnostic and resection specimens of GI cancers during the COVID-19 pandemic, disproportionately affecting older colorectal cancer patients.
Sections du résumé
BACKGROUND
The COVID-19 pandemic disrupted routine screening for and treatment of gastrointestinal (GI) cancers. We analyzed changes in GI cancer pathology specimens resulting from diagnostic and therapeutic procedures at a single academic center in an epicenter of the COVID-19 pandemic. Our aim was to determine which cancer types, procedures, and patients were impacted by the pandemic.
METHODS
This was a retrospective, cohort study of patients identified based on carcinoma containing pathologic specimens reviewed in our institution resulting from diagnostic or resection procedures. Pathology and medical records of patients with GI and liver carcinoma and high-grade dysplasia were reviewed from February 1 to April 30 in 2018, 2019 and 2020. We used March 16, 2020 to delineate the pre-COVID-19 and COVID-19 period in 2020. Chi-squared or t-tests, as appropriate, were used to compare these time periods in each year. Mann Kendall test was used to test for trend in volume. ANCOVA was used to compare differences across years.
RESULTS
A total of 1028 pathology samples from 949 unique patients were identified during the study period. There was a 57% drop in samples within 2020 (p = 0.01) that was not present in either 2018 or 2019 (p<0.01). In 2020, there were significantly fewer resections compared to biopsies overall in the COVID-19 period (p = 0.01). There were fewer colorectal cancer specimens (p = 0.04) which were procured from older patients (p<0.01) in the 2020 COVID-19 period compared to pre-COVID-19.
CONCLUSIONS
In our institution, there was a significant drop in diagnostic and resection specimens of GI cancers during the COVID-19 pandemic, disproportionately affecting older colorectal cancer patients.
Identifiants
pubmed: 34823067
pii: S2210-7401(21)00217-5
doi: 10.1016/j.clinre.2021.101839
pmc: PMC8608414
pii:
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
101839Informations de copyright
Copyright © 2021 Elsevier Masson SAS. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Références
Science. 2020 Jun 19;368(6497):1290
pubmed: 32554570
Dis Colon Rectum. 2020 Jun;63(6):720-722
pubmed: 32384401
MMWR Morb Mortal Wkly Rep. 2020 May 15;69(19):603-605
pubmed: 32407306
JAMA. 2020 May 26;323(20):2005-2006
pubmed: 32282023
Adv Radiat Oncol. 2020 Apr 22;5(4):687-689
pubmed: 32322758
Lancet Gastroenterol Hepatol. 2020 Aug;5(8):726-727
pubmed: 32569576
Gastroenterology. 2020 Sep;159(3):1164-1166.e3
pubmed: 32425228
Br J Haematol. 2020 Jul;190(1):e5-e8
pubmed: 32369605
J Am Coll Cardiol. 2020 Jun 9;75(22):2871-2872
pubmed: 32283124
Gastroenterology. 2020 Oct;159(4):1579-1581.e5
pubmed: 32534934
MMWR Morb Mortal Wkly Rep. 2020 Jun 12;69(23):699-704
pubmed: 32525856
Ann Surg Oncol. 2020 Jun;27(6):1717-1720
pubmed: 32270420
Lancet Oncol. 2020 Jun;21(6):750-751
pubmed: 32359403
Br J Surg. 2020 Sep;107(10):1250-1261
pubmed: 32350857
Lancet Oncol. 2020 May;21(5):603
pubmed: 32359483
Lancet Haematol. 2020 Jun;7(6):e432-e435
pubmed: 32339482