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Yi JP, Yoon CI, Lim SH, Choi H, Oh SJ, Kim H, Park DS, Baek JM, Kim YS, Jeon YW, Rhu J, Kang YJ. Prognosis of Patients with Breast Cancer Following Delayed Diagnosis During the COVID-19 Pandemic: A Real-World Cohort Study. Ann Surg Oncol 2025; 32:2029-2037. [PMID: 39633173 DOI: 10.1245/s10434-024-16645-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2024] [Accepted: 11/21/2024] [Indexed: 12/07/2024]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has globally impacted healthcare systems, delaying cancer screening, diagnosis, and treatment. South Korea experienced a 3-month lockdown during the peak of the pandemic, leading to postponements in breast cancer diagnosis and treatment. Although the pandemic's severity has decreased, addressing the treatment gap remains a concern. METHODS This retrospective cohort study included patients diagnosed with breast cancer at five academic hospitals in South Korea during the pre-COVID (May-July 2019) and COVID (May-July 2020) periods. The primary endpoint was recurrence-free survival (RFS), and secondary endpoints included overall survival (OS), stage distribution, and age subgroup analyses. RESULTS Among 716 patients (374 pre-COVID, 342 COVID), the 3-year RFS was significantly lower in the COVID group (88.3 vs. 89.7%, p = 0.030), while the 3-year OS was similar between groups (96.2 vs. 95.5%, p = 0.439). Age subgroup analysis revealed a significant RFS difference in patients under 65 years of age (p = 0.005) but not in those aged 65 years and older (p = 0.682). Stage distribution did not differ significantly between groups (p = 0.531). CONCLUSIONS The COVID-19 pandemic adversely affected 3-year RFS, especially among younger patients, despite no significant increase in advanced-stage distribution. Timely cancer screening remains crucial for young patients with fewer infectious disease complications.
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Affiliation(s)
- Jae Pak Yi
- Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
- Department of Medicine, Graduate School, Kyung Hee University, Seoul, Korea
| | - Chang Ik Yoon
- Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Su Hyun Lim
- Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Hoon Choi
- Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Se Jeong Oh
- Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Hyobin Kim
- Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Dae Sun Park
- Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Jong Min Baek
- Department of Surgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yong-Seok Kim
- Department of Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
| | - Ye Won Jeon
- Department of Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Jiyoung Rhu
- Department of Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
| | - Young-Joon Kang
- Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea.
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Shintani Y, Yamamoto H, Sato Y, Inoue M, Asakura K, Ito H, Uramoto H, Okada Y, Sato T, Fukui M, Hoshikawa Y, Chen-Yoshikawa TF, Chida M, Ikeda N, Yoshino I. Effects of the COVID-19 pandemic on surgical treatment for thoracic malignant tumor cases in Japan: a national clinical database analysis. Surg Today 2025; 55:265-272. [PMID: 39644388 PMCID: PMC11757856 DOI: 10.1007/s00595-024-02907-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 07/15/2024] [Indexed: 12/09/2024]
Abstract
OBJECTIVE Surgical care has been significantly affected by the COVID-19 pandemic. This study was conducted to evaluate the effects of the pandemic on lung cancer and mediastinal tumor surgery. METHODS Changes in the number of surgical procedures for lung cancer and mediastinal tumors were analyzed using the National Clinical Database of Japan. Patient characteristics, including disease stage and histological type, from 2019 to 2022 were evaluated using annual datasets. RESULTS Comparisons with 2019 showed that the number of patients who underwent surgery for primary lung cancer or a mediastinal tumor decreased in 2020 and then remained stable. There were no clinically significant changes in the trend over the four-year period regarding the number of patients for each clinical and pathological stage of lung cancer. Regarding mediastinal tumors, there was no significant difference in tumor size between years. There was a slight change in the selection of surgical indication during the second quarter of 2020, although its impact on annual trends in the stage distribution for lung cancer and primary disease for mediastinal tumors was minimal. CONCLUSIONS Analyses of lung cancer and mediastinal tumor surgery cases in Japan during the COVID-19 pandemic showed no significant disease profile changes related to treatment delay.
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Affiliation(s)
- Yasushi Shintani
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2-L5, Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Hiroyuki Yamamoto
- Department of Healthcare Quality Assessment, The University of Tokyo, Tokyo, Japan
| | - Yukio Sato
- Department of Thoracic Surgery, University of Tsukuba, Ibaraki, Japan
| | - Masayoshi Inoue
- Division of Thoracic Surgery, Department Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Keisuke Asakura
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hiroyuki Ito
- Department of Thoracic Surgery, Kanagawa Cancer Center, Kanagawa, Japan
| | - Hidetaka Uramoto
- Department of Thoracic Surgery, Kanazawa Medical University, Ishikawa, Japan
| | - Yoshinori Okada
- Department of Thoracic Surgery, Tohoku University, Miyagi, Japan
| | - Toshihiko Sato
- Department of General Thoracic, Breast and Pediatric Surgery, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Mariko Fukui
- Department of General Thoracic Surgery, Juntendo University, Tokyo, Japan
| | - Yasushi Hoshikawa
- Department of Thoracic Surgery, Fujita Health University School of Medicine, Aichi, Japan
| | | | - Masayuki Chida
- Department of General Thoracic Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Norihiko Ikeda
- Department of Surgery, Tokyo Medical University, Tokyo, Japan
| | - Ichiro Yoshino
- Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
- Department of Thoracic Surgery, International University of Health and Welfare School of Medicine, Chiba, Japan
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Ahmed RA, Aldalbahi AA, Alhumaidan NI, Alotaibi TA, Alharbi MA, Alharbi MA, Alzahrani MMM, Althobaiti AA, Alzelfawi L, Almouaalamy NA. An approach to COVID‑19 and oncology: From impact, staging and management to vaccine outcomes in cancer patients: A systematic review and meta‑analysis. Exp Ther Med 2025; 29:37. [PMID: 39776889 PMCID: PMC11705223 DOI: 10.3892/etm.2024.12787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Accepted: 10/15/2024] [Indexed: 01/11/2025] Open
Abstract
The COVID-19 pandemic has had a global impact, with >771 million confirmed cases and 6 million deaths reported by October 2023. Cancer patients, due to their immunosuppressed status, face an increased infection risk and higher COVID-19 complications. The present study aimed to assess clinical outcomes in COVID-19-infected cancer patients, focusing on mortality rates and other aspects, providing valuable insight for better protection and outcomes. This systematic review was conducted by searching the PubMed, Cochrane and Embase databases from August 2023 following the PRISMA guidelines. Studies from 2020 to 2023 pertaining to the impact of COVID-19 on patients previously diagnosed with malignancies were considered. Inclusion criteria entailed a pre-existing malignancy diagnosis, confirmed COVID-19 infection and an impact of COVID-19 on any aspect of the patient's cancer management. Studies written in English were exclusively reviewed. Post-COVID-19 malignancy diagnoses, case reports, review articles and data-insufficient studies were excluded. Screening and consensus on eligibility were carried out by a team of four authors, with disputes resolved by a non-screening author. Data extraction was performed by a five-author team, detailing study and population characteristics, as well as cancer patient outcomes related to COVID-19. Cross-checking was conducted by the same team, with conflicts resolved by a third author. The review of 27 studies explored COVID-19's impact on oncology, revealing diverse sample sizes (1,807,559 to 177 participants). Studies spanned various cancer types, including gastric adenocarcinoma, breast, lung, gynecologic, colorectal and non-melanoma skin cancer. Mortality rates were higher among cancer patients with COVID-19 compared to those without. Gastric adenocarcinoma exhibited a 5.9% mortality rate. Thoracic cancer patients faced elevated mortality and gastrectomies decreased. A meta-analysis (10 studies, 5,151 patients) showed a 19.1% mortality rate for COVID-19-infected cancer patients, contrasting with 1% for non-COVID-19 cancer patients (5 studies, 54,528 patients). The odds ratio for mortality in non-COVID-19 vs. COVID-19 cancer patients was 0.1036 (3 studies, 3,496 patients). Cancer patients consistently faced elevated mortality during the pandemic, with specific cancers showing unique impacts. Gastric adenocarcinoma exhibited a significant COVID-19 mortality rate. Patients with thoracic cancer faced increased risks, influencing surgical trends. Meta-analysis revealed an overall elevated mortality rate among COVID-19-infected cancer patients compared to non-COVID-19 counterparts.
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Affiliation(s)
- Ruqayyah Ali Ahmed
- Department of Medicine and Surgery, Batterjee Medical College for Science and Technology, Jeddah 21442, Saudi Arabia
| | | | | | | | | | - Mohammed A. Alharbi
- College of Medicine, Imam Abdulrahman bin Faisal University, Dammam 31441, Saudi Arabia
| | | | | | - Lama Alzelfawi
- College of Medicine, Princess Noura University, Riyadh 11564, Saudi Arabia
| | - Nabil A. Almouaalamy
- Oncology Department, Princess Noorah Oncology Center, King Abdul Aziz Medical City, Ministry of National Guard-Health Affairs, King Abdullah International Medical Research Centre, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Makkah-Jeddah Highway Road, Jeddah 22384, Saudi Arabia
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4
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Grumstrup Simonsen M, Fenger Carlander AL, Kronberg Jakobsen K, Grønhøj C, Von Buchwald C. The impact of the COVID-19 pandemic on time to treatment in head and neck cancer management: a systematic review. Acta Oncol 2025; 64:156-166. [PMID: 39876689 PMCID: PMC11808816 DOI: 10.2340/1651-226x.2025.41366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2024] [Accepted: 11/14/2024] [Indexed: 01/30/2025]
Abstract
BACKGROUND AND PURPOSE Coronavirus disease 2019 (COVID-19) caused a need for reorganization in the healthcare systems. First, we aimed to determine the impact of the COVID-19 pandemic on time to treatment in head and neck cancer (HNC) patients. Second, we aimed to determine the impact of COVID-19 on tumor stage and changes in treatment regimens used. MATERIAL AND METHODS A systematic search in PubMed and Embase was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria were: (1) Studies including patients with head and neck squamous cell carcinomas; (2) Studies containing a comparison of time to treatment; (3) Studies containing a well-defined time interval with restrictions on health care due to COVID-19 and a well-defined time interval without restrictions. RESULTS A total of 19 studies were included comprising 24,898 patients treated for HNC cancer. Six studies (10.1% of the patients) reported an increase in waiting time within at least one interval, while seven studies reported a decrease (83.2% of the patients), and six studies found no significant effect. No changes in treatment modalities were observed. Seven of 15 studies (12.7% of the patients) observed an increase in either overall stage, size, or tumor node and metastasis classification during the COVID-19 pandemic. Among these, two studies reported increased waiting times as well. INTERPRETATION The impact of the COIVD-19 pandemic on time to treatment was heterogenous and subject to considerable intercountry and interregional variations. A tendency toward a higher T-classification was observed. In conclusion, otorhinolaryngology departments demonstrated resilience, as the pandemic led to only slight alterations in time to treatment.
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Affiliation(s)
- Malte Grumstrup Simonsen
- Department of Otolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen University Hospital, Denmark.
| | - Amanda-Louise Fenger Carlander
- Department of Otolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen University Hospital, Denmark
| | - Kathrine Kronberg Jakobsen
- Department of Otolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen University Hospital, Denmark
| | - Christian Grønhøj
- Department of Otolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen University Hospital, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Christian Von Buchwald
- Department of Otolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen University Hospital, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark
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Raasthøj Holst I, Sætre LMS, Lauridsen GB, Balasubramaniam K, Haastrup P, Wehberg S, Jarbøl DE. Considerations and experiences with healthcare-seeking during the first COVID-19 lockdown in Denmark. Scand J Prim Health Care 2025:1-14. [PMID: 39831697 DOI: 10.1080/02813432.2025.2452924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 01/08/2025] [Indexed: 01/22/2025] Open
Abstract
AIM To (1) examine considerations before and experiences with GP contact during the first COronaVIrus Disease 2019 (COVID-19) lockdown among Danish citizens; (2) analyse the associations with sex, age, chronic disease, and socioeconomic factors; and (3) explore changes in healthcare-seeking behaviour post-pandemic. METHOD A total of 100,000 Danes aged 20 years or older, randomly selected in the general population, were invited to participate in a survey examining considerations and experiences with healthcare seeking during the first COVID-19 lockdown. Data were collected in spring 2022 and linked to register data on socioeconomic factors. Descriptive statistics and multivariable logistic regression models were applied. RESULTS Of the 27,369 eligible individuals, 18% reported a need to contact their GP. Being worried about burdening the healthcare system was most frequently reported (45%), followed by being in doubt about acceptable contact reasons (33%), and concern about infection (24%). Although 44% of those who needed to contact their GP found the digital solutions advantageous, individuals frequently found it difficult to discuss symptoms by telehealth (29%) and that they were examined less thoroughly. Generally, women, younger people, and individuals with lower socioeconomic status were more likely to be worried and report difficulties with contact to general practice. Some 86% of the respondents reported no changes in healthcare-seeking behaviour post-pandemic. CONCLUSION The results may assist in the organisation of healthcare in case of future lockdowns. Yet, the COVID-19 pandemic has only slightly affected the healthcare-seeking behaviour in the Danish general population.
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Affiliation(s)
- Isabella Raasthøj Holst
- The Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense M, Denmark
| | - Lisa Maria Sele Sætre
- The Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense M, Denmark
| | - Gitte Bruun Lauridsen
- The Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense M, Denmark
| | - Kirubakaran Balasubramaniam
- The Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense M, Denmark
| | - Peter Haastrup
- The Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense M, Denmark
| | - Sonja Wehberg
- The Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense M, Denmark
| | - Dorte Ejg Jarbøl
- The Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense M, Denmark
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6
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Lu J, Zhao X, Gan S. Global, regional and national burden of tracheal, bronchus, and lung cancer attributable to ambient particulate matter pollution from 1990 to 2021: an analysis of the global burden of disease study. BMC Public Health 2025; 25:108. [PMID: 39789484 PMCID: PMC11720299 DOI: 10.1186/s12889-024-21226-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2024] [Accepted: 12/27/2024] [Indexed: 01/12/2025] Open
Abstract
BACKGROUND The ambient particulate matter pollution may play a critical role in the initiation and development of tracheal, bronchus, and lung (TBL) cancer. Up to now, far too little attention has been paid to TBL cancer attributable to ambient particulate matter pollution. This study aims to assess the disease burden of TBL cancer attributable to ambient particulate matter pollution in global, regional and national from 1990 to 2021 to update the epidemiology data of this disease. METHODS Leveraging data from the Global Burden of Disease (GBD) 2021 study, we analyzed the worldwide burden of TBL cancer resulting from ambient particulate matter pollution using indices including disability-adjusted life years (DALYs), age-standardised rate of DALYs (ASDR). This burden was further segmented based on variables including geographical location, and socio-demographic index (SDI), age and sex. RESULTS The ASDR per 100,000 population of TBL cancer attributable to ambient particulate matter pollution increased by 0.2%[95% UI 0.1 to 0.3] to 79.6[95% UI 49.0 to 111.2] from 1990 to 2021 Globally. Middle-aged and elderly individuals accounted for the majority of the disease burden, with the highest value at the 65-69 years. Most of the disease burden was concentrated in countries with High-middle SDI. There was a positive correlation between ASDR of TBL cancer due to particulate matter pollution and the SDI(ρ = 0.66, p < 0.001). East Asia and Central Europe exhibited higher observed values than the fitted curves, while such as Austraiasia South Asia and Western Sub-Saharan Africa had a lower observed values than the fitted curves. Decomposition analysis showed that population aging and growth were the two major drivers of the increase in DALYs. CONCLUSIONS The disease burden of TBL cancer attributable to ambient particulate matter pollution has increased, especially in regions and countries with High-middle SDI.
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Affiliation(s)
- Jianguo Lu
- The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, 453100, Henan, P. R. China.
| | - Xiangmei Zhao
- School of Public Health, Xinxiang Medical University, Xinxiang, 453003, Henan, P. R. China
| | - Shaoyin Gan
- The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, 453100, Henan, P. R. China
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van den Bulk S, van Egeraat JWA, Petrus AHJ, Numans ME, Bonten TN. Incidence of primary care chest pain consultations during the COVID-19 pandemic: an interrupted time series analysis with routine care data. BMC PRIMARY CARE 2024; 25:433. [PMID: 39709389 DOI: 10.1186/s12875-024-02676-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2024] [Accepted: 12/02/2024] [Indexed: 12/23/2024]
Abstract
BACKGROUND The COVID-19 lockdown had profound effects on society and healthcare. Cardiology departments reported declines in chest pain evaluations and acute coronary syndrome (ACS) diagnoses. However, the pattern of chest pain in primary care is not clear yet. This study aims to assess the impact of the COVID-19 lockdown on the number of patients presenting with chest pain in primary care. METHODS Routine primary care data from the Extramural LUMC (Leiden University Medical Center) Academic Network (ELAN) in the Netherlands were used. Chest pain consultations from January 2017 to December 2020 were included. An interrupted time series analysis was performed to compare the incidence rate (IR) of chest pain consultations during the COVID-19 lockdown to the expected IR. Secondary outcomes were the type of consultations, referral proportions, and the IR of registered ACS diagnoses. RESULTS In total 9,908 chest pain consultations were included. During the COVID-19 lockdown the IR was 6.16 per 1000 person-years while the expected IR was 7.55 (95% CI 7.03-8.12). The immediate effect of the lockdown yielded an incidence rate ratio (IRR) of 0.62 (95% CI 0.50-0.77). A similar decrease was seen for ACS diagnoses (IRR 0.62, 95% CI 0.48-0.79), with no compensatory increase after the lockdown (IRR 1.04, 95% CI 0.89-1.21). Face-to-face consultations shifted to telephone consultations (p < 0.001) and hospital referrals decreased (9.9% vs. 19.0% (p < 0.001)). CONCLUSIONS During the COVID-19 lockdown the number of chest pain consultations and registered ACS diagnoses in primary care decreased significantly. In addition, fewer patients were assessed face-to-face and fewer patients were referred to the hospital.
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Affiliation(s)
- Simone van den Bulk
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, Leiden, 2333 ZD, The Netherlands
| | - Jasper W A van Egeraat
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, Leiden, 2333 ZD, The Netherlands.
| | - Annelieke H J Petrus
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, Leiden, 2333 ZD, The Netherlands
| | - Mattijs E Numans
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, Leiden, 2333 ZD, The Netherlands
| | - Tobias N Bonten
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, Leiden, 2333 ZD, The Netherlands
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Qamar A, Hui L. Sensitivity of major chronic diseases and patients of different ages to the collapse of the healthcare system during the COVID-19 pandemic in China. Medicine (Baltimore) 2024; 103:e40730. [PMID: 39612440 DOI: 10.1097/md.0000000000040730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2024] Open
Abstract
This study evaluates the sensitivity of major chronic diseases to the collapse of the healthcare system for developing prevention and control strategies under normal and emergency conditions. Data for the years 2018, 2019, and 2020 (coronavirus disease 2019 [COVID-19] pandemic) were curated from the National Disease Mortality Surveillance System, Chinese Center for Disease Control and Prevention for diseases such as cancer, heart disease (HD), cerebrovascular disease (CVD), and chronic obstructive pulmonary disease (COPD). The yearly death rate change for 2018, 2019, and 2020 were calculated. Similarly, expected and observed death cases, 95% confidence intervals, and Z-score were calculated for the year 2020 (COVID-19 pandemic). Furthermore, linear regression analysis was performed to analyze a correlation between the median age of various groups and the mortality rate. The observed death cases for cerebrovascular, heart, and other chronic diseases, were more than the expected death cases (430,007 vs 421,317, 369,684 vs 368,957, and 302,974 vs 300,366) as well as an upper limit of 95% confidence interval. The observed death cases for COPD and cancer are less than the expected death cases (127,786 vs 140,524, 450,346 vs 463,961) and lower limit of the 95% confidence interval. The highest Z-score was noted for cerebrovascular disease (105.14). The disease impact of severity was CVD, other chronic diseases, and HD in descending order. The unexpected decline in deaths was found for COPD and cancers with Z-scores (-166.45 and -116.32). The severity of impact was CVD, other chronic diseases, HD, cancer, and COPD in descending order. The COVID-19 pandemic has also resulted in an increase in deaths of the relatively young population as shown by the difference in rate of slop. The healthcare system collapsed due to prevention, control measures and increased burden of COVID-19 patients, affected chronic disease treatment/management and as a consequence variation in death rates occurs in different chronic diseases. A marked increase in mortality was observed in cerebrovascular disease. The unexpected decline in deaths from COPD and cancers, and increase in deaths of the relatively young population suggests that there may be opportunities for improvement in chronic disease management.
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Affiliation(s)
- Ayub Qamar
- Department of Laboratory and Quarantine, Dalian Medical University, Dalian, China
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Erdmann F, Wellbrock M, De Santis KK, Hübner J, Voigtländer S, Arndt V. Impact of the COVID-19 pandemic on cancer diagnoses, oncological care and cancer patients in Germany: a report from the "COVID & Cancer" workshop 2023 of the German Society for Epidemiology (DGEpi). J Cancer Res Clin Oncol 2024; 150:491. [PMID: 39516427 PMCID: PMC11549193 DOI: 10.1007/s00432-024-06019-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2024] [Accepted: 10/25/2024] [Indexed: 11/16/2024]
Abstract
PURPOSE The COVID-19 pandemic was associated with severe disruptions in healthcare worldwide. Cancer patients are at particular risk of adverse consequences from delays in diagnosis and treatment. To evaluate the available data on the impact of the pandemic on cancer diagnoses, oncological care and patient well-being in Germany, the German Society for Epidemiology (DGEpi) in collaboration with the Epidemiological Cancer Registry of Lower Saxony invited to a workshop on "COVID & Cancer" (held on 26-27 October 2023 in Hanover, Germany). This report provides a summary of the scientific presentations, highlights methodological challenges, and recognises essential evidence gaps. METHODS Twelve studies addressing various aspects in relation to cancer diagnoses, oncological care and patient well-being during the COVID-19 pandemic in Germany and two talks sharing experiences from the UK and the Netherlands were presented at the workshop. RESULTS AND CONCLUSIONS Results from German cancer registries consistently showed lower number of incident cancer diagnoses among adults during the first months of the pandemic compared to the respective months of the years before the pandemic. Data from the cancer registries of Baden-Württemberg and Lower Saxony found especially for breast cancer a notable drop (by approximately one third) in the numbers of diagnoses during the first restriction period (April-May 2020), during which the nationwide mammography screening programme in Germany was temporarily suspended. Overall, the extent and ways, in which the pandemic had adversely affected cancer diagnoses, oncological care and created service backlogs, is still not adequately understood. The long-term consequences are yet to be determined.
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Affiliation(s)
- Friederike Erdmann
- Research Group Aetiology and Inequalities in Childhood Cancer, Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University, Langenbeckstraße 1, 55131, Mainz, Germany.
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
| | - Maike Wellbrock
- Research Group Aetiology and Inequalities in Childhood Cancer, Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University, Langenbeckstraße 1, 55131, Mainz, Germany
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Karina Karolina De Santis
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Joachim Hübner
- Agency for Clinical Cancer Data of Lower Saxony, Oldenburg, Germany
| | - Sven Voigtländer
- Bavarian Cancer Registry, Bavarian Health and Food Safety Authority, Nuremberg, Germany
| | - Volker Arndt
- Epidemiological Cancer Registry Baden-Württemberg & Research Group Cancer Survivorship, German Cancer Research Center, Heidelberg, Germany
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10
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Shires CB, Yang J, Landry M, Conrad S, Dewan K. The Impact of COVID-19 on Cholesteatoma Diagnosis and Treatment. Cureus 2024; 16:e73306. [PMID: 39659347 PMCID: PMC11628201 DOI: 10.7759/cureus.73306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2024] [Indexed: 12/12/2024] Open
Abstract
OBJECTIVES This investigation aimed to examine the effects of the COVID-19 pandemic on treatment delays and the severity of initial disease presentation in cholesteatoma patients treated in the prepandemic and pandemic periods. METHODS This retrospective cohort study was of patients who underwent primary surgical management of cholesteatoma between October 2018 and December 2021, split between the prepandemic (October 2018 to February 2020) and pandemic (April 2020 to December 2021) time periods. Data collected included time from referral to otology clinic visit, time of diagnosis, and time of surgical interventions. The extent of cholesteatoma disease and surgery, hearing loss levels, and the need for additional surgical intervention were also considered. The datasets were compared using the Wilcoxon rank-sum test. RESULTS Eighty-six patients met inclusion criteria, 36 of whom were treated prepandemic and 50 after March 2020. Of the examined variables, only time from diagnosis to surgery and case duration were significantly different between the two cohorts, with the pandemic cohort experiencing less time between initial diagnosis and surgery (51.4 days prepandemic vs. 38.4 days pandemic, p = 0.02) and shorter case duration (221.0 minutes prepandemic vs. 171.8 minutes pandemic, p = 0.0008). There was no difference between the severity of presentation in the prepandemic and pandemic populations. CONCLUSIONS There was no significant difference in disease severity or delays in treatment when comparing the prepandemic to the pandemic population. There was a quicker time from referral to surgery and decreased surgical times during the pandemic.
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Affiliation(s)
| | - Jeremy Yang
- Pediatric Otolaryngology, Rady Children's Hospital, San Diego, USA
| | - Mark Landry
- Otolaryngology - Head and Neck Surgery, Louisiana State University Shreveport, Shreveport, USA
| | - Steven Conrad
- Pulmonary and Critical Care Medicine, Louisiana State University (LSU) Health Shreveport, Shreveport, USA
| | - Karuna Dewan
- Otolaryngology - Head and Neck Surgery, Louisiana State University (LSU) Health Shreveport, Shreveport, USA
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11
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Furumaya A, van Delden OM, de Wilde RF, de Vos-Geelen J, van der Geest LG. Impact of COVID-19 on Incidence, Treatment, and Survival of Patients with Hepatocellular Carcinoma in the Netherlands. Disaster Med Public Health Prep 2024; 18:e243. [PMID: 39473387 DOI: 10.1017/dmp.2024.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2025]
Abstract
OBJECTIVE The impact of the coronavirus disease 2019 (COVID-19) on hepatocellular carcinoma (HCC) care is unclear. This study reports on HCC patterns during the COVID-19 pandemic in the Netherlands. METHODS Patients diagnosed with HCC between 2017 and 2020 were identified from the Netherlands Cancer Registration. Monthly incidence rates were compared between 2020 and 2017-2019. Patient, tumor, process, and treatment characteristics and survival were compared between 2020 and 2017-2019, and between COVID-high (April and May 2020) and COVID-low (June and July 2020) months. RESULTS The incidence of HCC was lower in May 2020 (IRR 0.56, P = 0.001) and higher in June 2020 (IRR 1.32, P = 0.05) compared to the same months in 2017-2019. In 2017-2019, 2134 patients presented with HCC, compared to 660 in 2020. Time-to-treatment was shorter in 2020 (median 60 vs. 70 days, P < 0.001). The percentage of patients undergoing any treatment did not differ, yet if treatment was not performed this was more commonly due to comorbidity in 2020 (52 vs. 39%, P < 0.001). No other differences were found in patient, tumor, process and treatment characteristics and survival between COVID-high and COVID-low months. CONCLUSIONS This study demonstrated no impact of the COVID-19 pandemic on HCC patients, despite a decrease in HCC diagnoses.
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Affiliation(s)
- Alicia Furumaya
- Department of Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Otto M van Delden
- Cancer Center Amsterdam, Amsterdam, The Netherlands
- Department of Interventional Radiology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Roeland F de Wilde
- Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Judith de Vos-Geelen
- Department of Internal Medicine, Division of Medical Oncology, GROW, Maastricht University Medical Centre, Maastricht, the Netherlands
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12
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Reger M, Manz K, Kaeuferle T, Coffey R, Wotschofsky Z, von Luettichau I, Schlegel PG, Frühwald MC, Corbacioglu S, Metzler M, Feuchtinger T. Impact of regional SARS-CoV-2 proceedings on changes in diagnoses of pediatric malignancies in Bavaria during the COVID-19 pandemic. Pediatr Hematol Oncol 2024; 41:504-518. [PMID: 39235390 DOI: 10.1080/08880018.2024.2393623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 08/08/2024] [Accepted: 08/12/2024] [Indexed: 09/06/2024]
Abstract
The COVID-19 pandemic affected daily life significantly and had massive consequences for healthcare systems with tremendous regional differences. This retrospective study aimed to investigate whether the pandemic and resulting societal changes impacted the diagnosis of pediatric malignancies in a distinct region. Pediatric cancer cases in Bavaria (2016-2021) and SARS-CoV-2 proceedings during the peak phase of the pandemic (2020-2021) were retrospectively analyzed. All new diagnoses of pediatric malignancies reported from cancer centers in Bavaria were included. Clinical data from pre-pandemic years was compared to diagnoses made during the pandemic. Official SARS-CoV-2 reports were received from the Bavarian Health and Food Safety Authority and data on regional pandemic measures were obtained from the Healthcare Data Platform. With this design, a comprehensive analysis of the pandemic proceedings was performed. We found significantly decreased incidence-rate ratios for pediatric cancer diagnosis during the early spring peak of SARS-CoV-2 as it was observed in May during the pandemic, followed by non-significantly increased metastatic cancer diagnosis two months later. Additionally, the time-to-diagnosis of pediatric malignancies was significantly prolonged during the pandemic, and outpatient contacts were significantly reduced, although the availability of consultations remained the same. From our findings, we may hypothesize that there have been effects on pediatric cancer diagnosis during the COVID-19 pandemic at vulnerable times. Interpretation of changes remains speculative with potential causes from behavior patterns, such as hesitation, concerns, and potential societal changes during phases of public restrictions, rather than overwhelmed medical capacities. Nevertheless, specific awareness is needed to protect this patient population during potential future pandemics.
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Affiliation(s)
- Mira Reger
- Department of Pediatric Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Dr. von Hauner Children's Hospital, University Hospital, Ludwig-Maximilians University (LMU), Munich, Germany
| | - Kirsi Manz
- Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Munich, Germany
| | - Theresa Kaeuferle
- Department of Pediatric Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Dr. von Hauner Children's Hospital, University Hospital, Ludwig-Maximilians University (LMU), Munich, Germany
- German Center for Infection Research (DZIF), Munich, Germany
| | - Ramona Coffey
- Department of Pediatric Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Dr. von Hauner Children's Hospital, University Hospital, Ludwig-Maximilians University (LMU), Munich, Germany
| | - Zofia Wotschofsky
- Department of Pediatrics and Adolescent Medicine, University Hospital, Erlangen, Germany
- Pediatric Oncology Network Bavaria, KIONET, Bavaria, Germany
| | - Irene von Luettichau
- Pediatric Oncology Network Bavaria, KIONET, Bavaria, Germany
- Department of Pediatrics and Children's Cancer Research Center, TUM School of Medicine, Children's Hospital Munich Schwabing, Technical University of Munich, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Bavaria, Germany
| | - Paul-Gerhardt Schlegel
- Pediatric Oncology Network Bavaria, KIONET, Bavaria, Germany
- Bavarian Cancer Research Center (BZKF), Bavaria, Germany
- Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, University Children's Hospital, University of Würzburg, Würzburg, Germany
| | - Michael C Frühwald
- Pediatric Oncology Network Bavaria, KIONET, Bavaria, Germany
- Bavarian Cancer Research Center (BZKF), Bavaria, Germany
- Pediatrics and Adolescent Medicine, Swabian Children's Cancer Center, University Medical Center Augsburg, Augsburg, Germany
| | - Selim Corbacioglu
- Pediatric Oncology Network Bavaria, KIONET, Bavaria, Germany
- Bavarian Cancer Research Center (BZKF), Bavaria, Germany
- Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, University of Regensburg, Regensburg, Germany
| | - Markus Metzler
- Department of Pediatrics and Adolescent Medicine, University Hospital, Erlangen, Germany
- Pediatric Oncology Network Bavaria, KIONET, Bavaria, Germany
- Bavarian Cancer Research Center (BZKF), Bavaria, Germany
| | - Tobias Feuchtinger
- Department of Pediatric Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Dr. von Hauner Children's Hospital, University Hospital, Ludwig-Maximilians University (LMU), Munich, Germany
- German Center for Infection Research (DZIF), Munich, Germany
- Pediatric Oncology Network Bavaria, KIONET, Bavaria, Germany
- Bavarian Cancer Research Center (BZKF), Bavaria, Germany
- Pediatric Hematology, Oncology and Stem Cell Transplantation, University Medical Center Freiburg, Freiburg, Germany
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13
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Peacock HM, Van Meensel M, Van Gool B, Silversmit G, Dekoninck K, Brierley JD, Van Eycken L. Cancer incidence, stage shift and survival during the 2020 COVID-19 pandemic: A population-based study in Belgium. Int J Cancer 2024; 155:1212-1224. [PMID: 38728107 DOI: 10.1002/ijc.35001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 04/02/2024] [Accepted: 04/16/2024] [Indexed: 05/12/2024]
Abstract
The COVID-19 pandemic was associated with a profound decline in cancer diagnoses in 2020 in Belgium. Disruption in diagnostic and screening services and patient reluctance to visit health facilities led to fewer new cases and concerns that cancers may be diagnosed at more advanced stages and hence have poorer prognosis. Using data from mandatory cancer registration covering all of Belgium, we predicted cancer incidence, stage distribution and 1-year relative survival for 2020 using a Poisson count model over the preceding years, extrapolated to 2020 for 11 common cancer types. We compared these expected values to the observed values in 2020 to specifically quantify the impact of the COVID-19 pandemic, accounting for background trends. A significantly lower incidence was observed for cervical, prostate, head and neck, colorectal, bladder and breast cancer, with limited or no recovery of diagnoses in the second half of 2020 for these cancer types. Changes in stage distribution were observed for cervical, prostate, bladder and ovarian and fallopian tube tumours. Generally, changes in stage distribution mainly represented decline in early-stage than in late-stage tumours. One-year relative survival was lower than predicted for lung cancer and colorectal cancer. Stage shifts are hypothesised to result from alterations in access to diagnosis, potentially due to prioritisation of symptomatic patients, and patient reluctance to contact a physician. Since there were over 5000 fewer cancer diagnoses than expected by the end of 2020, it is critical to monitor incidence, stage distribution and survival for these cancers in the coming years.
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Affiliation(s)
| | | | | | | | | | - James D Brierley
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
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14
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Claveau S, Mahmood F, Amir B, Kwan JJW, White C, Vipond J, Iannattone L. COVID-19 and Cancer Care: A Review and Practical Guide to Caring for Cancer Patients in the Era of COVID-19. Curr Oncol 2024; 31:5330-5343. [PMID: 39330021 PMCID: PMC11431468 DOI: 10.3390/curroncol31090393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 08/21/2024] [Accepted: 08/26/2024] [Indexed: 09/28/2024] Open
Abstract
COVID-19, a novel infectious disease caused by the emergence of the SARS-CoV-2 virus in 2020, has had a profound impact on healthcare, both at the individual and population level. The impact at the population level was felt most acutely during the emergency phase of the pandemic, with hospital capacity issues leading to widespread disruptions and delays in the delivery of healthcare services such as screening programs and elective surgeries. While hospitals are no longer being acutely overwhelmed by COVID-19 patients, the impact of the virus on vulnerable patient populations such as cancer patients continues to be of ongoing consequence. Cancer patients remain at high risk of hospitalization, ICU admission, and death due to COVID-19, even in the era of vaccination. Infection prevention and risk mitigation strategies such air quality control, masking, testing, vaccination, and treatment should therefore be integrated into the usual care and counseling of cancer patients moving forward to avoid preventable morbidity and mortality from this infection and ensure the safety of this vulnerable cohort as they navigate their cancer diagnosis and treatment in the era of COVID-19.
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Affiliation(s)
- Simon Claveau
- Department of Medicine, McGill University, Montreal, QC H3A 0G4, Canada
| | - Farhan Mahmood
- Department of Medicine, McGill University, Montreal, QC H3A 0G4, Canada
| | - Baraa Amir
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | | | - Cheryl White
- Independent Researcher, Toronto, ON M6P 3X9, Canada
| | - Joe Vipond
- Department of Emergency Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Lisa Iannattone
- Department of Medicine, McGill University, Montreal, QC H3A 0G4, Canada
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15
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Oyama R, Endo M, Shimada E, Matsunobu T, Setsu N, Ishihara S, Kanahori M, Kawaguchi K, Hirose T, Nabeshima A, Fujiwara T, Yoshimoto M, Maekawa A, Hanada M, Yokoyama N, Matsumoto Y, Nakashima Y. Impact of COVID-19 pandemic on bone and soft tissue sarcoma patients' consultation and diagnosis. Sci Rep 2024; 14:20627. [PMID: 39232087 PMCID: PMC11374780 DOI: 10.1038/s41598-024-71830-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 08/30/2024] [Indexed: 09/06/2024] Open
Abstract
The coronavirus disease (COVID-19) pandemic negatively affected the diagnosis and treatment of several cancer types. However, this pandemic's exact impact and extent on bone and soft tissue sarcomas need to be clarified. We aimed to investigate the effect of the COVID-19 pandemic and emergency declaration by the local government on consultation behavior and clinical stage at diagnosis of bone and soft tissue sarcoma. A total of 403 patients diagnosed with bone and soft tissue sarcoma who initially visited three sarcoma treatment hospitals between January 2018 and December 2021 were included. The monthly number of newly diagnosed soft tissue sarcoma patients was reduced by 25%, and the proportion of soft tissue patients with stage IV disease at diagnosis significantly increased by 9% during the COVID-19 pandemic compared to before the COVID-19 pandemic. Furthermore, the monthly number of new primary bone and soft tissue sarcoma patients significantly decreased by 43% during the state of emergency declaration. The COVID-19 pandemic had a negative impact on soft tissue sarcoma patients' consultation behavior and increased the proportion of advanced-stage patients at initial diagnosis. An emergency declaration by the local government also negatively affected primary bone and soft tissue sarcoma patients' consultation behavior.
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Affiliation(s)
- Ryunosuke Oyama
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Makoto Endo
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Eijiro Shimada
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Tomoya Matsunobu
- Department of Orthopaedic Surgery, Kyushu Rosai Hospital, Fukuoka, Japan
| | - Nokitaka Setsu
- Department of Orthopaedic Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Shin Ishihara
- Department of Orthopaedic Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Masaya Kanahori
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Kengo Kawaguchi
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Takeshi Hirose
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Akira Nabeshima
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Toshifumi Fujiwara
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Masato Yoshimoto
- Department of Orthopaedic Surgery, Kyushu Rosai Hospital, Fukuoka, Japan
| | - Akira Maekawa
- Department of Orthopaedic Surgery, Kyushu Rosai Hospital, Fukuoka, Japan
| | - Masuo Hanada
- Department of Orthopaedic Surgery, Kyushu Rosai Hospital, Fukuoka, Japan
| | - Nobuhiko Yokoyama
- Department of Orthopaedic Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Yoshihiro Matsumoto
- Department of Orthopaedic Surgery, Fukushima Medical University, Fukushima, Japan
| | - Yasuharu Nakashima
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
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16
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Song Y, Wang R, Wang J, Tan X, Ma J. Global burden of lung cancer in women of childbearing age attributable to ambient particulate matter pollution: 1990-2021. Cancer Med 2024; 13:e70241. [PMID: 39315583 PMCID: PMC11420659 DOI: 10.1002/cam4.70241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2024] [Revised: 09/02/2024] [Accepted: 09/03/2024] [Indexed: 09/25/2024] Open
Abstract
BACKGROUND This study aimed to evaluate the global burden of lung cancer due to ambient particulate matter (PM) pollution in women of childbearing age from 1990 to 2021. METHODS This was a secondary analysis utilizing data from the Global Burden of Disease (GBD) 2021, with a focus on the temporal trends of the lung cancer burden attributable to ambient PM2.5 among women of childbearing age. RESULTS In 2021, the global mortality and disability-adjusted life years (DALYs) number of lung cancer burden attributable to ambient PM2.5 among women of childbearing age were approximately 5205 and 247,211, respectively. The rate of lung cancer attributable to ambient PM2.5 among women of childbearing age increased between 1990 and 2021, with the age-standardized mortality rate (ASMR) increasing from 0.22 (95% uncertainty interval [UI]; 0.13 to 0.33) to 0.25 (95% UI; 0.14 to 0.37; average annual percent change [AAPC] = 0.40) and the age-standardized DALYs rate (ASDR) increasing from 10.39 (95% UI; 5.96 to 15.72) to 12.06 (95% UI; 6.83 to 17.51; AAPC = 0.41). The middle sociodemographic index (SDI) region, East Asia, and China had the heaviest burden, while the high SDI region showed the highest decrease. ASMR and ASDR exhibited an inverted U-shaped relationship with the SDI. CONCLUSIONS From 1990 to 2021, the lung cancer burden attributable to ambient PM2.5 among women of childbearing age exhibited an increasing trend. Furthermore, increasing attention should be paid to the middle SDI region, East Asia, and China, as ambient PM pollution remains a critical target for intervention.
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Affiliation(s)
- Ying‐da Song
- Department of Thoracic SurgeryShanxi Provincial People's HospitalTaiyuanShanxiChina
- Fifth Clinical Medical College, Shanxi Medical UniversityTaiyuanShanxiChina
| | - Ruizhe Wang
- Department of Thoracic SurgeryShanxi Provincial People's HospitalTaiyuanShanxiChina
- Fifth Clinical Medical College, Shanxi Medical UniversityTaiyuanShanxiChina
| | - Jia‐xuan Wang
- First Clinical Medical College, Changzhi Medical CollegeChangzhiShanxiChina
| | - Xun‐wu Tan
- Second Clinical Medical College, Changzhi Medical CollegeChangzhiShanxiChina
| | - Jun Ma
- Department of Thoracic SurgeryShanxi Provincial People's HospitalTaiyuanShanxiChina
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17
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Dong S, Wang Y, Ding Y. Opportunities and challenges encountered in managing cervical cancer during the coronavirus disease 2019 pandemic. Infect Agent Cancer 2024; 19:41. [PMID: 39210452 PMCID: PMC11361151 DOI: 10.1186/s13027-024-00594-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 07/02/2024] [Indexed: 09/04/2024] Open
Abstract
OBJECTIVES The COVID-19 pandemic, while putting pressure on the global healthcare system, has had a significant impact on the prevention, diagnosis, and treatment of cervical cancer. The aim of this study is to provide an overview of the challenges and opportunities presented to cervical cancer during the COVID-19 pandemic and to provide lessons for better coping with cervical cancer in future pandemics. METHODS The search terms included the following: SARS-CoV-2 and/or COVID-19 with cervical cancer and HPV. The initial literature search began on June 1, 2022 and ended on March 1, 2023. OUTCOME COVID-19 has hindered the cervical cancer screening, delayed the diagnosis and treatment of cervical cancer, increased the public's anxiety, and negatively affected the management of cervical cancer. However, the occurrence of COVID-19 pandemic has promoted the development of new human papillomavirus (HPV) tests and improved the rates of HPV self-sampling, offering a small window of opportunity to eliminate cervical cancer. CONCLUSIONS In the next few years, the COVID-19 pandemic will come to an end, and the eradication of cervical cancer should always be carried out. We should draw lessons and experience from this global pandemic, and make efforts for the subsequent eradication of cervical cancer.
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Affiliation(s)
- Shixiang Dong
- Department of Obstetrics & Gynecology, The Affiliated Hospital of Qingdao University, Jiangsu Road No. 16, Shinan District, Qingdao, 266000, China
| | - Yankui Wang
- Department of Obstetrics & Gynecology, The Affiliated Hospital of Qingdao University, Jiangsu Road No. 16, Shinan District, Qingdao, 266000, China.
| | - Yu Ding
- Department of Reproductive Medicine, The Affiliated Hospital of Qingdao University, 59 Haier Road, Qingdao, 266000, China.
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18
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Suárez I, Rauschning D, Schüller C, Hagemeier A, Stecher M, Lehmann C, Schommers P, Schlabe S, Vehreschild JJ, Koll C, Schwarze-Zander C, Wasmuth JC, Klingmüller A, Rockstroh JK, Fätkenheuer G, Boesecke C, Rybniker J. Incidence and risk factors for HIV-tuberculosis coinfection in the Cologne-Bonn region: a retrospective cohort study. Infection 2024; 52:1439-1448. [PMID: 38492196 PMCID: PMC11289312 DOI: 10.1007/s15010-024-02215-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 02/13/2024] [Indexed: 03/18/2024]
Abstract
PURPOSE The risk of developing active tuberculosis (TB) is considerably increased in people living with HIV/AIDS (PLWH). However, incidence of HIV/TB coinfection is difficult to assess as surveillance data are lacking in many countries. Here, we aimed to perform a quantitative analysis of HIV/TB coinfections within the Cologne/Bonn HIV cohort and to determine risk factors for active TB. METHODS We systematically evaluated data of patients with HIV/TB coinfection between 2006 and 2017. In this retrospective analysis, we compared HIV/TB-coinfected patients with a cohort of HIV-positive patients. The incidence density rate (IDR) was calculated for active TB cases at different time points. RESULTS During 2006-2017, 60 out of 4673 PLWH were diagnosed with active TB. Overall IDR was 0.181 cases/100 patient-years and ranged from 0.266 in 2006-2009 to 0.133 in 2014-2017. Patients originating from Sub-Saharan Africa had a significantly (p < 0.001) higher IDR (0.694/100 patient-years of observation, 95% CI [0.435-1.050]) in comparison to patients of German origin (0.053/100 patient-years of observation, 95% CI [0.028-0.091]). In terms of TB-free survival, individuals originating from countries with a TB incidence higher than 10/100,000 exhibited a markedly reduced TB-free survival compared to those originating from regions with lower incidence (p < 0.001). In 22 patients, TB and HIV infection were diagnosed simultaneously. CONCLUSION Overall, we observed a decline in the incidence density rate (IDR) of HIV/TB coinfections between 2006 and 2017. Patients originating from regions with high incidence bear a higher risk of falling ill with active TB. For PLWH born in Germany, the observed risk of active TB appears to be lower compared to other groups within the cohort. These findings should be considered when developing TB containment and screening strategies for PLWH in low-incidence countries.
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Affiliation(s)
- Isabelle Suárez
- Department I of Internal Medicine, Medical Faculty and University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne/Bonn, Germany
| | - Dominic Rauschning
- Department I of Internal Medicine, Medical Faculty and University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
- Department IB of Internal Medicine, Bundeswehrzentralkrankenhaus Koblenz, Koblenz, Germany
| | - Cora Schüller
- Department I of Internal Medicine, Medical Faculty and University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Anna Hagemeier
- Medical Faculty and University Hospital Cologne, Institute of Medical Statistics and Computational Biology, University of Cologne, Cologne, Germany
| | - Melanie Stecher
- Department I of Internal Medicine, Medical Faculty and University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne/Bonn, Germany
| | - Clara Lehmann
- Department I of Internal Medicine, Medical Faculty and University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne/Bonn, Germany
- Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany
| | - Philipp Schommers
- Department I of Internal Medicine, Medical Faculty and University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne/Bonn, Germany
- Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany
| | - Stefan Schlabe
- Department of Medicine I, University Hospital Bonn, Bonn, Germany
| | - Jörg-Janne Vehreschild
- Department I of Internal Medicine, Medical Faculty and University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne/Bonn, Germany
- Medical Department 2 (Hematology/Oncology and Infectious Diseases), Center for Internal Medicine, University Hospital, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Carolin Koll
- Department I of Internal Medicine, Medical Faculty and University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Carolynne Schwarze-Zander
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne/Bonn, Germany
- Department of Medicine I, University Hospital Bonn, Bonn, Germany
- Gemeinschaftspraxis am Kaiserplatz, Bonn, Germany
| | - Jan-Christian Wasmuth
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne/Bonn, Germany
- Department of Medicine I, University Hospital Bonn, Bonn, Germany
| | - Angela Klingmüller
- Department I of Internal Medicine, Medical Faculty and University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Jürgen Kurt Rockstroh
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne/Bonn, Germany
- Department of Medicine I, University Hospital Bonn, Bonn, Germany
| | - Gerd Fätkenheuer
- Department I of Internal Medicine, Medical Faculty and University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne/Bonn, Germany
| | - Christoph Boesecke
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne/Bonn, Germany
- Department of Medicine I, University Hospital Bonn, Bonn, Germany
| | - Jan Rybniker
- Department I of Internal Medicine, Medical Faculty and University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne/Bonn, Germany.
- Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany.
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Yasin N, Yu M, Jones K, Woolfield A, Hughes I, Nascimento M, Green H. The impact of the COVID-19 public health response on service demand and patient perceptions in a tertiary Australian gynaecology oncology unit. Aust N Z J Obstet Gynaecol 2024. [PMID: 39073108 DOI: 10.1111/ajo.13867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 07/09/2024] [Indexed: 07/30/2024]
Abstract
INTRODUCTION The public health response (PHR) to the COVID-19 pandemic significantly disrupted healthcare services worldwide. Our hospital, a major tertiary centre, is a unique two-state service across Queensland and New South Wales (NSW). OBJECTIVE The primary objective is to describe changes in service demand and delivery in our hospital resulting from the COVID-19 PHR. The secondary objective is to investigate patient perceptions of this impact. MATERIALS AND METHODS We performed a retrospective interrupted time series analysis and a population-based survey to examine patient perceptions of the impact of the COVID-19 PHR. The study periods were demarcated by the initiation of the COVID-19 PHR on 1 March 2020 with the 'pre' and 'during' COVID-19 periods defined as the 12 months before and after this date respectively. RESULTS More patients were seen during the COVID-19 PHR period. The number or stage of cancer diagnoses was not different (P > 0.05). There was evidence (P = 0.03) of an increase in overall occasions of service and fewer failed attendances (P = 0.005). Fewer surgeries were performed on NSW patients (P = 0.005). The survey response rate was 19.3% (n = 185) with 48% stating that COVID-19 had negatively affected their emotional wellbeing. More participants from NSW than Queensland identified border closures as the most significant impact of the COVID-19 PHR. DISCUSSION The COVID-19 PHR resulted in an unexpected increase in unit service demand and delivery. The necessary implementation of telephone appointments, while less preferred by patients, sustained service requirements. Cross-border tertiary healthcare services should consider the significant impact of border restrictions on patient wellbeing.
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Affiliation(s)
- Nooraishah Yasin
- Gold Coast Hospital and Health Service, Southport, Queensland, Australia
| | - Michael Yu
- Gold Coast Hospital and Health Service, Southport, Queensland, Australia
| | - Kristen Jones
- Gold Coast Hospital and Health Service, Southport, Queensland, Australia
| | - Anne Woolfield
- Gold Coast Hospital and Health Service, Southport, Queensland, Australia
- University of Queensland, Brisbane, Queensland, Australia
| | - Ian Hughes
- Gold Coast Hospital and Health Service, Southport, Queensland, Australia
| | - Marcelo Nascimento
- Gold Coast Hospital and Health Service, Southport, Queensland, Australia
| | - Helen Green
- Gold Coast Hospital and Health Service, Southport, Queensland, Australia
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20
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Klamminger GG, Bitterlich A, Nigdelis MP, Schnöder L, Hamoud BH, Solomayer EF, Wagner M. Impact of the COVID-19 Pandemic on Tumor Stage and Pathohistological Parameters of Vulvar Cancer. J Clin Med 2024; 13:4058. [PMID: 39064099 PMCID: PMC11277637 DOI: 10.3390/jcm13144058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 07/09/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024] Open
Abstract
Background/Objectives: Vulvar cancer (VC) comprises a small fraction of female neoplasms with notable high-incidence clusters among German regions. Despite a proposed impact of nationwide lockdowns in response to the COVID-19 pandemic on oncological diseases, the effect on VC staging and tumor characteristics remains yet to be resolved; therefore, analyzing pathological data from patients with squamous cell VC pre-, during, and post-COVID in a high-incidence region may offer insights into potential epidemiological and clinical trends. Methods: We identified a total of 90 patients who were diagnosed at the Institute of Pathology, University Hospital Saarland, between 2018 and 2023, and defined three distinct cohorts: a pre-COVID cohort (2018-2019), a COVID cohort (2020-2021), and a post-COVID cohort (2022-2023). Histomorphological data were collected from the individual patient reports and statistically analyzed using Fisher's exact test or the Kruskal-Wallis test. Results: Although we found no statistically significant differences in age, T-stage, perineural infiltration, blood vessel infiltration, resection status, grading, or resection margin between our three cohorts, surprisingly, we determined a greater extent of lymphovascular infiltration (Fisher's exact test; p = 0.041), as well as deeper tumor infiltration depth (Kruskal-Wallis test; p < 0.001) before the COVID-19 pandemic. Furthermore, we did not identify any soft indications of abnormalities in patient care within our center (unchanged status of the resection margins across all three cohorts). Conclusions: Our results clearly do not support a negative affection of clinical or pathobiological characteristics of VC during or after the pandemic. However, final assessments regarding the pandemic's effect on VC require additional study approaches in various regions, preferably with future extended timeframes of a longer follow-up.
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Affiliation(s)
- Gilbert Georg Klamminger
- Department of General and Special Pathology, Saarland University (USAAR), 66424 Homburg, Germany
- Department of General and Special Pathology, Saarland University Medical Center (UKS), 66424 Homburg, Germany
| | - Annick Bitterlich
- Department of General and Special Pathology, Saarland University (USAAR), 66424 Homburg, Germany
- Department of General and Special Pathology, Saarland University Medical Center (UKS), 66424 Homburg, Germany
| | - Meletios P. Nigdelis
- Department of Gynecology and Obstetrics, Saarland University Medical Center (UKS), 66424 Homburg, Germany
| | - Laura Schnöder
- Saarland University Medical Center for Tumor Diseases (UTS), Saarland University (USAAR), 66424 Homburg, Germany
| | - Bashar Haj Hamoud
- Department of Gynecology and Obstetrics, Saarland University Medical Center (UKS), 66424 Homburg, Germany
| | - Erich-Franz Solomayer
- Department of Gynecology and Obstetrics, Saarland University Medical Center (UKS), 66424 Homburg, Germany
- Saarland University Medical Center for Tumor Diseases (UTS), Saarland University (USAAR), 66424 Homburg, Germany
| | - Mathias Wagner
- Department of General and Special Pathology, Saarland University (USAAR), 66424 Homburg, Germany
- Department of General and Special Pathology, Saarland University Medical Center (UKS), 66424 Homburg, Germany
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21
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Cleland JB, Greenzaid JD, Doerfler L, Ahn CS. Wait times for surgery of cutaneous malignancies following the COVID-19 pandemic: a retrospective cohort analysis. Arch Dermatol Res 2024; 316:452. [PMID: 38967839 DOI: 10.1007/s00403-024-03200-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 06/20/2024] [Accepted: 06/23/2024] [Indexed: 07/06/2024]
Affiliation(s)
- Jane B Cleland
- Department of Dermatology, Wake Forest University School of Medicine Medical Center Boulevard Winston-Salem, Winston-Salem, NC, 27157-1071, USA
| | - Jonathan D Greenzaid
- Department of Dermatology, Wake Forest University School of Medicine Medical Center Boulevard Winston-Salem, Winston-Salem, NC, 27157-1071, USA.
| | - Laura Doerfler
- Department of Dermatology, Wake Forest University School of Medicine Medical Center Boulevard Winston-Salem, Winston-Salem, NC, 27157-1071, USA
| | - Christine S Ahn
- Department of Dermatology, Wake Forest University School of Medicine Medical Center Boulevard Winston-Salem, Winston-Salem, NC, 27157-1071, USA
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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22
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Estupiñán-Romero F, Royo-Sierra S, González-Galindo J, Martínez-Lizaga N, Bogaert P, Schutte N, Van Eycken L, Van Damme N, Henau K, Lyons RA, Aldridge SJ, Faragalli A, Carle F, Gesuita R, Palmieri L, Misiņš J, Thiβen M, Bernal-Delgado E. Delayed treatment in breast cancer patients during the COVID-19 pandemic: a population health information research infrastructure (PHIRI) case study. Eur J Public Health 2024; 34:i50-i57. [PMID: 38946448 PMCID: PMC11215325 DOI: 10.1093/eurpub/ckae038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2024] Open
Abstract
BACKGROUND The indirect impact of the coronavirus disease 2019 pandemic on healthcare services was studied by assessing changes in the trend of the time to first treatment for women 18 or older who were diagnosed and treated for breast cancer between 2017 and 2021. METHODS An observational retrospective longitudinal study based on aggregated data from four European Union (EU) countries/regions investigating the time it took to receive breast cancer treatment. We compiled outputs from a federated analysis to detect structural breakpoints, confirming the empirical breakpoints by differences between the trends observed and forecasted after March 2020. Finally, we built several segmented regressions to explore the association of contextual factors with the observed changes in treatment delays. RESULTS We observed empirical structural breakpoints on the monthly median time to surgery trend in Aragon (ranging from 9.20 to 17.38 days), Marche (from 37.17 to 42.04 days) and Wales (from 28.67 to 35.08 days). On the contrary, no empirical structural breakpoints were observed in Belgium (ranging from 21.25 to 23.95 days) after the pandemic's beginning. Furthermore, we confirmed statistically significant differences between the observed trend and the forecasts for Aragon and Wales. Finally, we found the interaction between the region and the pandemic's start (before/after March 2020) significantly associated with the trend of delayed breast cancer treatment at the population level. CONCLUSIONS Although they were not clinically relevant, only Aragon and Wales showed significant differences with expected delays after March 2020. However, experiences differed between countries/regions, pointing to structural factors other than the pandemic.
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Affiliation(s)
- Francisco Estupiñán-Romero
- Data Science for Health Services and Policy Research, Health Science Institute in Aragon (IACS), Aragon, Spain
| | - Santiago Royo-Sierra
- Data Science for Health Services and Policy Research, Health Science Institute in Aragon (IACS), Aragon, Spain
| | - Javier González-Galindo
- Data Science for Health Services and Policy Research, Health Science Institute in Aragon (IACS), Aragon, Spain
| | - Natalia Martínez-Lizaga
- Data Science for Health Services and Policy Research, Health Science Institute in Aragon (IACS), Aragon, Spain
| | | | | | | | | | - Kris Henau
- Belgian Cancer Registry, Brussels, Belgium
| | - Ronan A Lyons
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health, and Life Science, Swansea University (SU), Swansea, United Kingdom
| | - Sarah J Aldridge
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health, and Life Science, Swansea University (SU), Swansea, United Kingdom
| | - Andrea Faragalli
- Center of Epidemiology Biostatistics and Medical Information Technology, Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche Home, Marche, Italy
| | - Flavia Carle
- Center of Epidemiology Biostatistics and Medical Information Technology, Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche Home, Marche, Italy
| | - Rosaria Gesuita
- Center of Epidemiology Biostatistics and Medical Information Technology, Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche Home, Marche, Italy
| | - Luigi Palmieri
- Department of Cardiovascular and Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanità, Italy
| | - Jānis Misiņš
- Department of Research and Health Statistics, Centre for Disease Prevention and Control (CDPC), Riga, Latvia
| | - Martin Thiβen
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Enrique Bernal-Delgado
- Data Science for Health Services and Policy Research, Health Science Institute in Aragon (IACS), Aragon, Spain
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Fritsch TZ, Ben Bordinhão G, Manfroi LM, Paiva de Sousa RV, Rosa dos Santos M, Diniz de Oliveira Bonetti G, Vargas Alves RJ, Bica CG. Impact of COVID-19 on the clinical staging of breast cancer: A cross-sectional study. ADVANCES IN CANCER BIOLOGY - METASTASIS 2024; 10:100116. [DOI: 10.1016/j.adcanc.2024.100116] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2025]
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24
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Homburg M, Berger M, Berends M, Meijer E, Kupers T, Ramerman L, Rijpkema C, de Schepper E, Olde Hartman T, Muris J, Verheij R, Peters L. Dutch GP healthcare consumption in COVID-19 heterogeneous regions: an interregional time-series approach in 2020-2021. BJGP Open 2024; 8:BJGPO.2023.0121. [PMID: 38128964 PMCID: PMC11300972 DOI: 10.3399/bjgpo.2023.0121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/22/2023] [Accepted: 11/01/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Many countries observed a sharp decline in the use of general practice services after the outbreak of the COVID-19 pandemic. However, research has not yet considered how changes in healthcare consumption varied among regions with the same restrictive measures but different COVID-19 prevalence. AIM To investigate how the COVID-19 pandemic affected healthcare consumption in Dutch general practice during 2020 and 2021, among regions with known heterogeneity in COVID-19 prevalence, from a pre-pandemic baseline in 2019. DESIGN & SETTING Population-based cohort study using electronic health records. The study was undertaken in Dutch general practices involved in regional research networks. METHOD An interrupted time-series analysis of changes in healthcare consumption from before to during the pandemic was performed. Descriptive statistics were used on the number of potential COVID-19-related contacts, reason for contact, and type of contact. RESULTS The study covered 3 595 802 contacts (425 639 patients), 3 506 637 contacts (433 340 patients), and 4 105 413 contacts (434 872 patients) in 2019, 2020, and 2021, respectively. Time-series analysis revealed a significant decrease in healthcare consumption after the outbreak of the pandemic. Despite interregional heterogeneity in COVID-19 prevalence, healthcare consumption decreased comparably over time in the three regions, before rebounding to a level significantly higher than baseline in 2021. Physical consultations transitioned to phone or digital over time. CONCLUSION Healthcare consumption decreased irrespective of the regional prevalence of COVID-19 from the start of the pandemic, with the Delta variant triggering a further decrease. Overall, changes in care consumption appeared to reflect contextual factors and societal restrictions rather than infection rates.
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Affiliation(s)
- Maarten Homburg
- Department of Primary and Long-term Care, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Marjolein Berger
- Department of Primary and Long-term Care, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Matthijs Berends
- Department of Primary and Long-term Care, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
- Department of Medical Epidemiology, Certe Medical Diagnostics and Advice Foundation, Groningen, the Netherlands
| | - Eline Meijer
- Department of Primary and Long-term Care, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
- Data Science Center in Health, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Thijmen Kupers
- Department of Primary and Long-term Care, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
- Data Science Center in Health, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Lotte Ramerman
- Nivel, Netherlands Institute for Health Services Research, Utrecht, the Netherlands
| | - Corinne Rijpkema
- Nivel, Netherlands Institute for Health Services Research, Utrecht, the Netherlands
| | - Evelien de Schepper
- Department of General Practice, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Tim Olde Hartman
- Department of Primary and Community Care, Radboud Institute of Health Sciences, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
| | - Jean Muris
- Department of Family Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Robert Verheij
- Nivel, Netherlands Institute for Health Services Research, Utrecht, the Netherlands
- Tranzo, Department of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
| | - Lilian Peters
- Department of Primary and Long-term Care, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
- Midwifery Science, AVAG, Amsterdam Public Health, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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25
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Arbour C, Lapierre A, Hjeij D, Bilodeau K. Do All Patients Benefit From the Soothing Properties of a Conversational Nursing Intervention to Reduce Symptom Burden During Outpatient Chemotherapy?: A Multimethod Secondary Analysis. Cancer Nurs 2024:00002820-990000000-00259. [PMID: 38865610 DOI: 10.1097/ncc.0000000000001376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Abstract
BACKGROUND Soothing conversation (SC) is particularly promising for symptom management during outpatient chemotherapy. However, we know little about the profile of patients who are most likely to benefit from this intervention. OBJECTIVE To gain a better understanding of the profile of patients most likely to benefit from SC to reduce symptom burden during outpatient chemotherapy. METHODS We performed a multimethod secondary analysis of 2 data sets: the first gathered during a quantitative pilot trial investigating the impact of SC on patients' symptom fluctuations during chemotherapy perfusion (n = 24); the second derived from qualitative interviews about nurses' experiences with SC in this context (n = 6). RESULTS Secondary quantitative analysis suggests that symptom control with SC is more effective in older patients, reporting lower education, widowed status, work incapacity, advanced cancer, and undergoing chemotherapy perfusion for less than 1 hour. According to nurses' interviews, SC could best benefit patients (1) prone to anxiety and fear, (2) with unalleviated pain, (3) who are unaccompanied during treatment, and contrary to what was shown with quantitative data, (4) undergoing longer perfusion duration. CONCLUSION Although this study provides valuable insights, much work remains to be done to fully understand the factors that predispose patients to respond positively to SC during outpatient chemotherapy. IMPLICATIONS FOR PRACTICE This study extends previous research on the effectiveness of SC for symptom management during outpatient chemotherapy by comparing nurses' experience with the intervention to patients' results. Results could be used to inform the assignment and delivery of supportive communication-based interventions during chemotherapy protocols.
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Affiliation(s)
- Caroline Arbour
- Author Affiliations: Hôpital du Sacré-Cœur de Montréal, CIUSSS du Nord-de-l'Île-de-Montréal (Drs Arbour and Lapierre and Mrs Hjeij); Faculty of Nursing, Université de Montréal (Drs Arbour, Lapierre, and Bilodeau); Hôpital Maisonneuve-Rosemont, CIUSSS de l'Est-de-l'Île-de-Montréal (Dr Bilodeau), Quebec, Canada
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26
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Madronich S, Bernhard GH, Neale PJ, Heikkilä A, Andersen MPS, Andrady AL, Aucamp PJ, Bais AF, Banaszak AT, Barnes PJ, Bornman JF, Bruckman LS, Busquets R, Chiodo G, Häder DP, Hanson ML, Hylander S, Jansen MAK, Lingham G, Lucas RM, Calderon RM, Olsen C, Ossola R, Pandey KK, Petropavlovskikh I, Revell LE, Rhodes LE, Robinson SA, Robson TM, Rose KC, Schikowski T, Solomon KR, Sulzberger B, Wallington TJ, Wang QW, Wängberg SÅ, White CC, Wilson SR, Zhu L, Neale RE. Continuing benefits of the Montreal Protocol and protection of the stratospheric ozone layer for human health and the environment. Photochem Photobiol Sci 2024; 23:1087-1115. [PMID: 38763938 DOI: 10.1007/s43630-024-00577-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 04/09/2024] [Indexed: 05/21/2024]
Abstract
The protection of Earth's stratospheric ozone (O3) is an ongoing process under the auspices of the universally ratified Montreal Protocol and its Amendments and adjustments. A critical part of this process is the assessment of the environmental issues related to changes in O3. The United Nations Environment Programme's Environmental Effects Assessment Panel provides annual scientific evaluations of some of the key issues arising in the recent collective knowledge base. This current update includes a comprehensive assessment of the incidence rates of skin cancer, cataract and other skin and eye diseases observed worldwide; the effects of UV radiation on tropospheric oxidants, and air and water quality; trends in breakdown products of fluorinated chemicals and recent information of their toxicity; and recent technological innovations of building materials for greater resistance to UV radiation. These issues span a wide range of topics, including both harmful and beneficial effects of exposure to UV radiation, and complex interactions with climate change. While the Montreal Protocol has succeeded in preventing large reductions in stratospheric O3, future changes may occur due to a number of natural and anthropogenic factors. Thus, frequent assessments of potential environmental impacts are essential to ensure that policies remain based on the best available scientific knowledge.
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Affiliation(s)
- S Madronich
- National Center for Atmospheric Research, Boulder, CO, USA.
- Natural Resource Ecology Laboratory, USDA UV-B Monitoring and Research Program, Colorado State University, Fort Collins, CO, USA.
| | - G H Bernhard
- Biospherical Instruments Inc, San Diego, CA, USA
| | - P J Neale
- Smithsonian Environmental Research Center, Edgewater, MD, USA
| | - A Heikkilä
- Finnish Meteorological Institute, Helsinki, Finland
| | - M P Sulbæk Andersen
- Department of Chemistry and Biochemistry, California State University Northridge, Northridge, CA, USA
- Department of Chemistry, University of Copenhagen, Copenhagen, Denmark
| | - A L Andrady
- Department of Chemical and Biomolecular Engineering, North Carolina State University , Raleigh, NC, USA
| | - P J Aucamp
- Ptersa Environmental Consultants, Faerie Glen, South Africa
| | - A F Bais
- Laboratory of Atmospheric Physics, Department of Physics, Aristotle University, Thessaloniki, Greece
| | - A T Banaszak
- Unidad Académica de Sistemas Arrecifales, Instituto de Ciencias del Mar y Limnología, Universidad Nacional Autónoma de México, Puerto Morelos, Mexico
| | - P J Barnes
- Department of Biological Sciences and Environment Program, Loyola University New Orleans, New Orleans, LA, USA
| | - J F Bornman
- Food Futures Institute, Murdoch University, Perth, Australia
| | - L S Bruckman
- Department of Materials Science and Engineering, Reserve University, Cleveland, OH, USA
| | - R Busquets
- Chemical and Pharmaceutical Sciences, Kingston University London, Kingston Upon Thames, UK
| | - G Chiodo
- Institute for Atmospheric and Climate Science, ETH Zürich, Zurich, Switzerland
| | - D-P Häder
- Friedrich-Alexander University, Möhrendorf, Germany
| | - M L Hanson
- Department of Environment and Geography, University of Manitoba, Winnipeg, MB, Canada
| | - S Hylander
- Centre for Ecology and Evolution in Microbial Model Systems, Linnaeus University, Kalmar, Sweden
| | - M A K Jansen
- School of Biological, Earth and Environmental Sciences, University College, Cork, Ireland
| | - G Lingham
- Centre For Ophthalmology and Visual Science (Incorporating Lion's Eye Institute), University of Western Australia, Perth, Australia
- Centre for Eye Research Ireland, Environmental, Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland
| | - R M Lucas
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra, Australia
| | - R Mackenzie Calderon
- Cape Horn International Center, Puerto Williams, Chile
- Millennium Institute Biodiversity of Antarctic and Subantarctic Ecosystems BASE, Santiago, Chile
- Centro Universitario Cabo de Hornos, Universidad de Magallanes, O'Higgins 310, Puerto Williams, Chile
| | - C Olsen
- Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - R Ossola
- Department of Chemistry, Colorado State University, Fort Collins, CO, USA
| | - K K Pandey
- Indian Academy of Wood Science, Bengaluru, India
| | - I Petropavlovskikh
- Cooperative Institute for Research in Environmental Sciences, University of Colorado , Boulder, CO, USA
- NOAA Global Monitoring Laboratory, Boulder, CO, USA
| | - L E Revell
- School of Physical and Chemical Sciences, University of Canterbury, Christchurch, New Zealand
| | - L E Rhodes
- Faculty of Biology Medicine and Health, School of Biological Sciences, The University of Manchester, Manchester, UK
- Dermatology Centre, Salford Royal Hospital, Greater Manchester, UK
| | - S A Robinson
- Securing Antarctica's Environmental Future, University of Wollongong, Wollongong, Australia
- School of Earth, Atmospheric and Life Sciences, University of Wollongong, Wollongong, Australia
| | - T M Robson
- UK National School of Forestry, University of Cumbria, Ambleside Campus, UK
- Viikki Plant Science Centre, Faculty of Biological and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - K C Rose
- Department of Biological Sciences, Rensselaer Polytechnic Institute, Troy, NY, USA
| | - T Schikowski
- IUF-Leibniz Research Institute for Environmental Medicine, Dusseldorf, Germany
| | - K R Solomon
- School of Environmental Sciences, University of Guelph, Guelph, Canada
| | - B Sulzberger
- Eawag, Swiss Federal Institute of Aquatic Science and Technology, Duebendorf, Switzerland
| | - T J Wallington
- Center for Sustainable Systems, School for Environment and Sustainability, University of Michigan, Ann Arbor, MI, USA
| | - Q-W Wang
- Institute of Applied Ecology, Chinese Academy of Sciences, Shenyang, China
| | - S-Å Wängberg
- Department of Marine Sciences, University of Gothenburg, Gothenburg, Sweden
| | | | - S R Wilson
- School of Earth, Atmospheric and Life Sciences, University of Wollongong, Wollongong, Australia
| | - L Zhu
- State Key Lab for Modification of Chemical Fibers and Polymer Materials, College of Materials Science and Engineering, Donghua University, Shanghai, China
| | - R E Neale
- Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
- School of Public Health, University of Queensland, Brisbane, Australia.
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Balan L, Secosan C, Sorop VB, Pirtea M, Cimpean AM, Chiriac D, Balan C, Borsi E, Iorga A, Pirtea L. Impact of SARS-CoV-2 Pandemic on the Diagnosis of Cervical Cancer and Precursor Lesions-A Single-Center Retrospective Study. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:909. [PMID: 38929526 PMCID: PMC11206154 DOI: 10.3390/medicina60060909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 05/19/2024] [Accepted: 05/28/2024] [Indexed: 06/28/2024]
Abstract
Background and Objectives: Our aim was to perform a retrospective analysis of the volume of cervical screening tests, the number of patients treated with an excision method, and the incidence of invasive and non-invasive cervical during a pandemic and pre-pandemic period of 24 months. Materials and Methods: The study compared 404 patients who underwent cervical cone biopsy for cervical cancer. The study examined patients' specimens based on histopathological characteristics and categorized cervical lesions based on pap smear. Results: There was a statistically significant age difference between the two study periods. The mean difference was 32 years before the pandemic and 35 years during the pandemic (p-value > 0.05). The biggest patient loss ratio identified by age group was in the 50-59-year group, with a 14.53% loss in the pre-pandemic period and a 9.1% loss in the pandemic period. In the pandemic period, patients from rural areas presented in the clinical trial with a lower rate of 39.52% (83 patients) vs. 60.47% (127 patients) in urban areas. A higher percentage of patients experiencing cervicorrhagia as a clinical manifestation in the pandemic period vs. the pre-pandemic period, with an increase in more severe lesions in the pandemic period, had a statistical significance of 8% more newly diagnosed compared to the pre-pandemic period. Conclusions: The addressability of the patients during the COVID period was not affected in a drastic way in our study. We encountered a decrease in appointments in the age group of 50-59 years and a decrease in patients with rural residence. In our study, we found an increase in cervical bleeding as a reason for consultation in the pandemic period with a higher lesion degree, both on a pap smear and on a cervical biopsy.
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Affiliation(s)
- Lavinia Balan
- Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (L.B.); (V.-B.S.); (M.P.); (D.C.); (L.P.)
| | - Cristina Secosan
- Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (L.B.); (V.-B.S.); (M.P.); (D.C.); (L.P.)
| | - Virgiliu-Bogdan Sorop
- Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (L.B.); (V.-B.S.); (M.P.); (D.C.); (L.P.)
| | - Marilena Pirtea
- Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (L.B.); (V.-B.S.); (M.P.); (D.C.); (L.P.)
| | - Anca Maria Cimpean
- Department of Microscopic Morphology/Histology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Daniela Chiriac
- Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (L.B.); (V.-B.S.); (M.P.); (D.C.); (L.P.)
| | - Catalin Balan
- Department of Cell and Molecular Biology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Ema Borsi
- Department of Internal Medicine, Discipline of Hematology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Ariana Iorga
- Clinical Hospital of Infectious Diseases and Pulmonology “Dr. Victor Babes”, 300310 Timisoara, Romania;
| | - Laurentiu Pirtea
- Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (L.B.); (V.-B.S.); (M.P.); (D.C.); (L.P.)
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Romanowska-Dixon B, Nowak MS, Śmigielski J, Dębicka-Kumela M. Impact of the SARS-CoV-2 (COVID-19) Pandemic on Characteristics and Management of Uveal Melanoma in the National Referral Center in Poland. Cancers (Basel) 2024; 16:2061. [PMID: 38893180 PMCID: PMC11171075 DOI: 10.3390/cancers16112061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/20/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024] Open
Abstract
(1) Background: to analyze the impact of the COVID-19 pandemic on the characteristics and management of uveal melanoma (UM) in the National Referral Center in Poland. (2) Materials and Methods: the retrospective analysis of 1336 patients who were newly diagnosed with UM at the Department of Ophthalmology and Ophthalmic Oncology, Jagiellonian University Collegium Medicum Krakow, Poland between 1 January 2018 and 31 December 2021. The demographic and clinical data were compiled, including localization, size, and treatment methods of tumors. (3) Results: In total, 728 patients with UM were included before the COVID-19 pandemic, in the years 2018-2019, and 608 were included during the COVID-19 pandemic, in the years 2020-2021. Fixed-base dynamics indicators for the incidence of uveal melanoma (base year 2018) in the National Referral Center in Poland were 80.22% and 86.81% in the years 2020 and 2021, respectively. UMs were statistically significantly larger and more frequently localized anterior to the equator of the eye globe in the year 2021 than in the year 2018 (Chi-square Pearson test p = 0.0001 and p = 0.0077, respectively). The rate of patients treated with enucleation increased from 15.94% in the year 2018 to 26.90% in the year 2021 (Chi-square Pearson test p = 0.0005). (4) Conclusions: Statistically significant differences were found in the management of uveal melanoma in the National Referral Center in Poland during the COVID-19 pandemic with tumors being larger, more frequently localized anterior to the equator of the eye globe, and more often enucleated.
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Affiliation(s)
- Bożena Romanowska-Dixon
- Department of Ophthalmology, Jagiellonian University Collegium Medicum, 38 Kopernika Str., 31-501 Krakow, Poland; (B.R.-D.); (M.D.-K.)
- Ophthalmology and Ophthalmic Oncology Clinic, University Hospital, 38 Kopernika Str., 31-501 Krakow, Poland
| | - Michał Szymon Nowak
- Institute of Optics and Optometry, University of Social Science, 121 Gdanska Str., 90-519 Lodz, Poland
- Provisus Eye Clinic, 112 Redzinska Str., 42-209 Czestochowa, Poland
| | - Janusz Śmigielski
- Department of Statistics, State University of Applied Science in Konin, 1 Przyjazni Str., 65-510 Konin, Poland;
| | - Magdalena Dębicka-Kumela
- Department of Ophthalmology, Jagiellonian University Collegium Medicum, 38 Kopernika Str., 31-501 Krakow, Poland; (B.R.-D.); (M.D.-K.)
- Ophthalmology and Ophthalmic Oncology Clinic, University Hospital, 38 Kopernika Str., 31-501 Krakow, Poland
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29
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Olsen CM, Pandeya N, Neale RE, Whiteman DC. Age group-specific changes in keratinocyte cancer treatment rates in Australia, 2012-2021: a retrospective cohort study based on MBS claims data. Med J Aust 2024; 220:472-479. [PMID: 38685827 DOI: 10.5694/mja2.52293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 11/30/2023] [Indexed: 05/02/2024]
Abstract
OBJECTIVES To examine recent changes in the numbers of Medicare-subsidised keratinocyte cancer excisions, particularly for younger people exposed to primary prevention campaigns since the early 1980s. STUDY DESIGN Retrospective cohort study; analysis of administrative data. SETTING, PARTICIPANTS Analysis of Medicare Benefits Schedule (MBS) claims data for procedures related to the diagnosis and treatment of keratinocyte cancer in Australia, 2012-2021. MAIN OUTCOME MEASURES Age-standardised rates for MBS-subsidised claims for first surgical squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) excisions, Mohs surgery, surgical excisions of benign lesions, skin biopsies, and cryotherapy or serial curettage of premalignant and malignant lesions, overall, and by sex, state/territory, and age group; average annual percentage change in rate for time intervals determined by joinpoint regression. RESULTS In men, the age-standardised rate of BCC/SCC excisions increased by 1.9% (95% confidence interval [CI], 1.4-2.4%) per year during 2012-2019 (from 2931 to 3371 per 100 000 men) and then declined by 3.8% (95% CI, 0.5-7.0%) per year during 2019-2021 (to 3152 per 100 000). In women, the age-standardised rate increased by 2.2% (95% CI, 1.7-2.8%) per year during 2012-2019 (from 1798 to 2093 per 100 000 women); the decline to 1967 excisions per 100 000 women in 2021 was not statistically significant. BCC/SCC excision rates declined for men under 55 years of age (by 1.0-3.4% per year) and women under 45 years of age (by 1.7-2.3% per year). Age-standardised biopsy rates increased during 2012-2021 in all age groups (by 2.8-6.9% per year). CONCLUSIONS Rates of MBS-subsidised treatment for keratinocyte cancers increased during 2012-2019, but BCC/SCC treatment rates declined among younger Australians, who have probably been exposed to less sunlight than earlier generations because of public health interventions and population-wide lifestyle changes related to technology use.
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Affiliation(s)
- Catherine M Olsen
- QIMR Berghofer Medical Research Institute, Brisbane, QLD
- The University of Queensland, Brisbane, QLD
| | - Nirmala Pandeya
- QIMR Berghofer Medical Research Institute, Brisbane, QLD
- The University of Queensland, Brisbane, QLD
| | - Rachel E Neale
- QIMR Berghofer Medical Research Institute, Brisbane, QLD
- The University of Queensland, Brisbane, QLD
| | - David C Whiteman
- QIMR Berghofer Medical Research Institute, Brisbane, QLD
- The University of Queensland, Brisbane, QLD
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Slotman E, Weijzen F, Fransen HP, van Hoeve JC, Huijben AMT, Kuip EJM, Jager A, Kunst PWA, van Laarhoven HWM, Tol J, Tjan-Heijnen VCG, Raijmakers NJH, van der Linden YM, Siesling S. Continuity of care for patients with de novo metastatic cancer during the COVID-19 pandemic: A population-based observational study. Int J Cancer 2024; 154:1786-1793. [PMID: 38268393 DOI: 10.1002/ijc.34857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 12/12/2023] [Accepted: 12/13/2023] [Indexed: 01/26/2024]
Abstract
During the COVID-19 pandemic recommendations were made to adapt cancer care. This population-based study aimed to investigate possible differences between the treatment of patients with metastatic cancer before and during the pandemic by comparing the initial treatments in five COVID-19 periods (weeks 1-12 2020: pre-COVID-19, weeks 12-20 2020: 1st peak, weeks 21-41 2020: recovery, weeks 42-53 2020: 2nd peak, weeks 1-20 2021: prolonged 2nd peak) with reference data from 2017 to 2019. The proportion of patients receiving different treatment modalities (chemotherapy, hormonal therapy, immunotherapy or targeted therapy, radiotherapy primary tumor, resection primary tumor, resection metastases) within 6 weeks of diagnosis and the time between diagnosis and first treatment were compared by period. In total, 74,208 patients were included. Overall, patients were more likely to receive treatments in the COVID-19 periods than in previous years. This mainly holds for hormone therapy, immunotherapy or targeted therapy and resection of metastases. Lower odds were observed for resection of the primary tumor during the recovery period (OR 0.87; 95% CI 0.77-0.99) and for radiotherapy on the primary tumor during the prolonged 2nd peak (OR 0.84; 95% CI 0.72-0.98). The time from diagnosis to the start of first treatment was shorter, mainly during the 1st peak (average 5 days, p < .001). These findings show that during the first 1.5 years of the COVID-19 pandemic, there were only minor changes in the initial treatment of metastatic cancer. Remarkably, time from diagnosis to first treatment was shorter. Overall, the results suggest continuity of care for patients with metastatic cancer during the pandemic.
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Affiliation(s)
- Ellis Slotman
- Technical Medical Centre, Department of Health Technology and Services Research, University of Twente, Enschede, Netherlands
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, Netherlands
- Netherlands Association for Palliative Care, Utrecht, Netherlands
| | - Feike Weijzen
- Technical Medical Centre, Department of Health Technology and Services Research, University of Twente, Enschede, Netherlands
| | - Heidi P Fransen
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, Netherlands
- Netherlands Association for Palliative Care, Utrecht, Netherlands
| | - Jolanda C van Hoeve
- Technical Medical Centre, Department of Health Technology and Services Research, University of Twente, Enschede, Netherlands
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, Netherlands
| | - Auke M T Huijben
- Department of Internal Medicine, Maasstad Hospital, Rotterdam, Netherlands
| | - Evelien J M Kuip
- Department of Medical Oncology and Department of Anesthesiology, Pain and Palliative Care, Radboud Medical Center, Nijmegen, Netherlands
| | - Agnes Jager
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Peter W A Kunst
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, Netherlands
- Department of Pulmonology, Onze Lieve Vrouwe Gasthuis, Amsterdam, Netherlands
| | - Hanneke W M van Laarhoven
- Medical Oncology, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Cancer Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, Netherlands
| | - Jolien Tol
- Department of Internal Medicine, Jeroen Bosch Hospital, 's-Hertogenbosch, Netherlands
| | - Vivianne C G Tjan-Heijnen
- Department of Medical Oncology, Research Institute GROW, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Natasja J H Raijmakers
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, Netherlands
- Netherlands Association for Palliative Care, Utrecht, Netherlands
| | - Yvette M van der Linden
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, Netherlands
- Department of Radiotherapy, Leiden University Medical Centre, Leiden, Netherlands
- Centre of Expertise in Palliative Care, Leiden University Medical Centre, Leiden, Netherlands
| | - Sabine Siesling
- Technical Medical Centre, Department of Health Technology and Services Research, University of Twente, Enschede, Netherlands
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, Netherlands
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Ladbury C, Eustace N, Kassardjian A, Amini A, Chen YJ, Wang E, Kohut A, Tergas A, Han E, Song M, Glaser S. Explainable artificial intelligence analysis of brachytherapy boost receipt in cervical cancer during the COVID-19 era. Brachytherapy 2024; 23:237-247. [PMID: 38553406 DOI: 10.1016/j.brachy.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 01/11/2024] [Accepted: 01/24/2024] [Indexed: 05/18/2024]
Abstract
PURPOSE Brachytherapy is a critical component of the standard-of-care curative radiotherapy regimen for women with locally advanced cervical cancer (LACC). However, existing literature suggests that many patients will not receive the brachytherapy boost. We used machine learning (ML) and explainable artificial intelligence to characterize this disparity. MATERIALS AND METHODS Patients with LACC diagnosed from 2004 to 2020 who received definitive radiation were identified in the National Cancer Database. Five ML models were trained to predict if a patient received a brachytherapy boost. The best-performing model was explained using SHapley Additive exPlanation (SHAP) values. To identify trends that may be attributable to the coronavirus disease 2019 (COVID-19) pandemic, the previous analysis was repeated and limited to 2019 to 2020. RESULTS A total of 37,564 patients with LACC were identified; 5799 were diagnosed from 2019 to 2020 (COVID cohort). Of these patients, 59.3% received a brachytherapy boost, with 76.4% of patients diagnosed in 2019 to 2020 receiving a boost. The random forest model achieved the best performance for both the overall and COVID cohorts. In the overall cohort, the most important predictive features were the year of diagnosis, stage, age, and insurance status. In the COVID cohort, the most important predictive features were FIGO stage, age, insurance status, and hospital type. Of the 26 patients who tested positive for COVID-19 during their course of radiotherapy, 19 (73.1%) received a brachytherapy boost. CONCLUSIONS A gradual increase in brachytherapy boost utilization has been noted, which did not seem to be significantly impacted by the onset of the COVID-19 pandemic. ML could be considered to identify patient populations where brachytherapy is underutilized, which can provide actionable feedback for improving access.
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Affiliation(s)
- Colton Ladbury
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA
| | - Nicholas Eustace
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA
| | - Ari Kassardjian
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA
| | - Arya Amini
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA
| | - Yi-Jen Chen
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA
| | - Edward Wang
- Department of Medical Oncology & Therapeutics Research, City of Hope National Medical Center, Duarte, CA
| | - Adrian Kohut
- Division of Gynecologic Oncology, City of Hope National Medical Center, Duarte, CA
| | - Ana Tergas
- Division of Gynecologic Oncology, City of Hope National Medical Center, Duarte, CA
| | - Ernest Han
- Department of Medical Oncology & Therapeutics Research, City of Hope National Medical Center, Duarte, CA
| | - Mihae Song
- Division of Gynecologic Oncology, City of Hope National Medical Center, Duarte, CA
| | - Scott Glaser
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA.
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Ho VKY, Deijen CL, Hemmes B, van Erning FN, Snaebjornsson P, van Triest B, Grotenhuis BA. Trends in epidemiology and primary treatment of anal squamous cell carcinoma in the Netherlands (1990-2021). Int J Cancer 2024; 154:1569-1578. [PMID: 38151810 DOI: 10.1002/ijc.34811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 10/20/2023] [Accepted: 11/07/2023] [Indexed: 12/29/2023]
Abstract
A rapid increase in the incidence of anal squamous cell carcinoma (SCC) was reported in several countries over the past decades. This study assessed trends in epidemiology and primary treatment over a 32-year period (1990-2021) using the Netherlands Cancer Registry. The study population included 4273 patients, 44.2% male and 55.8% female (median age 63 years). The age-standardised incidence rate (European Standardised Rate, ESR) increased from 0.5 to 1.6 per 100,000, which entailed an average annual percentage change (AAPC) of 5.0% (95% confidence interval [CI]: 4.5%-5.8%). While incidence among females increased continuously over the total period (AAPC 4.9%; 95%CI: 4.4%-5.6%), to 1.8 per 100,000 ESR in 2021, incidence among males increased until 2016 (annual percentage change [APC] of 6.3%; 95%CI: 5.6%-10.7%), after which it seemed to stabilise (APC -2.1%; 95%CI: -16.8%-4.5%). Significant trends were also observed in distribution of age, tumour stage and primary treatment modalities. Five-year relative survival (RS) was estimated using the Pohar-Perme estimator, and this improved from 56.1% in 1990-1997 (95%CI: 49.3%-62.4%) to 67.9% in 2014-2021 (95%CI: 64.7%-70.9%), but remained poor for stage IV disease. Evaluation through a multivariable Poisson regression model demonstrated diagnosis in the most recent period to be independently associated with better RS, in addition to female sex, younger age, early disease stage and any treatment. In conclusion, the rising incidence of anal SCC seems to decline in males, but not in females, and advances in diagnostics and therapeutic management have likely contributed to improved prognosis.
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Affiliation(s)
- Vincent K Y Ho
- Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Charlotte L Deijen
- Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Birgit Hemmes
- Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Felice N van Erning
- Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
- Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands
| | - Petur Snaebjornsson
- Department of Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Baukelien van Triest
- Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Brechtje A Grotenhuis
- Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
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Shanmugam R, Fulton L, Kruse CS, Beauvais B, Betancourt J, Pacheco G, Pradhan R, Sen K, Ramamonjiarivelo Z, Sharma A. The effect of COVID-19 on cancer incidences in the U.S. Heliyon 2024; 10:e28804. [PMID: 38601551 PMCID: PMC11004761 DOI: 10.1016/j.heliyon.2024.e28804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 03/10/2024] [Accepted: 03/25/2024] [Indexed: 04/12/2024] Open
Abstract
Fundamental data analysis assists in the evaluation of critical questions to discern essential facts and elicit formerly invisible evidence. In this article, we provide clarity into a subtle phenomenon observed in cancer incidences throughout the time of the COVID-19 pandemic. We analyzed the cancer incidence data from the American Cancer Society [1]. We partitioned the data into three groups: the pre-COVID-19 years (2017, 2018), during the COVID-19 years (2019, 2020, 2021), and the post-COVID-19 years (2022, 2023). In a novel manner, we applied principal components analysis (PCA), computed the angles between the cancer incidence vectors, and then added lognormal probability concepts in our analysis. Our analytic results revealed that the cancer incidences shifted within each era (pre, during, and post), with a meaningful change in the cancer incidences occurring in 2020, the peak of the COVID-19 era. We defined, computed, and interpreted the exceedance probability for a cancer type to have 1000 incidences in a future year among the breast, cervical, colorectal, uterine corpus, leukemia, lung & bronchus, melanoma, Hodgkin's lymphoma, prostate, and urinary cancers. We also defined, estimated, and illustrated indices for other cancer diagnoses from the vantage point of breast cancer in pre, during, and post-COVID-19 eras. The angle vectors post the COVID-19 were 72% less than pre-pandemic and 28% less than during the pandemic. The movement of cancer vectors was dynamic between these eras, and movement greatly differed by type of cancer. A trend chart of cervical cancer showed statistical anomalies in the years 2019 and 2021. Based on our findings, a few future research directions are pointed out.
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Affiliation(s)
- Ramalingam Shanmugam
- Texas State University, School of Health Administration, Encino Hall, Room 250A, 601 University Drive, San Marcos, TX, 78666, USA
| | - Larry Fulton
- Boston College, Woods College of Advancing Studies, St. Mary's Hall South, Chestnut Hill, MA, 02467, USA
| | - C. Scott Kruse
- Texas State University, School of Health Administration, Encino Hall, Room 250A, 601 University Drive, San Marcos, TX, 78666, USA
| | - Brad Beauvais
- Texas State University, School of Health Administration, Encino Hall, Room 250A, 601 University Drive, San Marcos, TX, 78666, USA
| | - Jose Betancourt
- Texas State University, School of Health Administration, Encino Hall, Room 250A, 601 University Drive, San Marcos, TX, 78666, USA
| | - Gerardo Pacheco
- Texas State University, School of Health Administration, Encino Hall, Room 250A, 601 University Drive, San Marcos, TX, 78666, USA
| | - Rohit Pradhan
- Texas State University, School of Health Administration, Encino Hall, Room 250A, 601 University Drive, San Marcos, TX, 78666, USA
| | - Keya Sen
- Texas State University, School of Health Administration, Encino Hall, Room 250A, 601 University Drive, San Marcos, TX, 78666, USA
| | - Zo Ramamonjiarivelo
- Texas State University, School of Health Administration, Encino Hall, Room 250A, 601 University Drive, San Marcos, TX, 78666, USA
| | - Arvind Sharma
- Boston College, Woods College of Advancing Studies, St. Mary's Hall South, Chestnut Hill, MA, 02467, USA
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Yildirim H, Bins AD, van den Hurk C, van Moorselaar RJA, van Oijen MGH, Bex A, Zondervan PJ, Aben KKH. The impact of the COVID-19 pandemic on renal cancer care. World J Urol 2024; 42:231. [PMID: 38613582 PMCID: PMC11016011 DOI: 10.1007/s00345-024-04925-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 03/06/2024] [Indexed: 04/15/2024] Open
Abstract
PURPOSE To evaluate the impact of the COVID-19 pandemic on renal cell carcinoma (RCC) care in the Netherlands. METHODS Newly diagnosed RCCs between 2018 and 2021 were selected from the Netherlands Cancer Registry; 2020-2021 was defined as COVID period and 2018-2019 as reference period. Numbers of RCCs were evaluated using 3-week-moving averages, overall and by disease stage and age. Changes in treatment were evaluated with logistic regression analyses. To evaluate possible delays in care, time to start of treatment was assessed. The cumulative number of metastatic RCC (mRCC) over time was assessed to evaluate stage shift. RESULTS During the 1st COVID wave (weeks 9-22, 2020), the number of new RCC diagnoses decreased with 15%. Numbers restored partially in 2020, but remained 10% lower compared to 2018/2019. The decline was mostly due to a drop in T1a/T1b RCCs and in age > 70 years. 2021 showed similar numbers of new RCC diagnoses compared to 2018/2019 without an increase due to previously missed RCCs. Treatment-related changes during the 1st COVID wave were limited and temporarily; less surgery in T1a RCCs in favor of more active surveillance, and in mRCC targeted therapy was preferred over immunotherapy. Time to start of firstline treatment was not prolonged during the 1st COVID wave. No increase in mRCC was found until the end of 2021. CONCLUSIONS The COVID-19 pandemic resulted in fewer RCC diagnoses, especially T1a/T1b tumors. Treatment-related changes appeared to be limited, temporarily and in accordance with the adapted guidelines. The diagnostic delay could lead to more advanced RCCs in later years but there are no indications for this yet.
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Affiliation(s)
- Hilin Yildirim
- Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, 4F, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands.
| | - Adriaan D Bins
- Department of Medical Oncology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Corina van den Hurk
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
| | | | - Martijn G H van Oijen
- Department of Medical Oncology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Axel Bex
- Department of Urology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- The Royal Free London NHS Foundation Trust, London, UK
- Division of Surgery and Interventional Science, University College London, London, UK
| | - Patricia J Zondervan
- Department of Urology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Katja K H Aben
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
- Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands
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Giacopelli P, Cristaudi A, Majno P, Roesel R, Iaquinandi F, Mongelli F. COVID-free surgical pathways for treating patients with acute calculous cholecystitis: a retrospective comparative study. Front Surg 2024; 11:1393948. [PMID: 38650660 PMCID: PMC11033475 DOI: 10.3389/fsurg.2024.1393948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 03/27/2024] [Indexed: 04/25/2024] Open
Abstract
Introduction During the Sars-Cov-2 crisis, some of the resources committed to emergency surgery services were transiently reallocated to the care of patients with severe COVID-19, preserving immediate treatment of mostly non-deferrable conditions. Moreover, the fear of contracting infections or hindering the treatment of critical COVID-19 patients has caused many individuals to defer seeking emergency care. This situation has then possibly modified the standard of care of some common surgical conditions and the relative outcomes. Our aims was to highlight any difference in surgical outcomes in patients treated for acute cholecystitis before and during the COVID-19 outbreak. Method This is a retrospective study on a prospectively collected database that included all consecutive patients treated for acute cholecystitis from March 2019 to February 2021 at the Lugano Regional Hospital, a COVID-free hospital for general surgery patients. Patients were divided into pre-and post-COVID-19 outbreak groups. We collected thorough clinical characteristics and intra-and postoperative outcomes. Results We included 124 patients, of which 60 and 64 were operated on before and after the COVID-19 outbreak respectively. The two groups resulted similar in terms of patients' clinical characteristics (age, gender, body mass index, ASA score, and comorbidities). Patients in the post-outbreak period were admitted to the hospital 0.7 days later than patients in the pre-outbreak period (3.8 ± 6.0 days vs. 3.1 ± 4.1 days, p = 0.453). Operative time, recovery room time, complications, and reoperations resulted similar between groups. More patients in the post-outbreak period received postoperative antibiotic therapy (63.3% vs. 37.5%, p = 0.004) and for a longer time (6.9 ± 5.1 days vs. 4.5 ± 3.9 days, p = 0.020). No significant histopathological difference was found in operatory specimens. Discussion Despite more frequent antibiotic therapy that suggests eventually worse inflammatory local status, our results showed similar outcomes for patients treated for acute cholecystitis before and during the COVID-19 pandemic. The local COVID management, reallocating resources, and keeping COVID-free hospitals was key to offering patients a high standard of treatment.
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Affiliation(s)
- Pietro Giacopelli
- Department of Surgery, Ospedale Regionale di Bellinzona e Valli, EOC, Bellinzona, Switzerland
| | | | - Pietro Majno
- Department of Surgery, Ospedale Regionale di Lugano, EOC, Lugano, Switzerland
- Faculty of Biomedical Science, Università della Svizzera Italiana, Lugano, Switzerland
| | - Raffaello Roesel
- Department of Surgery, Ospedale Regionale di Lugano, EOC, Lugano, Switzerland
| | - Fabiano Iaquinandi
- Department of Surgery, Ospedale Regionale di Bellinzona e Valli, EOC, Bellinzona, Switzerland
| | - Francesco Mongelli
- Department of Surgery, Ospedale Regionale di Bellinzona e Valli, EOC, Bellinzona, Switzerland
- Faculty of Biomedical Science, Università della Svizzera Italiana, Lugano, Switzerland
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Cioffi G, Waite KA, Price M, Neff C, Kruchko C, Ostrom QT, Barnholtz-Sloan JS. The impact of COVID-19 on 2020 monthly incidence trends of primary brain and other CNS tumors. Neuro Oncol 2024; 26:764-774. [PMID: 38167948 PMCID: PMC10995517 DOI: 10.1093/neuonc/noad235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND To mitigate disease spread, restrictions implemented in the United States surrounding the COVID-19 pandemic created an environment that led to delays in cancer diagnosis. The data needed to accurately analyze the impact of the pandemic on brain and CNS tumor incidence has not been available until now. Utilizing incidence data from the Central Brain Tumor Registry of the United States (CBTRUS) we analyzed the impact of the COVID-19 pandemic on primary brain and other CNS tumor incidence for the first year of the pandemic. METHODS Monthly age-adjusted incidence rates and incidence trends for 2019 and 2020 were determined for age at diagnosis, sex, race, ethnicity, diagnostic confirmation, behavior, tumor histopathology, and county-level urbanization. Monthly incidence rate ratios comparing 2020 and 2019 were evaluated for the same factors. RESULTS Overall, there was a notable decrease in incidence rates in March-May 2020 when compared to 2019. These decreases were driven by nonmalignant tumors, with a 50% incidence decrease between March 2020 and 2019. Individuals who were Black had a larger incidence decrease in early 2020 than individuals who were White. Radiographically confirmed tumors saw larger incidence decreases than histologically confirmed tumors. There were no changes in monthly incidence of glioblastoma in 2020 compared to 2019. CONCLUSIONS These data provide evidence that disruptions in medical care, such as governmental and health care mandates, in response to the COVID-19 pandemic resulted in an overall decreased incidence of primary brain tumors in early 2020.
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Affiliation(s)
- Gino Cioffi
- Trans Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
| | - Kristin A Waite
- Trans Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
| | - Mackenzie Price
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
- Department of Neurosurgery, Duke University School of Medicine, Durham, North Carolina, USA
| | - Corey Neff
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
- Department of Neurosurgery, Duke University School of Medicine, Durham, North Carolina, USA
| | - Carol Kruchko
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
| | - Quinn T Ostrom
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
- Department of Neurosurgery, Duke University School of Medicine, Durham, North Carolina, USA
- The Preston Robert Tisch Brain Tumor Center, Duke University School of Medicine, Durham, North Carolina, USA
| | - Jill S Barnholtz-Sloan
- Trans Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
- Center for Biomedical Informatics and Information Technology, National Cancer Institute, Bethesda, Maryland, USA
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Iijima K, Matsuhashi T, Shimodaira Y, Mikami T, Yoshimura T, Yanai S, Kudara N, Tsuji T, Matsushita H, Watanabe H, Koike T, Kato K, Abe Y, Shirahata N, Hikichi T, Katakura K, Kono K, Sakuraba H, Ueno Y, Ohira H, Masamune A, Matsumoto T, Fukuda S. Impact of the COVID-19 pandemic on the performance of endoscopy in the Tohoku region of Japan. DEN OPEN 2024; 4:e249. [PMID: 37273519 PMCID: PMC10235797 DOI: 10.1002/deo2.249] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 05/02/2023] [Accepted: 05/17/2023] [Indexed: 06/06/2023]
Abstract
Objectives The whole picture of the disturbance in endoscopy performance caused by the coronavirus disease 2019 (COVID-19) pandemic in Japan remains to be clarified. Therefore, the Japan Gastroenterological Endoscopy Society-Tohoku conducted this questionnaire survey in Tohoku region of Japan. Methods A questionnaire on the number of diagnostic endoscopy procedures and resulting diagnosed cancers in 2019 and 2020 was sent to all guidance/guidance cooperation hospitals in the Japan Gastroenterological Endoscopy Society who worked in the Tohoku region. The percentage change was calculated by comparing the numbers in 2020 with those in 2019 (the pre-COVID-19 period). Results Among the applicable 89 guidance/guidance cooperation hospitals, 83 (94%) returned the questionnaire. The number of endoscopy procedures promptly decreased to the nadir in April and May 2020 (during the first state of emergency in Japan); however, it recovered relatively quickly, within a few months after the state of emergency was lifted. Consequently, the annual reduction in the number of endoscopy procedures in 2020 (in comparison to 2019) was 10.1% for esophagogastroduodenoscopy and 7.9% for colonoscopy. The reduction in the number of diagnostic endoscopy procedures led to a 5.5% reduction in esophagogastric cancer and 2.7% in colorectal cancer. Conclusions This is the most comprehensive survey on the impact of the COVID-19 pandemic on the performance of endoscopy and the resulting diagnosis of cancer in Japan. Understanding the magnitude of the decline in endoscopic examinations and cancer detection due to the pandemic is critical to understanding how many people will ultimately be affected and establishing a strategy for providing endoscopy during national emergencies.
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Affiliation(s)
- Katsunori Iijima
- Department of GastroenterologyAkita University Graduate School of MedicineAkitaJapan
| | - Tamotsu Matsuhashi
- Department of GastroenterologyAkita University Graduate School of MedicineAkitaJapan
| | - Yosuke Shimodaira
- Department of GastroenterologyAkita University Graduate School of MedicineAkitaJapan
| | - Tatsuya Mikami
- Division of EndoscopyHirosaki University HospitalAomoriJapan
| | | | - Shunichi Yanai
- Department of Internal MedicineDivision of Gastroenterology and HepatologySchool of MedicineIwate Medical UniversityIwateJapan
| | - Norihiko Kudara
- Department of Internal Medicine and GastroenterologyIwate Prefectural Ofunato HospitalIwateJapan
| | | | | | | | - Tomoyuki Koike
- Division of GastroenterologyTohoku University Graduate School of MedicineMiyagiJapan
| | - Katsuaki Kato
- Cancer Detection Center, Miyagi Cancer SocietyMiyagiJapan
| | - Yasuhiko Abe
- Division of EndoscopyYamagata University HospitalYamagataJapan
| | - Nakao Shirahata
- Department of GastroenterologyYamagata Prefectural Central HospitalYamagataJapan
| | - Takuto Hikichi
- Department of EndoscopyFukushima Medical University HospitalFukushimaJapan
| | - Kyoko Katakura
- Department of GastroenterologyIwase general hospitalFukushimaJapan
| | - Koji Kono
- Department of Gastrointestinal Tract SurgeryFukushima Medical University School of MedicineFukushimaJapan
| | - Hirotake Sakuraba
- Department of GastroenterologyHirosaki University Graduate School of MedicineAomoriJapan
| | - Yoshiyuki Ueno
- Department of GastroenterologyFaculty of MedicineYamagata UniversityYamagataJapan
| | - Hiromasa Ohira
- Department of GastroenterologyFukushima Medical University School of MedicineFukushimaJapan
| | - Atsushi Masamune
- Division of GastroenterologyTohoku University Graduate School of MedicineMiyagiJapan
| | - Takayuki Matsumoto
- Department of Internal MedicineDivision of Gastroenterology and HepatologySchool of MedicineIwate Medical UniversityIwateJapan
| | - Shinsaku Fukuda
- Department of GastroenterologyHirosaki University Graduate School of MedicineAomoriJapan
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Barclay NL, Pineda Moncusí M, Jödicke AM, Prieto-Alhambra D, Raventós B, Newby D, Delmestri A, Man WY, Chen X, Català M. The impact of the UK COVID-19 lockdown on the screening, diagnostics and incidence of breast, colorectal, lung and prostate cancer in the UK: a population-based cohort study. Front Oncol 2024; 14:1370862. [PMID: 38601756 PMCID: PMC11004443 DOI: 10.3389/fonc.2024.1370862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 03/14/2024] [Indexed: 04/12/2024] Open
Abstract
Introduction The COVID-19 pandemic had collateral effects on many health systems. Cancer screening and diagnostic tests were postponed, resulting in delays in diagnosis and treatment. This study assessed the impact of the pandemic on screening, diagnostics and incidence of breast, colorectal, lung, and prostate cancer; and whether rates returned to pre-pandemic levels by December, 2021. Methods This is a cohort study of electronic health records from the United Kingdom (UK) primary care Clinical Practice Research Datalink (CPRD) GOLD database. The study included individuals registered with CPRD GOLD between January, 2017 and December, 2021, with at least 365 days of clinical history. The study focused on screening, diagnostic tests, referrals and diagnoses of first-ever breast, colorectal, lung, and prostate cancer. Incidence rates (IR) were stratified by age, sex, and region, and incidence rate ratios (IRR) were calculated to compare rates during and after lockdown with rates before lockdown. Forecasted rates were estimated using negative binomial regression models. Results Among 5,191,650 eligible participants, the first lockdown resulted in reduced screening and diagnostic tests for all cancers, which remained dramatically reduced across the whole observation period for almost all tests investigated. There were significant IRR reductions in breast (0.69 [95% CI: 0.63-0.74]), colorectal (0.74 [95% CI: 0.67-0.81]), and prostate (0.71 [95% CI: 0.66-0.78]) cancer diagnoses. IRR reductions for lung cancer were non-significant (0.92 [95% CI: 0.84-1.01]). Extrapolating to the entire UK population, an estimated 18,000 breast, 13,000 colorectal, 10,000 lung, and 21,000 prostate cancer diagnoses were missed from March, 2020 to December, 2021. Discussion The UK COVID-19 lockdown had a substantial impact on cancer screening, diagnostic tests, referrals, and diagnoses. Incidence rates remained significantly lower than pre-pandemic levels for breast and prostate cancers and associated tests by December, 2021. Delays in diagnosis are likely to have adverse consequences on cancer stage, treatment initiation, mortality rates, and years of life lost. Urgent strategies are needed to identify undiagnosed cases and address the long-term implications of delayed diagnoses.
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Affiliation(s)
- Nicola L. Barclay
- Pharmaco− and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom
| | - Marta Pineda Moncusí
- Pharmaco− and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom
| | - Annika M. Jödicke
- Pharmaco− and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom
| | - Daniel Prieto-Alhambra
- Pharmaco− and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom
- Department of Medical Informatics, Erasmus Medical Center University, Rotterdam, Netherlands
| | - Berta Raventós
- Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Danielle Newby
- Pharmaco− and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom
| | - Antonella Delmestri
- Pharmaco− and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom
| | - Wai Yi Man
- Pharmaco− and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom
| | - Xihang Chen
- Pharmaco− and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom
| | - Marti Català
- Pharmaco− and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom
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Radomyski P, Trojanowski M, Michalek IM, Kycler W. The impact of the COVID-19 pandemic on clinical staging, pathological staging and surgical management of breast cancer patients. Rep Pract Oncol Radiother 2024; 29:122-130. [PMID: 39165593 PMCID: PMC11333074 DOI: 10.5603/rpor.99357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 01/26/2024] [Indexed: 08/22/2024] Open
Abstract
Background This study analyzes the impact of the first six lockdown months during the COVID-19 pandemic on breast cancer (BC) patients at a regional cancer center in western Poland (Greater Poland region). Materials and methods Patient age, clinical stage, pathological stage, surgical management, and use of neoadjuvant therapy (NT) for patients diagnosed with BC during the pandemic (March-August 2020, n = 290) were compared with pre-COVID-19 data (March-August 2019, n = 405). Results There were statistically significant differences in the average age (58.2 pre-COVID-19 vs. 55.9 during COVID-19, p = 0.014), clinical stage (p = 0.017) with a stage shift (stage I being dominant pre-pandemic, stage II during the pandemic). Additionally, when comparing the 2019 and 2020 groups, there were statistically significant differences in clinically node-positive cases (27% vs. 37%, p = 0.007), pathologically node-positive cases (26% vs. 34%, p = 0.014), and NT use (27% vs. 43%, p = 0.001). Moreover, there was a notable increase in the prevalence of mastectomies from 44% to 53% (p = 0.017) and axillary lymph node dissections from 27% to 33% (p = 0.029). Conclusions The first six months of the COVID-19 pandemic had a discernible impact on BC patients in the Greater Poland region. Changes in patient age, clinical stage, pathological stage, and treatment approach were observed during this period. These findings underscore the importance of further research and adaptations in healthcare delivery to address the evolving needs of BC patients during times of crisis.
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Affiliation(s)
- Piotr Radomyski
- Radiology Department, Greater Poland Cancer Centre, Poznan, Poland
- Electroradiology Department, Poznan University of Medical Sciences, Poznan, Poland
| | - Maciej Trojanowski
- Greater Poland Cancer Registry, Greater Poland Cancer Centre, Poznan, Poland
| | - Irmina Maria Michalek
- Department of Cancer Pathology, Maria Sklodowska-Curie National Research Institute of Oncology (MSCI), Warsaw, Poland
| | - Witold Kycler
- Gastrointestinal Surgical Oncology Department, Greater Poland Cancer Centre, Poznan, Poland
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Saeedian A, Tabatabaei FS, Azimi A, Babaei M, Lashkari M, Esmati E, Abiar Z, Moadabshoar L, Sandoughdaran S, Kamrava M, Amini A, Ghalehtaki R. PErspective and current status of Radiotherapy Service in IRan (PERSIR)-1 study: assessment of current external beam radiotherapy facilities, staff and techniques compared to the international guidelines. BMC Cancer 2024; 24:324. [PMID: 38459443 PMCID: PMC10921664 DOI: 10.1186/s12885-024-12078-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 03/04/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND AND PURPOSE Radiotherapy (RT) is an essential treatment modality against cancer and becoming even more in demand due to the anticipated increase in cancer incidence. Due to the rapid development of RT technologies amid financial challenges, we aimed to assess the available RT facilities and the issues with achieving health equity based on current equipment compared to the previous reports from Iran. MATERIALS AND METHODS A survey arranged by the Iran Cancer Institute's Radiation Oncology Research Center (RORC) was sent to all of the country's radiotherapy centers in 2022. Four components were retrieved: the reimbursement type, equipment, human resources, and patient load. To calculate the radiotherapy utilization rate (RUR), the Lancet Commission was used. The findings were compared with the previous national data. RESULTS Seventy-six active radiotherapy centers with 123 Linear accelerators (LINACs) were identified. The centers have been directed in three ways. 10 (20 LINACs), 36 (50 LINACs), and 30 centers (53 LINACs) were charity-, private-, and public-based, respectively. Four provinces had no centers. There was no active intraoperative radiotherapy machine despite its availability in 4 centers. One orthovoltage X-ray machine was active and 14 brachytherapy devices were treating patients. There were 344, 252, and 419 active radiation oncologists, medical physicists, and radiation therapy technologists, respectively. The ratio of LINAC and radiation oncologists to one million populations was 1.68 and 4.10, respectively. Since 2017, 35±5 radiation oncology residents have been trained each year. CONCLUSION There has been a notable growth in RT facilities since the previous reports and Iran's situation is currently acceptable among LMICs. However, there is an urgent need to improve the distribution of the RT infrastructure and provide more facilities that can deliver advanced techniques.
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Affiliation(s)
- Arefeh Saeedian
- Radiation Oncology Research Center, Cancer Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh-Sadat Tabatabaei
- Radiation Oncology Research Center, Cancer Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirali Azimi
- Radiation Oncology Research Center, Cancer Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Babaei
- Department of Radiation Oncology, Cancer Institute, IKHC, Tehran University of Medical Sciences, Tehran, Iran
| | - Marzieh Lashkari
- Radiation Oncology Research Center, Cancer Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiation Oncology, Cancer Institute, IKHC, Tehran University of Medical Sciences, Tehran, Iran
| | - Ebrahim Esmati
- Radiation Oncology Research Center, Cancer Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiation Oncology, Cancer Institute, IKHC, Tehran University of Medical Sciences, Tehran, Iran
| | - Zeinab Abiar
- Radiation Oncology Research Center, Cancer Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Moadabshoar
- Radiation Oncology Research Center, Cancer Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mitchell Kamrava
- Radiation Oncology Research Center, Cancer Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiation Oncology, Cedars Sinai Medical Center, Los Angeles, CA, 90048, USA
| | - Arya Amini
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Reza Ghalehtaki
- Radiation Oncology Research Center, Cancer Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Radiation Oncology Research Center, Radio-Oncology Ward, Cancer Institute, Keshavarz Blvd, Qarib Street, Tehran, Iran.
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Youn HM, Zhang Y, Liu A, Ng CS, Liang J, Lau GKK, Lee SF, Lok J, Lam CLK, Wan EYF, Quan J. Decline in Cancer Diagnoses during the 'Zero COVID' Policy in Hong Kong: Indirect Spillover Impact of the COVID-19 Pandemic. Clin Oncol (R Coll Radiol) 2024; 36:157-164. [PMID: 38262779 DOI: 10.1016/j.clon.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 11/26/2023] [Accepted: 01/11/2024] [Indexed: 01/25/2024]
Abstract
AIMS Despite a largely successful 'zero COVID' policy in 2020, the COVID-19 pandemic disrupted routine cancer services in the city of Hong Kong. The aims of this study were to examine the trends in cancer incidence before and during the COVID-19 pandemic and estimate missed cancer diagnoses. MATERIALS AND METHODS We used population-based data from the Hong Kong Cancer Registry 1983-2020 to examine the trends of age- and sex-standardised cancer incidence before and during the COVID-19 pandemic. We applied: (i) the annual average percentage change (AAPC) calculated using the Joinpoint regression model and (ii) the autoregressive integrated moving average (ARIMA) model to forecast cancer incidence rates in 2020. Missed cancer diagnoses in 2020 were estimated by comparing forecasted incidence rates to reported rates. A subgroup analysis was conducted by sex, age and cancer site. RESULTS The cancer incidence in Hong Kong declined by 4.4% from 2019 to 2020 (male 8.1%; female 1.1%) compared with the long-term AAPC of 0.5% from 2005 to 2019 (95% confidence interval 0.3, 0.7). The gap between the reported and forecasted incidence for 2020 ranged from 5.1 to 5.7% (male 8.5%, 9.8%; female 2.3%, 3.5%). We estimated 1525-1596 missed cancer diagnoses (ARIMA estimate -98, 3148; AAPC 514, 1729) in 2020. Most missed diagnoses were in males (ARIMA 1361 [327, 2394]; AAPC 1401 [1353, 1460]), with an estimated 479-557 missed cases of colorectal cancer (ARIMA 112, 837; AAPC 518, 597) and 256-352 missed cases of prostate cancer (AAPC 231, 280; ARIMA 110, 594). CONCLUSION The incidence of new cancer diagnoses declined in 2020 contrary to the long-term increase over the previous decades. Significantly lower diagnoses than expected were observed in males, particularly for colorectal and prostate cancers. Fewer reported cancer cases indicate missed diagnoses and could lead to delayed treatment that could impact future health outcomes.
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Affiliation(s)
- H M Youn
- Department of Family Medicine and Primary Care, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Y Zhang
- School of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - A Liu
- School of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - C S Ng
- School of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - J Liang
- School of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - G K K Lau
- Department of Medicine, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - S F Lee
- Department of Radiation Oncology, National University Cancer Institute, Singapore
| | - J Lok
- Department of Pathology, United Christian Hospital, Hong Kong SAR, China
| | - C L K Lam
- Department of Family Medicine and Primary Care, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - E Y F Wan
- Department of Family Medicine and Primary Care, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China; Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China; Laboratory of Data Discovery for Health (D(2)4H), Hong Kong Science and Technology Park, Hong Kong SAR, China
| | - J Quan
- School of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China; HKU Business School, University of Hong Kong, Hong Kong SAR, China.
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Frey A, Tilstra AM, Verhagen MD. Inequalities in healthcare use during the COVID-19 pandemic. Nat Commun 2024; 15:1894. [PMID: 38424038 PMCID: PMC10904793 DOI: 10.1038/s41467-024-45720-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 02/02/2024] [Indexed: 03/02/2024] Open
Abstract
The COVID-19 pandemic led to reductions in non-COVID related healthcare use, but little is known whether this burden is shared equally. This study investigates whether reductions in administered care disproportionately affected certain sociodemographic strata, in particular marginalised groups. Using detailed medical claims data from the Dutch universal health care system and rich full population registry data, we predict expected healthcare use based on pre-pandemic trends (2017 - Feb 2020) and compare these expectations with observed healthcare use in 2020 and 2021. Our findings reveal a 10% decline in the number of weekly treated patients in 2020 and a 3% decline in 2021 relative to prior years. These declines are unequally distributed and are more pronounced for individuals below the poverty line, females, older people, and individuals with a migrant background, particularly during the initial wave of COVID-19 hospitalisations and for middle and low urgency procedures. While reductions in non-COVID related healthcare decreased following the initial shock of the pandemic, inequalities persist throughout 2020 and 2021. Our results demonstrate that the pandemic has not only had an unequal toll in terms of the direct health burden of the pandemic, but has also had a differential impact on the use of non-COVID healthcare.
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Affiliation(s)
- Arun Frey
- Leverhulme Centre for Demographic Science, 42 Park End St, Oxford, OX1 1JD, UK
- Nuffield College, University of Oxford, 1 New Rd, Oxford, OX1 1NF, UK
- Amsterdam Health and Technology Institute, Paasheuvelweg 25, Amsterdam, 1105 BP, The Netherlands
- Stanford University, 450 Jane Stanford Way, Stanford, CA, 94305, USA
- Department of Sociology, University of Oxford, 42 Park End St, Oxford, OX3 7LF, UK
| | - Andrea M Tilstra
- Leverhulme Centre for Demographic Science, 42 Park End St, Oxford, OX1 1JD, UK
- Nuffield College, University of Oxford, 1 New Rd, Oxford, OX1 1NF, UK
- Department of Sociology, University of Oxford, 42 Park End St, Oxford, OX3 7LF, UK
- Nuffield Department of Population Health, University of Oxford, 42 Park End St, Oxford, OX1 1JD, UK
| | - Mark D Verhagen
- Leverhulme Centre for Demographic Science, 42 Park End St, Oxford, OX1 1JD, UK.
- Nuffield College, University of Oxford, 1 New Rd, Oxford, OX1 1NF, UK.
- Amsterdam Health and Technology Institute, Paasheuvelweg 25, Amsterdam, 1105 BP, The Netherlands.
- Department of Sociology, University of Oxford, 42 Park End St, Oxford, OX3 7LF, UK.
- Nuffield Department of Population Health, University of Oxford, 42 Park End St, Oxford, OX1 1JD, UK.
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43
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Michailovich YI, Sumkina OV, Gorokh YL. СANCER INCIDENCE IN UKRAINE: TRENDS IN 2010-2019 AND THE IMPACT OF COVID-19 PANDEMIC. Exp Oncol 2024; 45:463-473. [PMID: 38328843 DOI: 10.15407/exp-oncology.2023.04.463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND In 2020, a sharp decrease in the number of new cancer cases was registered in Ukraine in the setting of the quarantine restrictions due to the COVID-19 pandemic, which contrasted with the previous trends. AIM To study trends of cancer incidence rates in Ukraine in the recent decade and to assess the impact of COVID-19 pandemic on cancer detection in 2020. MATERIALS AND METHODS Records on cancer cases diagnosed during 2010-2020 (n = 1,498,911) from the database of the National Cancer Registry of Ukraine were used; the data being submitted early in 2022. Trends of the age-standardized incidence rates in 2010-2019 were estimated by the Joinpoint Regression Program. RESULTS During 2010-2019, the incidence rates increased (p < 0.05) for colon, prostate, and pharyngeal cancers in males and for colon, thyroid, and pancreas in females with the rates of other prevalent cancers being stable or decreasing (lung and larynx in males, cervix and rectum in females, stomach in both genders); the incidence increased mainly at the expense of the population aged 60-74 years. A significant decrease in cancer incidence was in males aged 40-59 years. In 2020, the serious negative impact of COVID-19 outbreak on the timely detection of cancer occurred in all adult age groups of the Ukrainian population and involved all the most common cancers. The most pronounced diminution of the incidence rate was observed for non-melanoma skin cancers (by 35.9%- 37.9%); the decrements of the rates for other prevalent cancers varied from -23.0% (prostate gland) to -9.7% (pharynx) in males and from -21.2% (kidney) to -9.1% (pancreas) in females, the greatest ones being in the population aged 75+. CONCLUSIONS The sharp drop of the cancer incidence rates registered in Ukraine 2020 is evidently the result of the limited access to healthcare facilities as well as the reduced oncological alertness of the population due to the predominant focus on COVID-19 during the pandemic. However, it is not a manifestation of a decrease in cancer incidence as such. In the following years, this may increase the proportion of advanced-stage diagnoses, the load on the cancer care system, and cancer mortality in the Ukrainian population. An evaluation of the short-termand long-term effects of the COVID-19 pandemic on the cancer burden in Ukraine requires further monitoring.
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Affiliation(s)
- Yu I Michailovich
- State Non-commercial Enterprise "National Cancer Institute", National Cancer Registry of Ukraine, Kyiv, Ukraine
| | - O V Sumkina
- State Non-commercial Enterprise "National Cancer Institute", National Cancer Registry of Ukraine, Kyiv, Ukraine
| | - Ye L Gorokh
- State Non-commercial Enterprise "National Cancer Institute", National Cancer Registry of Ukraine, Kyiv, Ukraine
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Shigenobu Y, Miyamori D, Ikeda K, Yoshida S, Kikuchi Y, Kanno K, Kashima S, Ito M. Assessing the Influence of the COVID-19 Pandemic on Gastric Cancer Mortality Risk. J Clin Med 2024; 13:715. [PMID: 38337409 PMCID: PMC10856106 DOI: 10.3390/jcm13030715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND The global impact of the coronavirus disease 2019 (COVID-19) pandemic on public health has been significant. Upper gastrointestinal endoscopy for screening and diagnosis decreased along with new gastric cancer (GC) diagnoses. METHODS This study assesses how the pandemic affected GC mortality using data from Hiroshima Prefecture, comparing mortality rates between patients diagnosed during the pandemic (2020 and 2021) and pre-pandemic (2018 and 2019) periods. The crude hazard ratios (HRs) and HRs adjusted for age, sex, clinical stage, treatment status, and travel distance to the nearest GC screening facility were estimated using Cox regression models. Subgroup and sensitivity analyses were also performed. RESULTS A total of 9571 patients were diagnosed, with 4877 eligible for follow-up. The median age was 74 years, and 69% were male. The median follow-up period was 157 days, with events per 1000 person-years at 278 and 374 in the pre-pandemic and pandemic periods, respectively (crude HR, 1.37; adjusted HR, 1.17). The sensitivity and subgroup analyses yielded consistent results. CONCLUSIONS The COVID-19 pandemic increased mortality risk in patients with GC. Further studies are required to observe long-term outcomes and identify the disparities contributing to the increased mortality risk.
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Affiliation(s)
- Yuya Shigenobu
- Department of General Internal Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minamiku, Hiroshima 734-8551, Japan; (Y.S.); (K.I.); (S.Y.); (Y.K.); (K.K.); (M.I.)
| | - Daisuke Miyamori
- Department of General Internal Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minamiku, Hiroshima 734-8551, Japan; (Y.S.); (K.I.); (S.Y.); (Y.K.); (K.K.); (M.I.)
| | - Kotaro Ikeda
- Department of General Internal Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minamiku, Hiroshima 734-8551, Japan; (Y.S.); (K.I.); (S.Y.); (Y.K.); (K.K.); (M.I.)
| | - Shuhei Yoshida
- Department of General Internal Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minamiku, Hiroshima 734-8551, Japan; (Y.S.); (K.I.); (S.Y.); (Y.K.); (K.K.); (M.I.)
| | - Yuka Kikuchi
- Department of General Internal Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minamiku, Hiroshima 734-8551, Japan; (Y.S.); (K.I.); (S.Y.); (Y.K.); (K.K.); (M.I.)
| | - Keishi Kanno
- Department of General Internal Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minamiku, Hiroshima 734-8551, Japan; (Y.S.); (K.I.); (S.Y.); (Y.K.); (K.K.); (M.I.)
| | - Saori Kashima
- Environmental Health Sciences Laboratory, Graduate School of Advanced Science and Engineering, Hiroshima University, 1-5-1 Kagamiyama, Higashi-Hiroshima 739-8511, Japan;
- Center for the Planetary Health and Innovation Science, The IDEC Institute, Hiroshima University, 1-5-1 Kagamiyama, Higashi-Hiroshima 739-8511, Japan
| | - Masanori Ito
- Department of General Internal Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minamiku, Hiroshima 734-8551, Japan; (Y.S.); (K.I.); (S.Y.); (Y.K.); (K.K.); (M.I.)
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Bremmers LGM, Fabbricotti IN, Gräler ES, Uyl-de Groot CA, Hakkaart-van Roijen L. The impact of informal care provision on the quality of life of adults caring for persons with mental health problems: A cross-sectional assessment of caregiver quality of life. Health Psychol Open 2024; 11:20551029241262883. [PMID: 39118836 PMCID: PMC11307371 DOI: 10.1177/20551029241262883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2024] Open
Abstract
This study assessed the quality of life of informal caregivers for individuals with mental health problems in the Netherlands. An online survey was administered to a panel of informal caregivers in June 2020 (n = 261). Informal caregivers of persons with mental problems were found to have an exceptionally low quality of life. A high subjective burden (p < .001), lower perseverance time (p = .016), low caregiver overall health status (p = .004) and psychological wellbeing (p = .008), younger caregiver age (p = .011), child caregiving responsibilities (p = .025), and no social support network (p = .038) were associated with worse quality of life scores. These findings shed light on the significant challenges faced by informal caregivers of persons with mental health problem. This raises concerns about the long-term sustainability of informal care and mental healthcare reform.
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Murthy SS, Are C. Cancer surgery on the global stage: Updates and progress. J Surg Oncol 2024; 129:145-149. [PMID: 38059658 DOI: 10.1002/jso.27548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 11/02/2023] [Indexed: 12/08/2023]
Abstract
Over 5 billion people lack access to basic surgical procedures, and it is estimated, the number of surgical procedures needed for cancer care will increase by 5 million from 2018 to 2040. The greatest increase in demand will occur in low- and middle-income countries. In this article, we highlight progress made in surgical cancer care globally and gaps that still needs to be addressed. We highlight political support, workforce progress and shortages, impact of the COVID-19 pandemic, and the importance of high value cancer care.
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Affiliation(s)
- Shilpa S Murthy
- Department of Surgery, Division of Colon and Rectal Surgery, Yale University, New Haven, Connecticut, USA
| | - Chandrakanth Are
- Department of Surgery, Division of Surgical Oncology, University of Nebraska Medical Center, Omaha, Nebraska, USA
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Wolfkamp W, Meijer J, van Hoeve JC, van Erning F, de Geus‐Oei L, de Hingh I, Veltman J, Siesling S. Impact of the COVID-19 pandemic on the in-hospital diagnostic pathway of breast and colorectal cancer in the Netherlands: A population-based study. Cancer Med 2024; 13:e6861. [PMID: 38197670 PMCID: PMC10807577 DOI: 10.1002/cam4.6861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/06/2023] [Accepted: 12/10/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND In the Netherlands, the COVID-19 pandemic resulted in a temporary halt of population screening for cancer and limited hospital capacity for non-COVID care. We aimed to investigate the impact of the pandemic on the in-hospital diagnostic pathway of breast cancer (BC) and colorectal cancer (CRC). METHODS 71,159 BC and 48,900 CRC patients were selected from the Netherlands Cancer Registry. Patients, diagnosed between January 2020 and July 2021, were divided into six periods and compared to the average of patients diagnosed in the same periods in 2017-2019. Diagnostic procedures performed were analysed using logistic regression. Lead time of the diagnostic pathway was analysed using Cox regression. Analyses were stratified for cancer type and corrected for age, sex (only CRC), stage and region. RESULTS For BC, less mammograms were performed during the first recovery period in 2020. More PET-CTs were performed during the first peak, first recovery and third peak period. For CRC, less ultrasounds and more CT scans and MRIs were performed during the first peak. Lead time decreased the most during the first peak by 2 days (BC) and 8 days (CRC). Significantly fewer patients, mainly in lower stages, were diagnosed with BC (-47%) and CRC (-36%) during the first peak. CONCLUSION Significant impact of the COVID-19 pandemic was found on the diagnostic pathway, mainly during the first peak. In 2021, care returned to the same standards as before the pandemic. Long-term effects on patient outcomes are not known yet and will be the subject of future research.
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Affiliation(s)
- Wouter Wolfkamp
- Department of Research and DevelopmentNetherlands Comprehensive Cancer Organisation (IKNL)Utrechtthe Netherlands
- Department of Health Technology and Services ResearchUniversity of TwenteEnschedethe Netherlands
| | - Joyce Meijer
- Department of Research and DevelopmentNetherlands Comprehensive Cancer Organisation (IKNL)Utrechtthe Netherlands
- Department of Health Technology and Services ResearchUniversity of TwenteEnschedethe Netherlands
| | - Jolanda C. van Hoeve
- Department of Research and DevelopmentNetherlands Comprehensive Cancer Organisation (IKNL)Utrechtthe Netherlands
- Department of Health Technology and Services ResearchUniversity of TwenteEnschedethe Netherlands
| | - Felice van Erning
- Department of Research and DevelopmentNetherlands Comprehensive Cancer Organisation (IKNL)Utrechtthe Netherlands
- Department of Surgical OncologyCatharina Cancer InstituteEindhoventhe Netherlands
| | - Lioe‐Fee de Geus‐Oei
- Department of RadiologyLeiden University Medical Center (LUMC)Leidenthe Netherlands
- Biomedical Photonic Imaging GroupUniversity of TwenteEnschedethe Netherlands
- Department of Radiation Science & TechnologyDelft University of TechnologyDelftthe Netherlands
| | - Ignace de Hingh
- Department of Surgical OncologyCatharina Cancer InstituteEindhoventhe Netherlands
- Department of Knowledge and AdviceNetherlands Comprehensive Cancer Organisation (IKNL)Utrechtthe Netherlands
- Department of Epidemiology, GROW‐School for Oncology ReproductionMaastricht UniversityMaastrichtThe Netherlands
| | - Jeroen Veltman
- Biomedical Photonic Imaging GroupUniversity of TwenteEnschedethe Netherlands
- Department of RadiologyZGTAlmelothe Netherlands
| | - Sabine Siesling
- Department of Research and DevelopmentNetherlands Comprehensive Cancer Organisation (IKNL)Utrechtthe Netherlands
- Department of Health Technology and Services ResearchUniversity of TwenteEnschedethe Netherlands
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Akbari M, Ahadi S, Karimi E, Heidari F, Lotfi M, Rezvan S, Mazarei A, Beheshti A. Increasing stage and depth of invasion (DOI) in patients with tongue cancer during the COVID-19 pandemic: A time series study. Health Sci Rep 2024; 7:e1832. [PMID: 38264159 PMCID: PMC10803884 DOI: 10.1002/hsr2.1832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 12/08/2023] [Accepted: 01/04/2024] [Indexed: 01/25/2024] Open
Abstract
Background and Aims The outbreak of the Coronavirus disease 2019 (COVID-19) pandemic had a significant effect on the diagnosis and treatment of head and neck cancers. Therefore, in this study, we decided to discuss the impact of COVID-19 on the stage and histological characteristics of patients with tongue cancer from March 2020 to March 2021 and compared to the previous 3 years. Methods In this time series study, patients diagnosed with squamous cell carcinoma of the operated tongue cancer were divided into two groups. Patients who operated from March 2020 to March 2021 (n = 36) and patients who operated 3 years ago (n = 70) were included in the study. The results were analyzed using SPSS 21 software. Results The study found that during the pandemic, the stage of tongue cancer in patients who underwent surgery was higher than before the pandemic (p = 0.01). Moreover, the depth of invasion was significantly higher during the COVID-19 outbreak in the pathology sample of the patients (p = 0.006), while the involvement of lymph nodes and other variables between the groups was not statistically significant. Conclusion COVID-19 has adverse effects on the diagnosis and treatment of tongue cancer. Also, it leads to advanced stages of the tumor and increases the depth of invasion of the cancer. Hence, it is important to plan correctly and appropriately for the diagnosis and treatment of these patients in conditions such as the COVID-19 pandemic.
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Affiliation(s)
- Maryam Akbari
- Otorhinolaryngology Research Center, Amir Alam HospitalTehran University of Medical SciencesTehranIran
- Otorhinolaryngology Research Center, Department of Otolaryngology and Head and Neck Surgery, Amiralmomenin Hospital, School of MedicineGuilan University of Medical SciencesRashtIran
| | - Samira Ahadi
- Otorhinolaryngology Research Center, Amir Alam HospitalTehran University of Medical SciencesTehranIran
| | - Ebrahim Karimi
- Otorhinolaryngology Research Center, Amir Alam HospitalTehran University of Medical SciencesTehranIran
| | - Farrokh Heidari
- Otorhinolaryngology Research Center, Amir Alam HospitalTehran University of Medical SciencesTehranIran
| | - Maryam Lotfi
- Department of Pathology, Amir‐Alam HospitalTehran University of Medical SciencesTehranIran
| | - Sajjad Rezvan
- Department of RadiologyQom University of Medical SciencesQomIran
| | - Alireza Mazarei
- Otorhinolaryngology Research Center, Amir Alam HospitalTehran University of Medical SciencesTehranIran
| | - Amin Beheshti
- Otorhinolaryngology Research Center, Amir Alam HospitalTehran University of Medical SciencesTehranIran
- Department of Pathology, Amir‐Alam HospitalTehran University of Medical SciencesTehranIran
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Iijima K, Watanabe K, Shimodaira Y. Editorial: Comparisons of COVID-19-related disturbance in diagnosis of esophagogastric cancer between the Netherlands and Japan. J Gastroenterol 2024; 59:79-80. [PMID: 37971582 DOI: 10.1007/s00535-023-02056-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 10/21/2023] [Indexed: 11/19/2023]
Affiliation(s)
- Katsunori Iijima
- Department of Gastroenterology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
| | - Kenta Watanabe
- Department of Gastroenterology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Yosuke Shimodaira
- Department of Gastroenterology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
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Tiangco B, Daguit SEJ, Astrologo NC, Flores L, Parma RN, Celi LA. Challenges in the maintenance of an open hospital-based cancer registry system in a low-to-middle-income country (LMIC): 2017-2022 experience. PLOS DIGITAL HEALTH 2024; 3:e0000328. [PMID: 38265986 PMCID: PMC10807826 DOI: 10.1371/journal.pdig.0000328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 12/14/2023] [Indexed: 01/26/2024]
Abstract
Hospital-based cancer registries (HBCRs) record data on all patients diagnosed and/or treated for cancer at healthcare facilities and evaluate the burden of the disease and the quality of healthcare services at that hospital, helping improve patient care, and providing an assessment of healthcare quality. The CARE PH app was created as a tool to facilitate a system of hospital-based cancer registries in the Philippines, a lower middle-income country. From 2017 to 2022, a total of 60,021 cancer registrants from 44 CARE PH hospitals were entered into the database. Breast cancer was the most common primary site, accounting for 17,660 cases (29.4%). This was followed by colorectal cancer at 11.1%, cervical cancer at 6.2%, head and neck cancer at 5.9%, and prostate and other male genital cancer at 5.1%.Among the 30 data fields collected, 17 exhibited 0-20% missing data, eight displayed 21%-90% missing data, while five depicted 91%-100% missing data. Most of the data fields with missing data are in the treatment and follow-up modules, which are stored in separate forms in a patient's record. Digital transformation of hospitals from paper-based charts to electronic medical records, and the integration of the HBCR to the EMR and hospital information system, will likely be the best solution for these limitations. It is recommended that the creation and maintenance of HBCRs nationwide must be harmonized, and embedded in all relevant national programs and legislations. The development of an information technology process that is based on a cancer patient's journey, should be built on an open system embedded in a well designed enterprise architecture, functioning under the guidance of a strong leadership and governance team. All these must be present in order to create and maintain a robust HBCR that is useful for furthering cancer registry and research in the country.
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Affiliation(s)
- Beatrice Tiangco
- Cancer CARE Registry and Research Philippines Foundation, Inc, Pasig, Philippines
- University of the Philippines National Institutes of Health, Manila, Philippines
| | | | - Nicole Cathlene Astrologo
- Cancer CARE Registry and Research Philippines Foundation, Inc, Pasig, Philippines
- University of the Philippines Los Baños, Los Baños, Philippines
| | - Leo Flores
- Cancer CARE Registry and Research Philippines Foundation, Inc, Pasig, Philippines
| | - Ric Nonato Parma
- Cancer CARE Registry and Research Philippines Foundation, Inc, Pasig, Philippines
| | - Leo Anthony Celi
- Laboratory for Computational Physiology, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
- Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
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