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Aydin M, Avci İA. The effect of the music-supported education program on the awareness and health beliefs of Roma women about cervical cancer and screening. BMC Public Health 2025; 25:1536. [PMID: 40281521 PMCID: PMC12023546 DOI: 10.1186/s12889-025-21884-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2024] [Accepted: 02/10/2025] [Indexed: 04/29/2025] Open
Abstract
BACKGROUND Roma women, who have low education, are one of the risk groups for cervical cancer as it has proven that they marry and give birth at an early age and have limited access to preventive health services. AIM This study aims to reveal the effect of a music-supported education program based on the Health Belief Model on the awareness and health beliefs of Roma women about cervical cancer and screening. METHODS This study was conducted between June 2021- January 2022 with 40 Roma women in the experimental group and 40 in the control group. Data were collected using the Personal Information Form and the Health Belief Model Scale for Cervical Cancer and Pap Smear Test. The experimental group received a four-week training and a two-week music-supported training. RESULTS It was revealed that 27.5% of the Roma women in the experimental group had the pap smear test after the intervention, and there was a significant difference in the mean scores of the awareness of cervical cancer and screening and the factors of the Health Belief Model Scale for Cervical Cancer and Pap Smear Test compared to the pre-intervention. It was found that the intervention had a significant effect at the level of 77.9% in reducing the perceived barriers to the pap smear test (p < 0.001). CONCLUSION It was found that the music-supported education program based on the Health Belief Model positively affected the awareness and health beliefs of Roma women about cervical cancer and screening. TRIAL REGISTRATION The study was registered with the U.S.National of Medicine Clinical Trials Registry (NCT04756440 -15.08.2020).
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Affiliation(s)
- Mesiya Aydin
- Department of Nursing, Faculty of Health Science, Division of Nursing, Department of Public Health Nursing, Ondokuz Mayıs University, University Campus, 55500, Samsun, Türkiye.
| | - İlknur Aydin Avci
- Department of Nursing, Faculty of Health Science, Division of Nursing, Department of Public Health Nursing, Ondokuz Mayıs University, University Campus, 55500, Samsun, Türkiye
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Ghassemi-Rad MJ, Dennehy C, Lyons N, Henry MT, Kennedy MP, O'Reilly ÉJ, Connolly RM. The impact of the COVID-19 pandemic on the performance of the Rapid Access Lung Cancer Clinic. Ir J Med Sci 2024; 193:2625-2634. [PMID: 39037475 PMCID: PMC11666672 DOI: 10.1007/s11845-024-03749-8] [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: 01/21/2024] [Accepted: 06/30/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND The Rapid Access Lung Cancer Clinic (RALC) experienced fewer referrals during the COVID-19 pandemic in Ireland. AIMS Our aim was to determine the impact of the pandemic on the key performance indicators (KPIs) of the Cork University Hospital (CUH) RALC, using a retrospective chart review of the referrals and attendances. METHODS The medical charts of patients referred to CUH-RALC from 03/2019 to 02/2020 (period I), and from 03/2020 to 02/2021 (period II) were reviewed. Performance of the RALC was determined based on average wait time from referral to 1] acquisition of the first CT scan, 2] consultation, and 3] receiving a cancer diagnosis, and compared between periods I and II. RESULTS Average monthly referrals (57.3 vs 42.1, p = 0.0078) and RALC reviews (24.3 vs 22, p = 0.0310) were lower in period II compared to period I. However, no difference was seen in the length of time from referral to review at RALC or time to receive cancer diagnosis. There were shorter wait times from referral to CT scan (11.2 vs. 8.7 days, p = 0.0011) and to surgery (109.0 vs 79.3 days, p = 0.0236) in period II. CONCLUSIONS The COVID-19 pandemic had minimal impact on the performance of RALC at our institution. Fewer referrals to RALC in period II may relate to hesitancy in attending general practitioner (GP) and/or GPs raising the thresholds for referrals to RALC during the early lockdown period of the pandemic. A national evaluation will be required to fully determine the impact of this pandemic on lung cancer in Ireland.
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Affiliation(s)
- Mohammad J Ghassemi-Rad
- School of Medicine, College of Medicine and Health, University College Cork, Cork, Republic of Ireland
| | - Colum Dennehy
- Medical Oncology, Cork University Hospital, Wilton, Republic of Ireland
| | - Noreen Lyons
- Rapid Access Lung Cancer Clinic, Department of Respiratory Medicine, Cork University Hospital, Wilton, Republic of Ireland
| | - Michael T Henry
- Rapid Access Lung Cancer Clinic, Department of Respiratory Medicine, Cork University Hospital, Wilton, Republic of Ireland
| | - Marcus P Kennedy
- Rapid Access Lung Cancer Clinic, Department of Respiratory Medicine, Cork University Hospital, Wilton, Republic of Ireland
| | - Éilis J O'Reilly
- School of Public Health, College of Medicine and Health, University College Cork, Cork, Republic of Ireland
| | - Roisin M Connolly
- School of Medicine, College of Medicine and Health, University College Cork, Cork, Republic of Ireland.
- Cancer Research @ UCC, College of Medicine and Health, University College Cork, Western Gateway Building, 4.110, Western Road, Cork, Republic of Ireland.
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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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Tan YY, Chang WH, Katsoulis M, Denaxas S, King KC, Cox MP, Davie C, Balloux F, Lai AG. Impact of the COVID-19 pandemic on health-care use among patients with cancer in England, UK: a comprehensive phase-by-phase time-series analysis across attendance types for 38 cancers. Lancet Digit Health 2024; 6:e691-e704. [PMID: 39332853 DOI: 10.1016/s2589-7500(24)00152-3] [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: 09/04/2023] [Revised: 03/15/2024] [Accepted: 07/07/2024] [Indexed: 09/29/2024]
Abstract
BACKGROUND The COVID-19 pandemic resulted in the widespread disruption of cancer health provision services across the entirety of the cancer care pathway in the UK, from screening to treatment. The potential long-term health implications, including increased mortality for individuals who missed diagnoses or appointments, are concerning. However, the precise impact of lockdown policies on national cancer health service provision across diagnostic groups is understudied. We aimed to systematically evaluate changes in patterns of attendance for groups of individuals diagnosed with cancer, including the changes in attendance volume and consultation rates, stratified by both time-based exposures and by patient-based exposures and to better understand the impact of such changes on cancer-specific mortality. METHODS In this retrospective, cross-sectional, phase-by-phase time-series analysis, by using primary care records linked to hospitals and the death registry from Jan 1, 1998, to June 17, 2021, we conducted descriptive analyses to quantify attendance changes for groups stratified by patient-based exposures (Index of Multiple Deprivation, ethnicity, age, comorbidity count, practice region, diagnosis time, and cancer subtype) across different phases of the COVID-19 pandemic in England, UK. In this study, we defined the phases of the COVID-19 pandemic as: pre-pandemic period (Jan 1, 2018, to March 22, 2020), lockdown 1 (March 23 to June 21, 2020), minimal restrictions (June 22 to Sept 20, 2020), lockdown 2 (Sept 21, 2020, to Jan 3, 2021), lockdown 3 (Jan 4 to March 21, 2021), and lockdown restrictions lifted (March 22 to March 31, 2021). In the analyses we examined changes in both attendance volume and consultation rate. We further compared changes in attendance trends to cancer-specific mortality trends. Finally, we conducted an interrupted time-series analysis with the lockdown on March 23, 2020, as the intervention point using an autoregressive integrated moving average model. FINDINGS From 561 611 eligible individuals, 7 964 685 attendances were recorded. During the first lockdown, the median attendance volume decreased (-35·30% [IQR -36·10 to -34·25]) compared with the preceding pre-pandemic period, followed by a median change of 4·38% (2·66 to 5·15) during minimal restrictions. More drastic reductions in attendance volume were seen in the second (-48·71% [-49·54 to -48·26]) and third (-71·62% [-72·23 to -70·97]) lockdowns. These reductions were followed by a 4·48% (3·45 to 7·10) increase in attendance when lockdown restrictions were lifted. The median consultation rate change during the first lockdown was 31·32% (25·10 to 33·60), followed by a median change of -0·25% (-1·38 to 1·68) during minimal restrictions. The median consultation rate decreased in the second (-33·89% [-34·64 to -33·18]) and third (-4·98% [-5·71 to -4·00]) lockdowns, followed by a 416·16% increase (409·77 to 429·77) upon lifting of lockdown restrictions. Notably, across many weeks, a year-over-year decrease in weekly attendances corresponded with a year-over-year increase in cancer-specific mortality. Overall, the pandemic period revealed a statistically significant reduction in attendances for patients with cancer (lockdown 1 -24 070·19 attendances, p<0·0001; minimal restrictions -19 194·89 attendances, p<0·0001; lockdown 2 -31 311·28 attendances, p<0·0001; lockdown 3 -43 843·38 attendances, p<0·0001; and lockdown restrictions lifted -56 260·50 attendances, p<0·0001) compared with before the pandemic. INTERPRETATION The UK's COVID-19 pandemic lockdown affected cancer health service access negatively. Many groups of individuals with cancer had declines in attendance volume and consultation rate across the phases of the pandemic. A decrease in attendances might lead to delays in cancer diagnoses, treatment, and follow-up, putting such groups of individuals at higher risk of negative health outcomes, such as cancer-specific mortality. We discuss the factors potentially responsible for explaining changes in service provision trends and provide insight to help inform clinical follow-up for groups of individuals at risk, alongside potential future policy changes in the care of such patients. FUNDING Wellcome Trust, National Institute for Health Research University College London Hospitals Biomedical Research Centre, National Institute for Health Research Great Ormond Street Hospital Biomedical Research Centre, Academy of Medical Sciences, and the University College London Overseas Research Scholarship.
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Affiliation(s)
- Yen Yi Tan
- Institute of Health Informatics, University College London, London, UK.
| | - Wai Hoong Chang
- Institute of Health Informatics, University College London, London, UK
| | - Michail Katsoulis
- Institute of Health Informatics, University College London, London, UK
| | - Spiros Denaxas
- Institute of Health Informatics, University College London, London, UK
| | - Kayla C King
- Department of Biology, University of Oxford, Oxford, UK; Department of Zoology, University of British Columbia, Vancouver, BC, Canada; Department of Microbiology & Immunology, University of British Columbia, Vancouver, BC, Canada
| | - Murray P Cox
- Department of Statistics, University of Auckland, Auckland, New Zealand; School of Natural Sciences, Massey University, Auckland, New Zealand
| | | | | | - Alvina G Lai
- Institute of Health Informatics, University College London, London, UK
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Chen KY, Stanford O, Wenzel JA, Joyner RL, Dobs AS. Patient perspectives on cancer care during COVID-19: A qualitative study. PLoS One 2024; 19:e0306035. [PMID: 38990967 PMCID: PMC11238955 DOI: 10.1371/journal.pone.0306035] [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] [Received: 08/23/2023] [Accepted: 06/10/2024] [Indexed: 07/13/2024] Open
Abstract
PURPOSE The COVID-19 pandemic posed unique challenges to cancer-related care as health systems balanced competing risks of timely delivery of care and minimizing exposure to infection in a high-risk, immunocompromised patient population. This study aimed to better understand how pandemic-related factors affected the patient experience of cancer care during this time. METHODS We conducted fifteen semi-structured interviews with adults from rural counties in Maryland who were diagnosed with and/or actively treated for cancer at the TidalHealth healthcare network between January 2020 and October 2022. RESULTS Interviews from fifteen participants were analyzed. Two major themes emerged including COVID Impact on Care, and COVID Impact on Mental Health. Subthemes under COVID Impact on Care include Staffing Shortages, Hospital Regulations, Visitation, Importance of Advocacy, and Telehealth Utilization, and subthemes under COVID Impact on Mental Health include Loneliness, Support Networks, and Perceptions of COVID and Personal Protection. Overall, participants described positive care experiences despite notable delays, disruptions to continuity of care, difficult transitions to telemedicine, visitation policies that limited patient support, increased mental health struggles related to social distancing measures, and greater desire for patient advocacy. CONCLUSION Our findings reveal significant impacts of the COVID-19 pandemic on experiences of cancer treatment and survivorship in a more vulnerable, rural patient population with lower healthcare access and income level. Our findings suggest areas for targeted interventions to limit disruptions to quality care in future public health emergencies.
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Affiliation(s)
- Krista Y. Chen
- School of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Olivia Stanford
- School of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Office of Community Outreach and Engagement, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Jennifer A. Wenzel
- School of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- School of Nursing, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Robert L. Joyner
- Richard A. Henson Research Institute, TidalHealth Peninsula Regional, Salisbury, Maryland, United States of America
| | - Adrian S. Dobs
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
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Lüchtenborg M, Huynh J, Armes J, Plugge E, Hunter RM, Visser R, Taylor RM, Davies EA. Cancer incidence, treatment, and survival in the prison population compared with the general population in England: a population-based, matched cohort study. Lancet Oncol 2024; 25:553-562. [PMID: 38697154 DOI: 10.1016/s1470-2045(24)00035-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 01/16/2024] [Accepted: 01/17/2024] [Indexed: 05/04/2024]
Abstract
BACKGROUND The growing and ageing prison population in England makes accurate cancer data of increasing importance for prison health policies. This study aimed to compare cancer incidence, treatment, and survival between patients diagnosed in prison and the general population. METHODS In this population-based, matched cohort study, we used cancer registration data from the National Cancer Registration and Analysis Service in England to identify primary invasive cancers and cervical cancers in situ diagnosed in adults (aged ≥18 years) in the prison and general populations between Jan 1, 1998, and Dec 31, 2017. Ministry of Justice and Office for National Statistics population data for England were used to calculate age-standardised incidence rates (ASIR) per year and age-standardised incidence rate ratios (ASIRR) for the 20-year period. Patients diagnosed with primary invasive cancers (ie, excluding cervical cancers in situ) in prison between Jan 1, 2012, and Dec 31, 2017 were matched to individuals from the general population and linked to hospital and treatment datasets. Matching was done in a 1:5 ratio according to 5-year age group, gender, diagnosis year, cancer site, and disease stage. Our primary objectives were to compare the incidence of cancer (1998-2017); the receipt of treatment with curative intent (2012-17 matched cohort), using logistic regression adjusted for matching variables (excluding cancer site) and route to diagnosis; and overall survival following cancer diagnosis (2012-17 matched cohort), using a Cox proportional hazards model adjusted for matching variables (excluding cancer site) and route to diagnosis, with stratification for the receipt of any treatment with curative intent. FINDINGS We identified 2015 incident cancers among 1964 adults (1556 [77·2%] men and 459 [22·8%] women) in English prisons in the 20-year period up to Dec 31, 2017. The ASIR for cancer for men in prison was initially lower than for men in the general population (in 1998, ASIR 119·33 per 100 000 person-years [95% CI 48·59-219·16] vs 746·97 per 100 000 person-years [742·31-751·66]), but increased to a similar level towards the end of the study period (in 2017, 856·85 per 100 000 person-years [675·12-1060·44] vs 788·59 per 100 000 person-years [784·62-792·57]). For women, the invasive cancer incidence rate was low and so ASIR was not reported for this group. Over the 20-year period, the incidence of invasive cancer for men in prison increased (incidence rate ratio per year, 1·05 [95% CI 1·04-1·06], during 1999-2017 compared with 1998). ASIRRs showed that over the 20-year period, overall cancer incidence was lower in men in prison than in men in the general population (ASIRR 0·76 [95% CI 0·73-0·80]). The difference was not statistically significant for women (ASIRR 0·83 [0·68-1·00]). Between Jan 1, 2012, and Dec 31, 2017, patients diagnosed in prison were less likely to undergo curative treatment than matched patients in the general population (274 [32·3%] of 847 patients vs 1728 [41·5%] of 4165; adjusted odds ratio (OR) 0·72 [95% CI 0·60-0·85]). Being diagnosed in prison was associated with a significantly increased risk of death on adjustment for matching variables (347 deaths during 2021·9 person-years in the prison cohort vs 1626 deaths during 10 944·2 person-years in the general population; adjusted HR 1·16 [95% CI 1·03-1·30]); this association was partly explained by stratification by curative treatment and further adjustment for diagnosis route (adjusted HR 1·05 [0·93-1·18]). INTERPRETATION Cancer incidence increased in people in prisons in England between 1998 and 2017, with patients in prison less likely to receive curative treatments and having lower overall survival than the general population. The association with survival was partly explained by accounting for differences in receipt of curative treatment and adjustment for diagnosis route. Improved routine cancer surveillance is needed to inform prison cancer policies and decrease inequalities for this under-researched population. FUNDING UK National Institute for Health and Care Research, King's College London, and Strategic Priorities Fund 2019/20 of Research England via the University of Surrey.
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Affiliation(s)
- Margreet Lüchtenborg
- Cancer Epidemiology and Cancer Services Research, Centre for Cancer, Society & Public Health, Comprehensive Cancer Centre, King's College London, London, UK; National Disease Registration Service, Data and Analytics, Transformation Directorate, NHS England, UK
| | - Jennie Huynh
- Cancer Epidemiology and Cancer Services Research, Centre for Cancer, Society & Public Health, Comprehensive Cancer Centre, King's College London, London, UK; National Disease Registration Service, Data and Analytics, Transformation Directorate, NHS England, UK
| | - Jo Armes
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Emma Plugge
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Rachael M Hunter
- Applied Health Research, Institute of Epidemiology and Health, University College London, London, UK
| | - Renske Visser
- Faculty of Education and Psychology, University of Oulu, Oulu, Finland
| | - Rachel M Taylor
- Centre for Nurse, Midwife and Allied Health Professional Research, University College London Hospitals NHS Foundation Trust, London, UK
| | - Elizabeth A Davies
- Cancer Epidemiology and Cancer Services Research, Centre for Cancer, Society & Public Health, Comprehensive Cancer Centre, King's College London, London, UK.
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Bhan S, Gupta R, Vig S, Garg R, Gupta N, Kumar V, Bharati SJ, Mishra S, Ratre B, Pandit A, Sirohiya P, Singh R, Kumar B, Bhopale S, Bhatnagar S. Marching Ahead through the Pandemic: Continuing Anesthesia Services in COVID Era-Our Experience from a Tertiary Care Cancer Centre. South Asian J Cancer 2024; 13:51-56. [PMID: 38721100 PMCID: PMC11076068 DOI: 10.1055/s-0042-1757557] [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] [Indexed: 03/06/2023] Open
Abstract
Swati BhanIntroduction This paper aims to provide an overview of the administrative and clinical preparations done in a tertiary care cancer hospital in continuing operation theatre (OT) services through the COVID pandemic. Methods Retrospective data collection, data for the past 1.5 years (COVID period) March 2020 to August 2021 were compared to surgical output for a similar duration of time before the COVID era (September 2018-February 2020). Results A total of 1,022 surgeries were done under anesthesia in the COVID period as against 1,710 surgeries done in a similar time frame in the pre-COVID era. Overall, we saw a 40%drop in the total number of cases. Thorax, abdominal, and miscellaneous surgeries (soft tissue sarcomas, urology, and gyneconcology) saw a maximum fall in numbers; however, head and neck cases saw an increase in numbers during the pandemic. Surgical morbidity and mortality were similar in the COVID and pre-COVID era. No cases of severe COVID infection were reported among the healthcare staff working in OT. Discussion We could successfully continue our anesthesia services with minimal risk to healthcare staff throughout the pandemic by adopting major guidelines in a pragmatic and practical approach with minor changes to suit our setup.
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Affiliation(s)
- Swati Bhan
- Department of Onco-Anaesthesia and Palliative Medicine, National Cancer Institute, All India Institute Of Medical Sciences, New Delhi, India
| | - Raghav Gupta
- Department of Onco-Anaesthesia and Palliative Medicine, BRAIRCH, All India Institute Of Medical Sciences, New Delhi, India
| | - Saurabh Vig
- Department of Onco-Anaesthesia and Palliative Medicine, National Cancer Institute, All India Institute Of Medical Sciences, New Delhi, India
| | - Rakesh Garg
- Department of Onco-Anaesthesia and Palliative Medicine, BRAIRCH, All India Institute Of Medical Sciences, New Delhi, India
| | - Nishkarsh Gupta
- Department of Onco-Anaesthesia and Palliative Medicine, BRAIRCH, All India Institute Of Medical Sciences, New Delhi, India
| | - Vinod Kumar
- Department of Onco-Anaesthesia and Palliative Medicine, BRAIRCH, All India Institute Of Medical Sciences, New Delhi, India
| | - Sachidanand Jee Bharati
- Department of Onco-Anaesthesia and Palliative Medicine, BRAIRCH, All India Institute Of Medical Sciences, New Delhi, India
| | - Seema Mishra
- Department of Onco-Anaesthesia and Palliative Medicine, BRAIRCH, All India Institute Of Medical Sciences, New Delhi, India
| | - Brajesh Ratre
- Department of Onco-Anaesthesia and Palliative Medicine, BRAIRCH, All India Institute Of Medical Sciences, New Delhi, India
| | - Anuja Pandit
- Department of Onco-Anaesthesia and Palliative Medicine, National Cancer Institute, All India Institute Of Medical Sciences, New Delhi, India
| | - Prashant Sirohiya
- Department of Onco-Anaesthesia and Palliative Medicine, National Cancer Institute, All India Institute Of Medical Sciences, New Delhi, India
| | - Ram Singh
- Department of Onco-Anaesthesia and Palliative Medicine, National Cancer Institute, All India Institute Of Medical Sciences, New Delhi, India
| | - Balbir Kumar
- Department of Onco-Anaesthesia and Palliative Medicine, National Cancer Institute, All India Institute Of Medical Sciences, New Delhi, India
| | - Shweta Bhopale
- Department of Onco-Anaesthesia and Palliative Medicine, National Cancer Institute, All India Institute Of Medical Sciences, New Delhi, India
| | - Sushma Bhatnagar
- Department of Onco-Anaesthesia and Palliative Medicine, BRAIRCH, All India Institute Of Medical Sciences, New Delhi, India
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Jenciūtė G, Kasputytė G, Bunevičienė I, Korobeinikova E, Vaitiekus D, Inčiūra A, Jaruševičius L, Bunevičius R, Krikštolaitis R, Krilavičius T, Juozaitytė E, Bunevičius A. Digital Phenotyping for Monitoring and Disease Trajectory Prediction of Patients With Cancer: Protocol for a Prospective Observational Cohort Study. JMIR Res Protoc 2023; 12:e49096. [PMID: 37815850 PMCID: PMC10599285 DOI: 10.2196/49096] [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: 05/19/2023] [Revised: 07/24/2023] [Accepted: 07/31/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Timely recognition of cancer progression and treatment complications is important for treatment guidance. Digital phenotyping is a promising method for precise and remote monitoring of patients in their natural environments by using passively generated data from sensors of personal wearable devices. Further studies are needed to better understand the potential clinical benefits of digital phenotyping approaches to optimize care of patients with cancer. OBJECTIVE We aim to evaluate whether passively generated data from smartphone sensors are feasible for remote monitoring of patients with cancer to predict their disease trajectories and patient-centered health outcomes. METHODS We will recruit 200 patients undergoing treatment for cancer. Patients will be followed up for 6 months. Passively generated data by sensors of personal smartphone devices (eg, accelerometer, gyroscope, GPS) will be continuously collected using the developed LAIMA smartphone app during follow-up. We will evaluate (1) mobility data by using an accelerometer (mean time of active period, mean time of exertional physical activity, distance covered per day, duration of inactive period), GPS (places of interest visited daily, hospital visits), and gyroscope sensors and (2) sociability indices (frequency of duration of phone calls, frequency and length of text messages, and internet browsing time). Every 2 weeks, patients will be asked to complete questionnaires pertaining to quality of life (European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire [EORTC QLQ-C30]), depression symptoms (Patient Health Questionnaire-9 [PHQ-9]), and anxiety symptoms (General Anxiety Disorder-7 [GAD-7]) that will be deployed via the LAIMA app. Clinic visits will take place at 1-3 months and 3-6 months of the study. Patients will be evaluated for disease progression, cancer and treatment complications, and functional status (Eastern Cooperative Oncology Group) by the study oncologist and will complete the questionnaire for evaluating quality of life (EORTC QLQ-C30), depression symptoms (PHQ-9), and anxiety symptoms (GAD-7). We will examine the associations among digital, clinical, and patient-reported health outcomes to develop prediction models with clinically meaningful outcomes. RESULTS As of July 2023, we have reached the planned recruitment target, and patients are undergoing follow-up. Data collection is expected to be completed by September 2023. The final results should be available within 6 months after study completion. CONCLUSIONS This study will provide in-depth insight into temporally and spatially precise trajectories of patients with cancer that will provide a novel digital health approach and will inform the design of future interventional clinical trials in oncology. Our findings will allow a better understanding of the potential clinical value of passively generated smartphone sensor data (digital phenotyping) for continuous and real-time monitoring of patients with cancer for treatment side effects, cancer complications, functional status, and patient-reported outcomes as well as prediction of disease progression or trajectories. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/49096.
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Affiliation(s)
- Gabrielė Jenciūtė
- Faculty of Informatics, Vytautas Magnus University, Kaunas, Lithuania
| | | | - Inesa Bunevičienė
- Faculty of Political Science and Diplomacy, Vytautas Magnus University, Kaunas, Lithuania
| | - Erika Korobeinikova
- Oncology Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Domas Vaitiekus
- Oncology Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Arturas Inčiūra
- Oncology Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | | | | | - Tomas Krilavičius
- Faculty of Informatics, Vytautas Magnus University, Kaunas, Lithuania
| | - Elona Juozaitytė
- Oncology Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Adomas Bunevičius
- Department of Neurology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States
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9
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Schluter C, Fefer M, Lee G, Alty IG, Dee EC. Investigation of the Readability and Reliability of Online Health Information for Cancer Patients During the Coronavirus Pandemic. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:462-466. [PMID: 35469115 PMCID: PMC9038169 DOI: 10.1007/s13187-022-02140-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/17/2022] [Indexed: 05/20/2023]
Abstract
For cancer patients undergoing treatment who may be at higher risk of COVID-19, access to high-quality online health information (OHI) may be of particular importance amidst a plethora of harmful medical misinformation online. Therefore, we assessed the readability and quality of OHI available for various cancer types and treatment modalities. Search phrases included "cancer radiation COVID," "cancer surgery COVID," "cancer chemotherapy COVID," and "cancer type COVID," for the fourteen most common cancer types (e.g., "prostate cancer COVID" and "breast cancer COVID"), yielding a total of 17 search phrases. The first 20 sources were recorded and analyzed for each keyword, yielding a total of 340 unique sources. For each of these sources, the approximate grade level required to comprehend the text was calculated as a mean of five validated readability scores; subsequently, for the first ten results of each search, the DISCERN tool was manually used to assess quality. Search terms were translated into Spanish and French, and a quality assessment using the Health on the Net Code (HONcode) accreditation was conducted. The median grade level readability for all sources was 13 (IQR 11-14). Median DISCERN scores for the 170 sources assessed were 55 out of 75, suggesting good quality. OHI with quality scores below the median DISCERN score had a median readability of 12.5 (IQR 11-14) grade reading level vs 14 (IQR 12-17) for those above the median DISCERN score (T-test P < 0.0001). Percentages of HONcode-accredited websites were 34.9%, 39.9%, and 38.6% for English, Spanish, and French OHI, respectively. We conclude that efforts are needed to make high-quality OHI available at the appropriate reading level for patients with cancer; such efforts may contribute to the alleviation of disparities in access to healthcare information.
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Affiliation(s)
- Cameron Schluter
- Department of Biochemistry, Colby College, Waterville, ME, USA
- University of Massachusetts Medical School, Worcester, MA, USA
| | - Maia Fefer
- University of Massachusetts Medical School, Worcester, MA, USA
| | - Grace Lee
- Harvard Medical School, Boston, MA, USA
- Department of Radiation Oncology, Dana Farber Cancer Institute/Brigham and Women's Hospital, Boston, MA, USA
| | - Isaac G Alty
- Harvard Medical School, Boston, MA, USA.
- Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
| | - Edward Christopher Dee
- Harvard Medical School, Boston, MA, USA.
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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10
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Dalamaga M, Nasiri-Ansari N, Spyrou N. Perspectives and Challenges of COVID-19 with Obesity-Related Cancers. Cancers (Basel) 2023; 15:cancers15061771. [PMID: 36980657 PMCID: PMC10046880 DOI: 10.3390/cancers15061771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/07/2023] [Accepted: 03/10/2023] [Indexed: 03/17/2023] Open
Abstract
The emergence of COVID-19 has created an unprecedented threat worldwide, involving overwhelmed health-care systems in the majority of countries [...]
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Affiliation(s)
- Maria Dalamaga
- Department of Biological Chemistry, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias, 11527 Athens, Greece
- Correspondence:
| | - Narjes Nasiri-Ansari
- Department of Biological Chemistry, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias, 11527 Athens, Greece
| | - Nikolaos Spyrou
- Tisch Cancer Institute Icahn School of Medicine at Mount Sinai, 1190 One Gustave L. Levy Place, New York, NY 10029, USA
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11
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Anthony BF, Disbeschl S, Goulden N, Hendry A, Hiscock J, Hoare Z, Roberts J, Rose J, Surgey A, Williams NH, Walker D, Neal R, Wilkinson C, Edwards RT. Earlier cancer diagnosis in primary care: a feasibility economic analysis of ThinkCancer! BJGP Open 2023; 7:BJGPO.2022.0130. [PMID: 36543386 DOI: 10.3399/bjgpo.2022.0130] [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: 09/02/2022] [Revised: 12/07/2022] [Accepted: 12/18/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND UK cancer survival rates are much lower compared with other high-income countries. In primary care, there are opportunities for GPs and other healthcare professionals to act more quickly in response to presented symptoms that might represent cancer. ThinkCancer! is a complex behaviour change intervention aimed at primary care practice teams to improve the timely diagnosis of cancer. AIM To explore the costs of delivering the ThinkCancer! intervention to expedite cancer diagnosis in primary care. DESIGN & SETTING Feasibility economic analysis using a micro-costing approach, which was undertaken in 19 general practices in Wales, UK. METHOD From an NHS perspective, micro-costing methodology was used to determine whether it was feasible to gather sufficient economic data to cost the ThinkCancer! INTERVENTION Owing to the COVID-19 pandemic, ThinkCancer! was mainly delivered remotely online in a digital format. Budget impact analysis (BIA) and sensitivity analysis were conducted to explore the costs of face-to-face delivery of the ThinkCancer! intervention as intended pre-COVID-19. RESULTS The total costs of delivering the ThinkCancer! intervention across 19 general practices in Wales was £25 030, with an average cost per practice of £1317 (standard deviation [SD]: 578.2). Findings from the BIA indicated a total cost of £34 630 for face-to-face delivery. CONCLUSION Data collection methods were successful in gathering sufficient health economics data to cost the ThinkCancer! INTERVENTION Results of this feasibility study will be used to inform a future definitive economic evaluation alongside a pragmatic randomised controlled trial (RCT).
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Affiliation(s)
- Bethany Fern Anthony
- Centre for Health Economics and Medicines Evaluation (CHEME), Bangor University, Bangor, UK
| | - Stefanie Disbeschl
- North Wales Centre for Primary Care Research, Bangor University, Bangor, UK
| | | | - Annie Hendry
- North Wales Centre for Primary Care Research, Bangor University, Bangor, UK
| | - Julia Hiscock
- North Wales Centre for Primary Care Research, Bangor University, Bangor, UK
| | - Zoe Hoare
- NWORTH, Bangor University, Bangor, UK
| | - Jessica Roberts
- North Wales Centre for Primary Care Research, Bangor University, Bangor, UK
| | - Jan Rose
- National Cancer Research Institute (NCRI), Consumer Member, London, UK
| | - Alun Surgey
- North Wales Centre for Primary Care Research, Bangor University, Bangor, UK
| | - Nefyn Howard Williams
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Daniel Walker
- North Wales Centre for Primary Care Research, Bangor University, Bangor, UK
| | - Richard Neal
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Clare Wilkinson
- North Wales Centre for Primary Care Research, Bangor University, Bangor, UK
| | - Rhiannon Tudor Edwards
- Centre for Health Economics and Medicines Evaluation (CHEME), Bangor University, Bangor, UK
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12
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Neilson L, Kohli M, Munshi KD, K Peasah S, Henderson R, Passero V, Good CB. Impact of the COVID-19 pandemic on new starts to oral oncology medications in the US. J Oncol Pharm Pract 2023; 29:370-374. [PMID: 35014888 PMCID: PMC9902798 DOI: 10.1177/10781552211073778] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
INTRODUCTION The COVID-19 pandemic has had a significant impact on healthcare delivery. Although others have documented the impact on new cancer diagnoses, trends in new starts for oncology drugs are less clear. We examined changes in new users of oral oncology medications in the US following COVID-19 stay-at-home orders in 2020 compared to prior years. METHODS We examined prescription data for members enrolled with a national pharmacy benefits manager in the US from January 1-October 31 of 2018, 2019, and/or 2020. This is a retrospective, observational study comparing new users per 100,000 members per month for all oral oncology drugs, and separately for breast, lung, and prostate cancer, leukemia, and melanoma oral drugs. We performed a difference-in-differences analysis for change in new users from pre-period (prior to pandemic-induced disruption, January-March), to post-period (following pandemic-induced disruption, April-October), between 2020 and 2019, and 2020 and 2018. RESULTS New oral oncology drug users per 100,000 members per month declined by an additional 11.3% in the 2020 post-period compared to 2019 (p = 0.048). New oral breast cancer drug starts declined by an additional 14.0% in the 2020 post-period compared to 2019 (p = 0.040). Similar but non-significant trends were found between 2020 and 2018. No significant differences were found between post-period monthly new starts of leukemia, melanoma, lung or prostate cancer disease-specific oral medications. CONCLUSIONS Long-term implications of delays in cancer treatment initiation are unclear, although there is concern that patient outcomes may be negatively impacted.
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Affiliation(s)
- Lynn Neilson
- Centers for High Value Health Care and Value Based Pharmacy Initiatives, UPMC Health Plan Insurance Services Division, Pittsburgh, PA, USA
| | | | | | - Samuel K Peasah
- Centers for High Value Health Care and Value Based Pharmacy Initiatives, UPMC Health Plan Insurance Services Division, Pittsburgh, PA, USA
| | | | - Vida Passero
- VA Pittsburgh Healthcare System, Pittsburgh, PA, USA,Division of Hematology and Oncology, University of Pittsburgh School of Medicine, Pittsburgh PA, USA
| | - Chester B Good
- Centers for High Value Health Care and Value Based Pharmacy Initiatives, UPMC Health Plan Insurance Services Division, Pittsburgh, PA, USA,Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA,Chester B Good, Centers for High Value Health Care and Value Based Pharmacy Initiatives, US Steel Tower, Floor 40, 600 Grant Street, Pittsburgh, PA 15219, USA.
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13
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Tsuruta K, Majima T, Nishikimi T, Kashima A, Soeda Y, Inoue S, Sano T, Maeda M, Yamamoto A, Kobayashi I, Kajikawa K, Matsukawa Y, Kato M, Tsuzuki T, Sassa N. Impact of the coronavirus disease 2019 pandemic on the number of undergoing radical nephroureterectomy and postoperative adjuvant systematic therapy for upper tract urothelial carcinomas in Japan: A multicenter retrospective study. Int J Urol 2023; 30:464-471. [PMID: 36746652 DOI: 10.1111/iju.15157] [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: 10/26/2022] [Accepted: 01/18/2023] [Indexed: 02/08/2023]
Abstract
OBJECTIVES The coronavirus disease 2019 pandemic has affected cancer management worldwide. For upper tract urothelial carcinomas, delays in treatments are not recommended even during the pandemic. We investigated the impact of the pandemic on patients with these carcinomas who underwent radical nephroureterectomy (RNU) and adjuvant systematic therapy before and after COVID-19 spread in Japan. METHODS This multicenter retrospective study included 304 patients who underwent RNU for upper tract urothelial carcinomas between May 1, 2019, and December 31, 2021, in Aichi, Japan. The patients were categorized into three groups based on whether they underwent surgery in the prepandemic (before infection spread in Japan), early pandemic (between confirmation of the first case and vaccination initiation), and late pandemic (after the start of vaccination in Japan) phases. The patient characteristics, diagnostic methods, pathological findings, and postoperative therapy were compared among the three phases. RESULTS Overall, 74, 152, and 78 patients underwent RNU in the prepandemic, early pandemic, and late pandemic phases, respectively. The number of patients who underwent preoperative ureteroscopy decreased significantly from the prepandemic phase to the late pandemic phase due to pandemic-related restrictions (p = 0.016). There was no difference in the time to the first visit or pathological findings. Among patients classified as high-risk according to existing clinical trials, the proportion receiving adjuvant systematic therapy after RNU decreased significantly from 52.3% to 19% (p = 0.003). CONCLUSIONS There was no difference in the pathological findings. The number of patients receiving appropriate adjuvant systematic therapy decreased during the pandemic.
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Affiliation(s)
- Katsuhisa Tsuruta
- Department of Urology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Tsuyoshi Majima
- Department of Urology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Toshinori Nishikimi
- Department of Urology, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya, Japan
| | - Ayano Kashima
- Department of Urology, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya, Japan
| | - Yuya Soeda
- Department of Urology, Komaki City Hospital, Komaki, Japan
| | - Satoshi Inoue
- Department of Urology, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Nagoya, Japan
| | - Tomoyasu Sano
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Motohiro Maeda
- Department of Urology, Kariya-Toyota General Hospital, Kariya, Japan
| | - Akiyuki Yamamoto
- Department of Urology, Toyohashi Municipal Hospital, Toyohashi, Japan
| | - Ikuo Kobayashi
- Department of Urology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Keishi Kajikawa
- Department of Urology, Aichi Medical University School of Medicine, Nagakute, Japan
| | | | - Masahi Kato
- Department of Urology, Kariya-Toyota General Hospital, Kariya, Japan
| | - Toyonori Tsuzuki
- Department of Pathology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Naoto Sassa
- Department of Urology, Aichi Medical University School of Medicine, Nagakute, Japan
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14
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Mills SE, Brown-Kerr A, Buchanan D, Donnan PT, Smith BH. Free-text analysis of general practice out-of-hours (GPOOH) use by people with advanced cancer: an analysis of coded and uncoded free-text data. Br J Gen Pract 2023; 73:e124-e132. [PMID: 36702608 PMCID: PMC9888572 DOI: 10.3399/bjgp.2022.0084] [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: 03/25/2022] [Accepted: 10/06/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND People with advanced cancer frequently use the GP out-of-hours (GPOOH) service. Considerable amounts of routine GPOOH data are uncoded. Therefore, these data are omitted from existing healthcare datasets. AIM To conduct a free-text analysis of a GPOOH dataset, to identify reasons for attendance and care delivered through GPOOH to people with advanced cancer. DESIGN AND SETTING An analysis of a GPOOH healthcare dataset was undertaken. It contained all coded and free- text information for 5749 attendances from a cohort of 2443 people who died from cancer in Tayside, Scotland, from 2013-2015. METHOD Random sampling methods selected 575 consultations for free-text analysis. Each consultation was analysed by two independent reviewers to determine the following: assigned presenting complaints; key and additional palliative care symptoms recorded in free text; evidence of anticipatory care planning; and free-text recording of dispensed medications. Inter-rater reliability concordance was established through Kappa testing. RESULTS More than half of all coded reasons for attendance (n = 293; 51.0%) were 'other' or 'missing'. Free-text analysis demonstrated that nearly half (n = 284; 49.4%) of GPOOH attendances by people with advanced cancer were for pain or palliative care. More than half of GPOOH attendances (n = 325; 56.5%) recorded at least one key or additional palliative care symptom in free text, with the commonest being breathlessness, vomiting, cough, and nausea. Anticipatory care planning was poorly recorded in both coded and uncoded records. Uncoded medications were dispensed in more than one- quarter of GPOOH consultations. CONCLUSION GPOOH delivers a substantial amount of pain management and palliative care, much of which is uncoded. Therefore, it is unrecognised and under-reported in existing large healthcare data analyses.
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Affiliation(s)
- Sarah Ee Mills
- School of Medicine, University of St Andrews, St Andrews
| | | | | | - Peter T Donnan
- Population Health and Genomics Division, University of Dundee Medical School, Ninewells Hospital and Medical School, Dundee
| | - Blair H Smith
- Population Health and Genomics Division, University of Dundee Medical School, Ninewells Hospital and Medical School, Dundee
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15
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Li D, Jia AY, Zorzi J, Griffith P, Kim AK, Dao D, Anders RA, Georgiades C, Liddell RP, Hong K, Azad NS, Ho WJ, Baretti M, Christenson E, Baghdadi A, Kamel IR, Meyer J, Ghabi E, Burkhart RA, Lafaro K, He J, Shubert C, Yarchoan M. Impact of the COVID-19 Pandemic on Liver Cancer Staging at a Multidisciplinary Liver Cancer Clinic. ANNALS OF SURGERY OPEN 2022; 3:e207. [PMID: 36590894 PMCID: PMC9782462 DOI: 10.1097/as9.0000000000000207] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 08/05/2022] [Indexed: 01/03/2023] Open
Abstract
To compare liver cancer resectability rates before and during the COVID-19 pandemic. Background Liver cancers usually present with nonspecific symptoms or are diagnosed through screening programs for at-risk patients, and early detection can improve patient outcomes. In 2020, the COVID-19 pandemic upended medical care across all specialties, but whether the pandemic was associated with delays in liver cancer diagnosis is not known. Methods We performed a retrospective review of all patients evaluated at the Johns Hopkins Multidisciplinary Liver Cancer Clinic from January 2019 to June 2021 with a new diagnosis of suspected or confirmed hepatocellular carcinoma (HCC) or biliary tract cancer (BTC). Results There were 456 liver cancer patients (258 HCC and 198 BTC). From January 2019 to March 2020 (pre-pandemic), the surgical resectability rate was 20%. The subsequent 6 months (early pandemic), the resectability rate decreased to 11%. Afterward from October 2020 to June 2021 (late pandemic), the resectability rate increased to 27%. The resectability rate early pandemic was significantly lower than that for pre-pandemic and later pandemic combined (11% lower; 95% confidence interval [CI], 2%-20%). There was no significant difference in resectability rates pre-pandemic and later pandemic (7% difference; 95% CI, -3% to 16%). In subgroup analyses, the early pandemic was associated with a larger impact in BTC resectability rates than HCC resectability rates. Time from BTC symptom onset until Multidisciplinary Liver Clinic evaluation increased by over 6 weeks early pandemic versus pre-pandemic (Hazard Ratio, 0.63; 95% CI, 0.44-0.91). Conclusions During the early COVID-19 pandemic, we observed a drop in the percentage of patients presenting with curable liver cancers. This may reflect delays in liver cancer diagnosis and contribute to excess mortality related to the COVID-19 pandemic.
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Affiliation(s)
- Daniel Li
- From the Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Angela Y. Jia
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jane Zorzi
- From the Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Paige Griffith
- From the Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Amy K. Kim
- Department of Medicine, Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Doan Dao
- Department of Medicine, Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Robert A. Anders
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Christos Georgiades
- Department of Radiology and Radiological Sciences, Division of Vascular and Interventional Radiology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Robert P. Liddell
- Department of Radiology and Radiological Sciences, Division of Vascular and Interventional Radiology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Kelvin Hong
- Department of Radiology and Radiological Sciences, Division of Vascular and Interventional Radiology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Nilofer S. Azad
- From the Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Won Jin Ho
- From the Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Marina Baretti
- From the Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Eric Christenson
- From the Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Azarakhsh Baghdadi
- Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Ihab R. Kamel
- Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jeffrey Meyer
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Elie Ghabi
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Richard A. Burkhart
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Kelly Lafaro
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jin He
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Chris Shubert
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Mark Yarchoan
- From the Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD
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16
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Zyoud SH, Koni A, Al-Jabi SW, Amer R, Shakhshir M, Al Subu R, Salameh H, Odeh R, Musleh S, Abushamma F, Abu Taha A. Current global research landscape on COVID-19 and cancer: Bibliometric and visualization analysis. World J Clin Oncol 2022; 13:835-847. [PMID: 36337308 PMCID: PMC9630994 DOI: 10.5306/wjco.v13.i10.835] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/26/2022] [Accepted: 10/11/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Cancer is a severe public health issue that seriously jeopardizes global health. In individuals with coronavirus disease 2019 (COVID-19), cancer is considered an independent risk factor for severe illness and increased mortality. AIM To identify research hotspots and prospects, we used bibliometrics to examine the global production of COVID-19 literature published in the field of oncology. METHODS Data on publication output were identified based on the Scopus database between January 1, 2020, and June 21, 2022. This study used VOSviewer to analyze collaboration networks among countries and assess the terms most often used in the titles and abstracts of retrieved publications to determine research hotspots linked to cancer and COVID-19. The Impact Index Per Article for the top 10 high-cited papers collected from Reference Citation Analysis (RCA) are presented. RESULTS A total of 7015 publications were retrieved from the database. The United States published the greatest number of articles (2025; 28.87%), followed by Italy (964; 13.74%), the United Kingdom (839; 11.96%), and China (538; 7.67%). The University of Texas MD Anderson Cancer Center (n = 205, 2.92%) ranked first, followed by the Memorial Sloan-Kettering Cancer Center (n = 176, 2.51%). The European Journal of Cancer (n = 106, 1.51%) ranked first, followed by the Frontiers in Oncology (n = 104, 1.48%), Cancers (n = 102, 1.45%), and Pediatric Blood and Cancer (n = 95; 1.35%). The hot topics were stratified into "cancer care management during the COVID-19 pandemic"; and "COVID-19 vaccines in cancer patients". CONCLUSION This is the first bibliometric analysis to determine the present state and upcoming hot themes related to cancer and COVID-19 and vice versa using VOSviewer during the early stages of the pandemic. The emergence of hot themes related to cancer and COVID-19 may aid researchers in identifying new research areas in this field.
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Affiliation(s)
- Sa'ed H Zyoud
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
- Clinical Research Centre, An-Najah National University Hospital, Nablus 44839, Palestine
| | - Amer Koni
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
- Hematology and Oncology Department, An-Najah National University Hospital, Nablus 44839, Palestine
| | - Samah W Al-Jabi
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
| | - Riad Amer
- Hematology and Oncology Department, An-Najah National University Hospital, Nablus 44839, Palestine
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
| | - Muna Shakhshir
- Department of Nutrition, An-Najah National University Hospital, Nablus 44839, Palestine
| | - Rand Al Subu
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
| | - Husam Salameh
- Hematology and Oncology Department, An-Najah National University Hospital, Nablus 44839, Palestine
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
| | - Razan Odeh
- Hematology and Oncology Department, An-Najah National University Hospital, Nablus 44839, Palestine
| | - Sultan Musleh
- Hematology and Oncology Department, An-Najah National University Hospital, Nablus 44839, Palestine
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
| | - Faris Abushamma
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
- Department of Urology, An-Najah National University Hospital, Nablus 44839, Palestine
| | - Adham Abu Taha
- Department of Pathology, An-Najah National University Hospital, Nablus 44839, Palestine
- Department of Biomedical Sciences, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
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17
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Minamimoto R. Oncology and cardiology positron emission tomography/computed tomography faced with COVID-19: A review of available literature data. Front Med (Lausanne) 2022; 9:1052921. [PMID: 36341267 PMCID: PMC9626818 DOI: 10.3389/fmed.2022.1052921] [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: 09/24/2022] [Accepted: 10/07/2022] [Indexed: 09/07/2024] Open
Abstract
The COVID-19 pandemic has forced people to significantly change their lifestyles and attitudes, and has greatly burdened healthcare delivery systems worldwide. The redistribution of the medical delivery system to maintain normal medical care while responding generously to COVID-19 is a continuing challenge that weighs heavily on medical institutions. Among imaging modalities, chest X-rays and computed tomography (CT) examinations have clearly made a large contribution to treatment of COVID-19. In contrast, it is difficult to express the standpoint of nuclear medicine examinations in a straightforward manner, as the greatest emphasis in this modality has been on how necessary medical care can continue to be provided. Many clinical reports of nuclear medicine examinations related to COVID-19 have been published, and knowledge continues to accumulate. This review provides a summary of the current state of oncology and cardiology positron emission tomography (PET) examinations related to COVID-19, and includes preparation of the nuclear medicine department, trends in PET examinations, specific imaging findings on 18F-fluorodeoxyglucose (FDG) PET/CT, imaging of complications of COVID-19, PET tracers other than FDG, and the effects of vaccines on PET imaging findings.
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Affiliation(s)
- Ryogo Minamimoto
- Division of Nuclear Medicine, National Center for Global Health and Medicine, Tokyo, Japan
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18
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Glazanova TV, Shilova ER. Immune system disturbances after a new coronavirus infection COVID-19. JOURNAL INFECTOLOGY 2022. [DOI: 10.22625/2072-6732-2022-14-4-26-37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
During the pandemic, a large number of works devoted to COVID infection have appeared, which have made it possible to understand the pathogenetic features of the disease and to accumulate significant clinical experience. However, the question remains about the degree of participation of humoral and cellular (primarily T-cell) immunity in the mechanisms of immune defense and resistance to COVID-19, the individual features of the immune response in different subjects. Post-COVID syndrome is currently a separate diagnosis included in the ICD-10 International Classification of Diseases, but the long-term effects of the SARS-CoV-2 on the immune system are not yet well established. At the same time, a long-term increased activity of the immune system can contribute to the development of autoimmune reactions. The review of the literature presents the results of studies, mainly devoted to immune system disorders after COVID infection. The changes in subpopulations of T-lymphocytes, B-lymphocytes, their functional properties, the complement system and other factors of humoral immunity, as well as the production of a number of cytokines are described. Data on immune disorders in post-COVID syndrome and during the convalescence period are presented in detail. Since COVID-19 is an infection that has a significant impact on the hematopoietic system and hemostasis, special attention is paid to the category of subjects with an increased risk of severe complications. Among the latter are elderly patients, persons suffering from diabetes mellitus, oncological and oncohematological patients, in particular, with hematopoietic and lymphoid tissue neoplasia, such as chronic lymphocytic leukemia, lymphoma, multiple myeloma. The review pays special attention to the peculiarities of the course of COVID-19 and the response of the immune system to vaccination in patients with oncohematological diseases. Deciphering the significance of individual links of cellular and humoral immunity in patients who have undergone COVID-19 is an important issue in creating effective vaccines and improving therapeutic methods.
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Affiliation(s)
| | - E. R. Shilova
- Russian Research institute of hematology and transfusiology
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19
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Minto T, Abdelrahman T, Jones L, Wheat J, Key T, Shivakumar N, Ansell J, Seddon O, Cronin A, Tomkinson A, Theron A, Trickett RW, Sagua N, Sultana S, Clark A, McKay E, Johnson A, Behera K, Towler J, Kynaston H, Cardiff and Vale COVID-19 Research Collaborative MohamedABlackshawGThomasRJonesSShinkwinMPerryHEdgbeareDChopraSDaSilvaLWilliamsIContractorUBellSZaherSStechmanMBerrySClarkHBoisEVon OppellCAckermanLAblorsuEHorwoodJMehtaDFeatherstoneJFolaranmiEBrayMSiddallKKingEPhillipsMMorganJChopraIEvansDWhitehouseKLeachPThomasCDaviesEDyerMFoxAIrelandEMeehanEMukitANewellKParryDPophamBChapmanCBotrosH. Safety of maintaining elective and emergency surgery during the COVID-19 pandemic with the introduction of a Protected Elective Surgical Unit (PESU): A cross-specialty evaluation of 30-day outcomes in 9,925 patients undergoing surgery in a University Health Board. Surg Open Sci 2022; 10:168-173. [PMID: 36211629 PMCID: PMC9531361 DOI: 10.1016/j.sopen.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/29/2022] [Accepted: 09/12/2022] [Indexed: 11/06/2022] Open
Abstract
Background The COVID-19 pandemic has caused unprecedented health care challenges mandating surgical service reconfiguration. Within our hospital, emergency and elective streams were separated and self-contained Protected Elective Surgical Units were developed to mitigate against infection-related morbidity. Aims of this study were to determine the risk of COVID-19 transmission and mortality and whether the development of Protected Elective Surgical Units can result in significant reduction in risk. Methods A retrospective observational study of consecutive patients from 18 specialties undergoing elective or emergency surgery under general, spinal, or epidural anaesthetic over a 12-month study period was undertaken. Primary outcome measures were 30-day postoperative COVID-19 transmission rate and mortality. Secondary adjusted analyses were performed to ascertain hospital and Protected Elective Surgical Unit transmission rates. Results Between 15 March 2020 and 14 March 2021, 9,925 patients underwent surgery: 6,464 (65.1%) elective, 5,116 (51.5%) female, and median age 57 (39–70). A total of 69.5% of all procedures were performed in Protected Elective Surgical Units. Overall, 30-day postoperative COVID-19 transmission was 2.8% (3.4% emergency vs 1.2% elective P < .001). Protected Elective Surgical Unit postoperative transmission was significantly lower than non–Protected Elective Surgical Unit (0.42% vs 3.2% P < .001), with an adjusted likely in-hospital Protected Elective Surgical Unit transmission of 0.04%. The 30-day all-cause mortality was 1.7% and was 14.6% in COVID-19–positive patients. COVID-19 infection, age > 70, male sex, American Society of Anesthesiologists grade > 2, and emergency surgery were all independently associated with mortality. Conclusion This study has demonstrated that Protected Elective Surgical Units can facilitate high-volume elective surgical services throughout peaks of the COVID-19 pandemic while minimising viral transmission and mortality. However, mortality risk associated with perioperative COVID-19 infection remains high.
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Affiliation(s)
- T Minto
- University Hospital of Wales, Heath Park, Cardiff, United Kingdom CF14 4XW
| | - T Abdelrahman
- University Hospital of Wales, Heath Park, Cardiff, United Kingdom CF14 4XW
| | - L Jones
- University Hospital of Wales, Heath Park, Cardiff, United Kingdom CF14 4XW
| | - J Wheat
- University Hospital of Wales, Heath Park, Cardiff, United Kingdom CF14 4XW
| | - T Key
- University Hospital of Wales, Heath Park, Cardiff, United Kingdom CF14 4XW
| | - N Shivakumar
- University Hospital of Wales, Heath Park, Cardiff, United Kingdom CF14 4XW
| | - J Ansell
- University Hospital of Wales, Heath Park, Cardiff, United Kingdom CF14 4XW
| | - O Seddon
- University Hospital of Wales, Heath Park, Cardiff, United Kingdom CF14 4XW
| | - A Cronin
- University Hospital of Wales, Heath Park, Cardiff, United Kingdom CF14 4XW
| | - A Tomkinson
- University Hospital of Wales, Heath Park, Cardiff, United Kingdom CF14 4XW
| | - A Theron
- University Hospital of Wales, Heath Park, Cardiff, United Kingdom CF14 4XW
| | - RW Trickett
- University Hospital of Wales, Heath Park, Cardiff, United Kingdom CF14 4XW
| | - N Sagua
- School of Medicine, Cardiff University, University Hospital of Wales Main Bldg, Heath Park, Cardiff, United Kingdom CF14 4XN
| | - S Sultana
- School of Medicine, Cardiff University, University Hospital of Wales Main Bldg, Heath Park, Cardiff, United Kingdom CF14 4XN
| | - A Clark
- School of Medicine, Cardiff University, University Hospital of Wales Main Bldg, Heath Park, Cardiff, United Kingdom CF14 4XN
| | - E McKay
- School of Medicine, Cardiff University, University Hospital of Wales Main Bldg, Heath Park, Cardiff, United Kingdom CF14 4XN
| | - A Johnson
- School of Medicine, Cardiff University, University Hospital of Wales Main Bldg, Heath Park, Cardiff, United Kingdom CF14 4XN
| | - Karishma Behera
- School of Medicine, Cardiff University, University Hospital of Wales Main Bldg, Heath Park, Cardiff, United Kingdom CF14 4XN
| | - J Towler
- School of Medicine, Cardiff University, University Hospital of Wales Main Bldg, Heath Park, Cardiff, United Kingdom CF14 4XN
| | - H Kynaston
- University Hospital of Wales, Heath Park, Cardiff, United Kingdom CF14 4XW,School of Medicine, Cardiff University, University Hospital of Wales Main Bldg, Heath Park, Cardiff, United Kingdom CF14 4XN,Corresponding author at: School of Medicine, Cardiff University, Cardiff, United Kingdom CF14 4XN.
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20
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Freeman V, Hughes S, Carle C, Campbell D, Egger S, Hui H, Yap S, Deandrea S, Caruana M, Onyeka TC, IJzerman MJ, Ginsburg O, Bray F, Sullivan R, Aggarwal A, Peacock SJ, Chan KKW, Hanna TP, Soerjomataram I, O'Connell DL, Steinberg J, Canfell K. Are patients with cancer at higher risk of COVID-19-related death? A systematic review and critical appraisal of the early evidence. J Cancer Policy 2022; 33:100340. [PMID: 35680113 PMCID: PMC9169424 DOI: 10.1016/j.jcpo.2022.100340] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/31/2022] [Accepted: 06/01/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Early reports suggested that COVID-19 patients with cancer were at higher risk of COVID-19-related death. We conducted a systematic review with risk of bias assessment and synthesis of the early evidence on the risk of COVID-19-related death for COVID-19 patients with and without cancer. METHODS AND FINDINGS We searched Medline/Embase/BioRxiv/MedRxiv/SSRN databases to 1 July 2020. We included cohort or case-control studies published in English that reported on the risk of dying after developing COVID-19 for people with a pre-existing diagnosis of any cancer, lung cancer, or haematological cancers. We assessed risk of bias using tools adapted from the Newcastle-Ottawa Scale. We used the generic inverse-variance random-effects method for meta-analysis. Pooled odds ratios (ORs) and hazard ratios (HRs) were calculated separately. Of 96 included studies, 54 had sufficient non-overlapping data to be included in meta-analyses (>500,000 people with COVID-19, >8000 with cancer; 52 studies of any cancer, three of lung and six of haematological cancers). All studies had high risk of bias. Accounting for at least age consistently led to lower estimated ORs and HRs for COVID-19-related death in cancer patients (e.g. any cancer versus no cancer; six studies, unadjusted OR=3.30,95%CI:2.59-4.20, adjusted OR=1.37,95%CI:1.16-1.61). Adjusted effect estimates were not reported for people with lung or haematological cancers. Of 18 studies that adjusted for at least age, 17 reported positive associations between pre-existing cancer diagnosis and COVID-19-related death (e.g. any cancer versus no cancer; nine studies, adjusted OR=1.66,95%CI:1.33-2.08; five studies, adjusted HR=1.19,95%CI:1.02-1.38). CONCLUSIONS The initial evidence (published to 1 July 2020) on COVID-19-related death in people with cancer is characterised by multiple sources of bias and substantial overlap between data included in different studies. Pooled analyses of non-overlapping early data with adjustment for at least age indicated a significantly increased risk of COVID-19-related death for those with a pre-existing cancer diagnosis.
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Affiliation(s)
- Victoria Freeman
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Australia
| | - Suzanne Hughes
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Australia
| | - Chelsea Carle
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Australia
| | - Denise Campbell
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Australia
| | - Sam Egger
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Australia
| | - Harriet Hui
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Australia
| | - Sarsha Yap
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Australia
| | - Silvia Deandrea
- Directorate General for Health, Lombardy Region, Milano, Italy; Environmental Health Unit, Agency for Health Protection, Pavia, Italy
| | - Michael Caruana
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Australia
| | - Tonia C Onyeka
- Department of Anaesthesia/Pain & Palliative Care Unit, Multidisciplinary Oncology Centre, College of Medicine, University of Nigeria, Nigeria
| | - Maarten J IJzerman
- University of Melbourne, Centre for Cancer Research and Centre for Health Policy, Australia; Department of Cancer Research, Peter MacCallum Cancer Centre, Parkville, VIC, Australia
| | - Ophira Ginsburg
- Perlmutter Cancer Center and the Department of Population Health, NYU Grossman School of Medicine, New York, United States
| | - Freddie Bray
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Richard Sullivan
- King's Institute Cancer Policy, King's College London, United Kingdom
| | - Ajay Aggarwal
- King's Institute Cancer Policy, King's College London, United Kingdom; Department of Oncology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Stuart J Peacock
- Canadian Centre for Applied Research in Cancer Control (ARCC), Canada; Cancer Control Research, BC Cancer, Canada; Faculty of Health Sciences, Simon Fraser University, Canada
| | - Kelvin K W Chan
- Canadian Centre for Applied Research in Cancer Control (ARCC), Canada; Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Canada
| | - Timothy P Hanna
- Division of Cancer Care and Epidemiology, Cancer Research Institute at Queen's University, Kingston, ON, Canada; Department of Oncology and Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
| | | | - Dianne L O'Connell
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Australia
| | - Julia Steinberg
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Australia.
| | - Karen Canfell
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Australia.
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21
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Zheng X, Ding S, Wu M, Sun C, Wu Y, Wang S, Du Y, Yang L, Xue L, Wang B, Wang C, Cui W, Xie Y. Dynamic monitoring revealed a slightly prolonged waiting time for total gastrectomy during the COVID-19 pandemic without increasing the short-term complications. Front Oncol 2022; 12:944602. [PMID: 36119493 PMCID: PMC9471957 DOI: 10.3389/fonc.2022.944602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/17/2022] [Indexed: 01/08/2023] Open
Abstract
We aimed to determine the pattern of delay and its effect on the short-term outcomes of total gastrectomy before and during the coronavirus disease 2019 (COVID-19) pandemic. Overlaid line graphs were used to visualize the dynamic changes in the severity of the pandemic, number of gastric cancer patients, and waiting time for a total gastrectomy. We observed a slightly longer waiting time during the pandemic (median: 28.00 days, interquartile range: 22.00–34.75) than before the pandemic (median: 25.00 days, interquartile range: 18.00–34.00; p = 0.0071). Moreover, we study the effect of delayed surgery (waiting time > 30 days) on short-term outcomes using postoperative complications, extreme value of laboratory results, and postoperative stay. In patients who had longer waiting times, we did not observe worse short-term complication rates (grade II–IV: 15% vs. 19%, p = 0.27; grade III–IV: 7.3% vs. 9.2%, p = 0.51, the short waiting group vs. the prolonged waiting group) or a higher risk of a longer POD (univariable: OR 1.09, 95% CI 0.80–1.49, p = 0.59; multivariable: OR 1.10, 95% CI 0.78–1.55, p = 0.59). Patients in the short waiting group, rather than in the delayed surgery group, had an increased risk of bleeding in analyses of laboratory results (plasma prothrombin activity, hemoglobin, and hematocrit). A slightly prolonged preoperative waiting time during COVID-19 pandemic might not influence the short-term outcomes of patients who underwent total gastrectomy.
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Affiliation(s)
- Xiaohao Zheng
- Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shikang Ding
- Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ming Wu
- Department of Gastrointestinal Surgery, Yun Cheng Center Hospital, Yuncheng, China
| | - Chunyang Sun
- Department of General Surgery, The Central Hospital of Jia Mu Si City, Jiamusi, China
| | - Yunzi Wu
- Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shenghui Wang
- Department of General Surgery, Civil Aviation General Hospital, Beijing, China
| | - Yongxing Du
- Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lin Yang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Liyan Xue
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bingzhi Wang
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chengfeng Wang
- Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- State Key Lab of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- *Correspondence: Chengfeng Wang, ; Wei Cui, ; Yibin Xie,
| | - Wei Cui
- State Key Lab of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Clinical Laboratory, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- *Correspondence: Chengfeng Wang, ; Wei Cui, ; Yibin Xie,
| | - Yibin Xie
- Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Hebei Cancer Hospital, Chinese Academy of Medical Sciences, Langfang, China
- *Correspondence: Chengfeng Wang, ; Wei Cui, ; Yibin Xie,
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22
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Crossley JR, Nelson LL, VanDolah H, Davidson BJ, Maxwell JH. The impact of COVID-19 on presentation and diagnosis of head and neck squamous cell carcinoma. Laryngoscope Investig Otolaryngol 2022; 7:LIO2893. [PMID: 36249089 PMCID: PMC9538849 DOI: 10.1002/lio2.893] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 07/19/2022] [Accepted: 07/24/2022] [Indexed: 11/15/2022] Open
Abstract
Objective To analyze how the COVID-19 pandemic has influenced trends in head and neck squamous cell carcinoma (HNSCC) presentation and diagnosis-including referral patterns, stage at presentation, and time to diagnosis-over a longitudinal time course. Setting Multicenter tertiary care academic institution. Methods A retrospective review of patients with HNSCC presenting between January 1, 2019 and December 31, 2020 was performed. Patients were stratified into pre-COVID and COVID cohorts based upon presentation date either before or after the COVID pandemic was declared a national emergency. Data was collected on demographics, referral site, symptoms, tumor characteristics, and time to diagnosis. Results Of 203 patients with HNSCC identified, 77.3% (157/203) were in the pre-COVID cohort and 22.7% (46/203) were in the COVID cohort. Patients in the COVID cohort were more likely to present through inpatient or ER consultation (26% vs. 11%) than outpatient setting. There was a greater than 50% decrease in new tumor board case presentations per month in the COVID cohort (4.8) relative to the pre-COVID (10.9) cohort. Cancer stage at presentation was similar between cohorts. Time from presentation to diagnosis was similar between the cohorts at approximately 30 days. Conclusions These results suggest that patients presenting during the COVID pandemic may have unique referral patterns. A significant decrease in tumor board presentations was noted, which may contribute to more delayed presentations that have yet to be observed. Further investigation with a larger sample size is warranted. Lay Summary The COVID-19 pandemic may have changed where and how patients with head and neck cancer initially seek care. We found that patients with newly diagnosed head and neck cancer more often were initially seen in urgent settings than before the pandemic. Level of Evidence 3.
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Affiliation(s)
- Jason R. Crossley
- Department of Otolaryngology–Head and Neck SurgeryMedStar Georgetown University HospitalWashingtonDistrict of ColumbiaUSA
| | - Lacey L. Nelson
- Department of Otolaryngology–Head and Neck SurgeryStanford University School of MedicineStanfordCaliforniaUSA
| | - Hunter VanDolah
- School of MedicineGeorgetown UniversityWashingtonDistrict of ColumbiaUSA
| | - Bruce J. Davidson
- Department of Otolaryngology–Head and Neck SurgeryMedStar Georgetown University HospitalWashingtonDistrict of ColumbiaUSA
| | - Jessica H. Maxwell
- Department of Otolaryngology–Head and Neck SurgeryMedStar Georgetown University HospitalWashingtonDistrict of ColumbiaUSA
- Department of SurgeryWashington DC Veterans Affairs Medical CenterWashingtonDistrict of ColumbiaUSA
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Sirkis T, Jones B, Bowden J. Should RECOVERY have used response adaptive randomisation? Evidence from a simulation study. BMC Med Res Methodol 2022; 22:216. [PMID: 35933340 PMCID: PMC9356442 DOI: 10.1186/s12874-022-01691-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 07/18/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The Randomised Evaluation of COVID-19 Therapy (RECOVERY) trial is aimed at addressing the urgent need to find effective treatments for patients hospitalised with suspected or confirmed COVID-19. The trial has had many successes, including discovering that dexamethasone is effective at reducing COVID-19 mortality, the first treatment to reach this milestone in a randomised controlled trial. Despite this, it continues to use standard or 'fixed' randomisation to allocate patients to treatments. We assessed the impact of implementing response adaptive randomisation within RECOVERY using an array of performance measures, to learn if it could be beneficial going forward. This design feature has recently been implemented within the REMAP-CAP platform trial. METHODS Trial data was simulated to closely match the data for patients allocated to standard care, dexamethasone, hydroxychloroquine, or lopinavir-ritonavir in the RECOVERY trial from March-June 2020, representing four out of five arms tested throughout this period. Trials were simulated in both a two-arm trial setting using standard care and dexamethasone, and a four-arm trial setting utilising all above treatments. Two forms of fixed randomisation and two forms of response-adaptive randomisation were tested. In the two-arm setting, response-adaptive randomisation was implemented across both trial arms, whereas in the four-arm setting it was implemented in the three non-standard care arms only. In the two-arm trial, randomisation strategies were performed at the whole trial level as well as within three pre-specified patient subgroups defined by patients' respiratory support level. RESULTS All response-adaptive randomisation strategies led to more patients being given dexamethasone and a lower mortality rate in the trial. Subgroup specific response-adaptive randomisation reduced mortality rates even further. In the two-arm trial, response-adaptive randomisation reduced statistical power compared to FR, with subgroup level adaptive randomisation exhibiting the largest power reduction. In the four-arm trial, response-adaptive randomisation increased statistical power in the dexamethasone arm but reduced statistical power in the lopinavir arm. Response-adaptive randomisation did not induce any meaningful bias in treatment effect estimates nor did it cause any inflation in the type 1 error rate. CONCLUSIONS Using response-adaptive randomisation within RECOVERY could have increased the number of patients receiving the optimal COVID-19 treatment during the trial, while reducing the number of patients needed to attain the same study power as the original study. This would likely have reduced patient deaths during the trial and lead to dexamethasone being declared effective sooner. Deciding how to balance the needs of patients within a trial and future patients who have yet to fall ill is an important ethical question for the trials community to address. Response-adaptive randomisation deserves to be considered as a design feature in future trials of COVID-19 and other diseases.
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Affiliation(s)
- Tamir Sirkis
- University of Exeter College of Medicine and Health, Exeter, UK
| | - Benjamin Jones
- NIHR ARC South West Peninsula (PenARC), College of Medicine and Health, University of Exeter, Exeter, England
| | - Jack Bowden
- University of Exeter College of Medicine and Health, Exeter, UK
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24
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Zhang X, Sasmal S, Yu M, Bernardo B, Adeyanju T, Paskett ED. The Association of Socioeconomic Status, the Concern for Catching Covid-19, and Anxiety Between Individuals with and without a Cancer History from a Cross-sectional Study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.07.26.22278080. [PMID: 35923318 PMCID: PMC9347286 DOI: 10.1101/2022.07.26.22278080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background COVID-19 has negative impacts on mental health in all populations. Individuals with a history of cancer have an increased risk of catching and having more severe symptoms of COVID-19 than the general public. The objective of this study was to examine how cancer history and concern for catching COVID-19 relate to anxiety. Methods This cross-sectional study is part of the "Impact of COVID-19 on Behaviors across the Cancer Control Continuum in Ohio" project conducted from June to November 2020. The sample consisted of 7012 participants who completed survey online, by phone, or by mail. Self-reported concern for catching COVID-19 and anxiety over the last 7 days were used. Linear and logistic regression models were performed to determine the association between demographics, cancer history, concern for catching COVID-19, and anxiety. Results In our study sample, most participants rated their concern for catching COVID-19 as moderately high or high (56%) and reported anxiety for one day or more (63%). Individuals with a cancer history were more likely to report moderate-high or high concern for catching COVID-19 (59% vs.54%, P<0.001) but less likely to report anxiety (58% vs. 67%, P<0.001) compared to those without a cancer history. Individuals with higher SES were less likely to report anxiety (middle vs. low SES: OR=0.68, 95%CI=0.59-0.79; high vs. low SES: OR=0.70, 95%CI=0.61-0.82). Additionally, increased concern for catching COVID-19 was associated with higher likelihood of reporting anxiety (moderate-low vs. low: OR=1.65, 95%CI=1.42-1.92; moderate-high vs. low: OR=2.98, 95%CI=2.53-3.50; high vs. low: OR=4.35, 95%CI=3.74-5.07). Conclusions Our findings suggest individuals with a cancer history reported higher concern for catching COVID-19. Higher concern for catching COVID was associated with anxiety. These findings indicate that healthcare providers should pay special attention to the different populations to reduce concerns for catching COVID-19 and provide strategies to improve mental health during a pandemic outbreak. Funding This study was supported by a supplement to The Ohio State University Comprehensive Cancer Center (OSUCCC) core support grant ( P30 CA016058), and the OSUCCC The Recruitment, Intervention and Survey Shared Resource (RISSR)(P30 CA016058).The Ohio State University Center for Clinical and Translational Science grant support (National Center for Advancing Translational Sciences, Grant UL1TR001070) in publications relating to this project. This work was supported by the National Cancer Institute (F99CA253745 to X.Z.).
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Affiliation(s)
- Xiaochen Zhang
- Comprehensive Cancer Center, The Ohio State University
- College of Public Health, The Ohio State University
| | | | - Mengda Yu
- Center for Biostatistics, The Ohio State University
| | | | | | - Electra D. Paskett
- Comprehensive Cancer Center, The Ohio State University
- College of Public Health, The Ohio State University
- College of Medicine, The Ohio State University
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Kondili LA, Buti M, Riveiro-Barciela M, Maticic M, Negro F, Berg T, Craxì A. Impact of the COVID-19 pandemic on hepatitis B and C elimination: an EASL survey. JHEP Rep 2022; 4:100531. [PMID: 35967191 PMCID: PMC9364666 DOI: 10.1016/j.jhepr.2022.100531] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 06/08/2022] [Accepted: 06/11/2022] [Indexed: 02/09/2023] Open
Abstract
Background & Aims The World Health Organization (WHO) HBV and HCV elimination targets, set in 2016 and based on projections to 2030, were unable to consider the impact of intervening factors. To evaluate the impact of the COVID-19 pandemic on viral hepatitis elimination programs, the European Association for the Study of the Liver (EASL) conducted a survey in liver centers worldwide in 2021. Methods A web-based questionnaire was distributed (May-July 2021) to all EASL members representing clinical units providing HBV and HCV hepatitis care. Results are expressed as absolute numbers and reduction rates for each care activity. Results Data were collected from 32 European and 12 non-European clinical centers. Between January 2019 (pre-pandemic) and December 2020 (during the pandemic), chronic HBV consultations decreased by 32% and 26%, new referrals by 38% and 39%, HBV testing rates by 39% and 21% (for HBsAg detection) and 30% and 22% (for HBV DNA detection), and new HBV treatments by 20% and 44% (p = 0.328) in European and non-European centers, respectively. With regard to HCV during the same time frame, the overall reductions were 39% and 50% for consultations, 49% and 49% for new referrals, 11% and 38% for HCV RNA detection, and 51% and 54% for new HCV antiviral treatments for European and non-European Centers, respectively (p = 0.071). Conclusions All steps in the viral hepatitis care cascade have been hampered by the COVID-19 pandemic, with a comparable impact across different centers. These data reaffirm the pandemic’s major effect on global viral hepatitis elimination programs and suggest that actions to achieve the WHO 2030 targets should be reconsidered and revised to account for each country's progress relative to pre-pandemic values. Lay summary The EASL multinational survey conclusively shows that viral hepatitis elimination programs, expected to provide control of hepatitis B and hepatitis C worldwide by 2030, have been held back by the COVID-19 pandemic in clinical centers from several European and non-European countries, with a comparable impact across centers. Limitations in the cascade of care for both HBV and HCV were linked to limited access to screening, consultations, specific testing, and actual treatment. As restrictions for COVID-19 begin to lift, efforts to diagnose and provide treatment for viral hepatitis should remain high on the list of priorities for public health officials to maintain the WHO elimination efforts. Measures that have been put in place to control the COVID-19 pandemic could be transferred to increasing the diagnosis and linkage to care of people with hepatitis.
Viral hepatitis elimination programs have been hampered by the COVID-19 pandemic. A survey performed in several clinical centers shows the impact of COVID-19 on all steps of the viral hepatitis care cascade. Measures used to control COVID-19 could be used to increase the diagnosis and linkage to care of people living with hepatitis B and C.
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Lee-Ying R, O'Sullivan DE, Gagnon R, Bosma N, Stewart RN, Railton C, Tilley D, Alimohamed N, Basappa N, Cheng T, Kolinsky M, Karim S, Ruether D, North S, Yip S, Danielson B, Heng D, Brenner D. Stage migration of testicular germ cell tumours in Alberta, Canada, during the COVID-19 pandemic: a retrospective cohort study. CMAJ Open 2022; 10:E633-E642. [PMID: 35790231 PMCID: PMC9262347 DOI: 10.9778/cmajo.20210285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND An absence of screening recommendations and the rapid progression of testicular germ cell tumours (TGCTs) offer a perspective on the potential impact of the COVID-19 pandemic on cancer presentations. We evaluated the presenting cancer stages of TGCTs in a real-world population before and during the pandemic to assess stage migration. METHODS We performed a retrospective review of all new patients with TGCT diagnoses in Alberta, Canada, from Dec. 31, 2018, to Apr. 30, 2021, using the Alberta Cancer Registry. Because potential changes in staging should not occur instantaneously, we used a 6-month lag time from Apr. 1, 2020, for seminomas, and a 3-month lag time for nonseminomas, to compare initial cancer stages at presentation before and during the pandemic. We evaluated monthly rates of presentation by stage and histology. Exploratory outcomes included the largest tumour dimension, tumour markers and, for advanced disease, risk category and treatment setting. RESULTS Of 335 patients with TGCTs, 231 were diagnosed before the pandemic and 104 during the pandemic (using a lag time). In total, 18 (7.8%) patients diagnosed before the pandemic presented with stage III disease, compared to 16 (15.4%) diagnosed during the pandemic (relative risk 1.97, 95% confidence interval [CI] 1.05-3.72). We observed no significant differences for secondary outcomes. Without a lag time, the rate ratio for a stage II presentation decreased significantly during the pandemic (0.40, 95% CI 0.21-0.72). INTERPRETATION We observed signs of TGCT stage migration during the COVID-19 pandemic, driven by a decline in stage II disease and a potential rise in stage III disease. Management of TGCTs should remain a priority, even during a global pandemic.
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Affiliation(s)
- Richard Lee-Ying
- Department of Oncology (Lee-Ying, O'Sullivan, Gagnon, Stewart, Railton, Tilley, Alimohamed, Cheng, Karim, Ruether, Yip, Heng, Brenner), University of Calgary, Tom Baker Cancer Centre, Calgary, Alta.; BC Cancer Agency-Victoria (Bosma), Victoria, BC; Department of Oncology (Basappa, Kolinsky, North, Danielson), University of Alberta, Cross Cancer Institute, Edmonton, Alta
| | - Dylan E O'Sullivan
- Department of Oncology (Lee-Ying, O'Sullivan, Gagnon, Stewart, Railton, Tilley, Alimohamed, Cheng, Karim, Ruether, Yip, Heng, Brenner), University of Calgary, Tom Baker Cancer Centre, Calgary, Alta.; BC Cancer Agency-Victoria (Bosma), Victoria, BC; Department of Oncology (Basappa, Kolinsky, North, Danielson), University of Alberta, Cross Cancer Institute, Edmonton, Alta
| | - Richard Gagnon
- Department of Oncology (Lee-Ying, O'Sullivan, Gagnon, Stewart, Railton, Tilley, Alimohamed, Cheng, Karim, Ruether, Yip, Heng, Brenner), University of Calgary, Tom Baker Cancer Centre, Calgary, Alta.; BC Cancer Agency-Victoria (Bosma), Victoria, BC; Department of Oncology (Basappa, Kolinsky, North, Danielson), University of Alberta, Cross Cancer Institute, Edmonton, Alta.
| | - Nicholas Bosma
- Department of Oncology (Lee-Ying, O'Sullivan, Gagnon, Stewart, Railton, Tilley, Alimohamed, Cheng, Karim, Ruether, Yip, Heng, Brenner), University of Calgary, Tom Baker Cancer Centre, Calgary, Alta.; BC Cancer Agency-Victoria (Bosma), Victoria, BC; Department of Oncology (Basappa, Kolinsky, North, Danielson), University of Alberta, Cross Cancer Institute, Edmonton, Alta
| | - Rebecca N Stewart
- Department of Oncology (Lee-Ying, O'Sullivan, Gagnon, Stewart, Railton, Tilley, Alimohamed, Cheng, Karim, Ruether, Yip, Heng, Brenner), University of Calgary, Tom Baker Cancer Centre, Calgary, Alta.; BC Cancer Agency-Victoria (Bosma), Victoria, BC; Department of Oncology (Basappa, Kolinsky, North, Danielson), University of Alberta, Cross Cancer Institute, Edmonton, Alta
| | - Cindy Railton
- Department of Oncology (Lee-Ying, O'Sullivan, Gagnon, Stewart, Railton, Tilley, Alimohamed, Cheng, Karim, Ruether, Yip, Heng, Brenner), University of Calgary, Tom Baker Cancer Centre, Calgary, Alta.; BC Cancer Agency-Victoria (Bosma), Victoria, BC; Department of Oncology (Basappa, Kolinsky, North, Danielson), University of Alberta, Cross Cancer Institute, Edmonton, Alta
| | - Derek Tilley
- Department of Oncology (Lee-Ying, O'Sullivan, Gagnon, Stewart, Railton, Tilley, Alimohamed, Cheng, Karim, Ruether, Yip, Heng, Brenner), University of Calgary, Tom Baker Cancer Centre, Calgary, Alta.; BC Cancer Agency-Victoria (Bosma), Victoria, BC; Department of Oncology (Basappa, Kolinsky, North, Danielson), University of Alberta, Cross Cancer Institute, Edmonton, Alta
| | - Nimira Alimohamed
- Department of Oncology (Lee-Ying, O'Sullivan, Gagnon, Stewart, Railton, Tilley, Alimohamed, Cheng, Karim, Ruether, Yip, Heng, Brenner), University of Calgary, Tom Baker Cancer Centre, Calgary, Alta.; BC Cancer Agency-Victoria (Bosma), Victoria, BC; Department of Oncology (Basappa, Kolinsky, North, Danielson), University of Alberta, Cross Cancer Institute, Edmonton, Alta
| | - Naveen Basappa
- Department of Oncology (Lee-Ying, O'Sullivan, Gagnon, Stewart, Railton, Tilley, Alimohamed, Cheng, Karim, Ruether, Yip, Heng, Brenner), University of Calgary, Tom Baker Cancer Centre, Calgary, Alta.; BC Cancer Agency-Victoria (Bosma), Victoria, BC; Department of Oncology (Basappa, Kolinsky, North, Danielson), University of Alberta, Cross Cancer Institute, Edmonton, Alta
| | - Tina Cheng
- Department of Oncology (Lee-Ying, O'Sullivan, Gagnon, Stewart, Railton, Tilley, Alimohamed, Cheng, Karim, Ruether, Yip, Heng, Brenner), University of Calgary, Tom Baker Cancer Centre, Calgary, Alta.; BC Cancer Agency-Victoria (Bosma), Victoria, BC; Department of Oncology (Basappa, Kolinsky, North, Danielson), University of Alberta, Cross Cancer Institute, Edmonton, Alta
| | - Michael Kolinsky
- Department of Oncology (Lee-Ying, O'Sullivan, Gagnon, Stewart, Railton, Tilley, Alimohamed, Cheng, Karim, Ruether, Yip, Heng, Brenner), University of Calgary, Tom Baker Cancer Centre, Calgary, Alta.; BC Cancer Agency-Victoria (Bosma), Victoria, BC; Department of Oncology (Basappa, Kolinsky, North, Danielson), University of Alberta, Cross Cancer Institute, Edmonton, Alta
| | - Safiya Karim
- Department of Oncology (Lee-Ying, O'Sullivan, Gagnon, Stewart, Railton, Tilley, Alimohamed, Cheng, Karim, Ruether, Yip, Heng, Brenner), University of Calgary, Tom Baker Cancer Centre, Calgary, Alta.; BC Cancer Agency-Victoria (Bosma), Victoria, BC; Department of Oncology (Basappa, Kolinsky, North, Danielson), University of Alberta, Cross Cancer Institute, Edmonton, Alta
| | - Dean Ruether
- Department of Oncology (Lee-Ying, O'Sullivan, Gagnon, Stewart, Railton, Tilley, Alimohamed, Cheng, Karim, Ruether, Yip, Heng, Brenner), University of Calgary, Tom Baker Cancer Centre, Calgary, Alta.; BC Cancer Agency-Victoria (Bosma), Victoria, BC; Department of Oncology (Basappa, Kolinsky, North, Danielson), University of Alberta, Cross Cancer Institute, Edmonton, Alta
| | - Scott North
- Department of Oncology (Lee-Ying, O'Sullivan, Gagnon, Stewart, Railton, Tilley, Alimohamed, Cheng, Karim, Ruether, Yip, Heng, Brenner), University of Calgary, Tom Baker Cancer Centre, Calgary, Alta.; BC Cancer Agency-Victoria (Bosma), Victoria, BC; Department of Oncology (Basappa, Kolinsky, North, Danielson), University of Alberta, Cross Cancer Institute, Edmonton, Alta
| | - Steven Yip
- Department of Oncology (Lee-Ying, O'Sullivan, Gagnon, Stewart, Railton, Tilley, Alimohamed, Cheng, Karim, Ruether, Yip, Heng, Brenner), University of Calgary, Tom Baker Cancer Centre, Calgary, Alta.; BC Cancer Agency-Victoria (Bosma), Victoria, BC; Department of Oncology (Basappa, Kolinsky, North, Danielson), University of Alberta, Cross Cancer Institute, Edmonton, Alta
| | - Brita Danielson
- Department of Oncology (Lee-Ying, O'Sullivan, Gagnon, Stewart, Railton, Tilley, Alimohamed, Cheng, Karim, Ruether, Yip, Heng, Brenner), University of Calgary, Tom Baker Cancer Centre, Calgary, Alta.; BC Cancer Agency-Victoria (Bosma), Victoria, BC; Department of Oncology (Basappa, Kolinsky, North, Danielson), University of Alberta, Cross Cancer Institute, Edmonton, Alta
| | - Daniel Heng
- Department of Oncology (Lee-Ying, O'Sullivan, Gagnon, Stewart, Railton, Tilley, Alimohamed, Cheng, Karim, Ruether, Yip, Heng, Brenner), University of Calgary, Tom Baker Cancer Centre, Calgary, Alta.; BC Cancer Agency-Victoria (Bosma), Victoria, BC; Department of Oncology (Basappa, Kolinsky, North, Danielson), University of Alberta, Cross Cancer Institute, Edmonton, Alta
| | - Darren Brenner
- Department of Oncology (Lee-Ying, O'Sullivan, Gagnon, Stewart, Railton, Tilley, Alimohamed, Cheng, Karim, Ruether, Yip, Heng, Brenner), University of Calgary, Tom Baker Cancer Centre, Calgary, Alta.; BC Cancer Agency-Victoria (Bosma), Victoria, BC; Department of Oncology (Basappa, Kolinsky, North, Danielson), University of Alberta, Cross Cancer Institute, Edmonton, Alta
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Lomazzi M, Borisch B. Game changer in cancer treatment in Switzerland. J Cancer Policy 2022; 33:100343. [PMID: 35724957 DOI: 10.1016/j.jcpo.2022.100343] [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: 04/06/2022] [Accepted: 06/14/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND It is time for a game-changer in the cancer pathway in Switzerland and around the world. COVID-19 has made this more evident than ever. The prevalence, complexity, and cost of cancer care are increasing in Switzerland. Losses in efficiency, resources, and inappropriate attribution hinder health outcomes. This study examined opportunities for improvement across the cancer path, with a focus on patient-provider communication, effective policies and approaches to strengthen interprofessional collaboration. METHODS A qualitative study was undertaken. Key stakeholders, selected on the basis of their expertise in different areas of the cancer pathway, were assessed through interviews. The need to develop and implement innovative strategies to prevent and treat cancer was investigated, and key recommendations were identified for discussion with politicians and policy makers. Inductive content analysis was conducted. RESULTS There is a prominent need for collaboration and cross-sectoral action in cancer, encompassing clinical disciplines, communication strategies, and professional attitudes. The need and demand for collaboration responds to a highly fragmented cancer landscape in Switzerland, with a hierarchical organization of medical care entities and much competition. COVID-19 made these gaps more visible and highlighted the need to develop a new systematic approach and contingency plan to protect the most vulnerable. CONCLUSION Pressing developments are occurring in the health care system given the increasing prevalence of some cancers, the demographics of the Swiss population, the growing number of cancer survivors, and the consequences of the COVID-19 pandemic. POLICY SUMMARY More fundamental solutions and policies should be developed and implemented to meet patient needs and increase health outcomes: are providers and patients taking responsibility for change? Will business interests and the power play boycott policy development? Change must start now, with policymakers, patients, providers and insurers joining forces.
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Affiliation(s)
- M Lomazzi
- Institute of Global Health, University of Geneva, 1202 Geneva, Switzerland.
| | - B Borisch
- Institute of Global Health, University of Geneva, 1202 Geneva, Switzerland.
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Erdmann F, Spix C, Schrappe M, Borkhardt A, Schüz J. Temporal changes of the incidence of childhood cancer in Germany during the COVID-19 pandemic: Updated analyses from the German Childhood Cancer Registry. THE LANCET REGIONAL HEALTH. EUROPE 2022; 17:100398. [PMID: 35573974 PMCID: PMC9091810 DOI: 10.1016/j.lanepe.2022.100398] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Friederike Erdmann
- Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Obere Zahlbacher Straße 69, Mainz 55131, Germany
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer, World Health Organization (IARC/WHO), 150 cours Albert Thomas, Lyon 69372, France
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Achterstraße 30, Bremen 28359, Germany
| | - Claudia Spix
- Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Obere Zahlbacher Straße 69, Mainz 55131, Germany
| | - Martin Schrappe
- Department of Pediatrics and Adolescent Medicine, Christian-Albrechts-University and University Medical Center Schleswig-Holstein, Arnold-Heller Straße 3, Kiel 24105, Germany
| | - Arndt Borkhardt
- Department of Paediatric Oncology, Haematology and Clinical Immunology, Center for Child and Adolescent Health, Medical Faculty, Heinrich Heine University, Moorenstraße 5, Düsseldorf 40225, Germany
- German Cancer Consortium (DKTK), Partnering Site Essen/Düsseldorf, Germany
| | - Joachim Schüz
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer, World Health Organization (IARC/WHO), 150 cours Albert Thomas, Lyon 69372, France
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Abstract
Purpose for Review This perspective piece aims to understand the impacts of the COVID-19 pandemic on the field of oncology, exploring the factors provoking a fall in cancer diagnostic rates, interruption of cancer screening programmes, disruption of oncological treatment and adjuvant care, and the necessary adaption oncological practice has undergone (and will be required to undergo) post-pandemic, including the shift to digital consultations. Recent Findings During the COVID-19 pandemic, the field of oncological research has faced significant challenges. Yet, innovation has prevailed with new developments being made across the globe. Looking to the future of oncology, this piece will also suggest potential solutions to overcome the late-stage ramifications of the COVID-19 pandemic. Summary The COVID-19 pandemic has triggered a global health crisis, the ramifications of which have reached every corner of the world and overwhelmed already overburdened healthcare systems. However, we are still yet to see the full domino effect of the pandemic as it continues to reveal and exacerbate pre-existing weaknesses in healthcare systems across the world.
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Affiliation(s)
- Danielle Boniface
- School of Medicine, University of Adelaide, Adelaide, South Australia, Australia.
| | - Gonzalo Tapia-Rico
- School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
- Icon Cancer Centre Adelaide, Kurralta Park, South Australia, 5037, Australia
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Baird AM. Re-engaging EU citizens with national screening programmes and cancer diagnosis post-pandemic. Lancet Oncol 2022; 23:566-567. [PMID: 35489337 PMCID: PMC9045743 DOI: 10.1016/s1470-2045(22)00090-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/03/2022] [Accepted: 02/04/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Anne-Marie Baird
- School of Medicine, Trinity Translational Medicine Institute, Trinity College Dublin, The University of Dublin, Dublin, D08 W9RT, Ireland.
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Minamimoto R, Hotta M, Okafuji T, Tsutui S, Tsukuda M, Nakayama H, Shida Y, Tajima T. Change in cancer diagnosis during the COVID-19 pandemic: Trends estimated from FDG-PET/CT. Glob Health Med 2022; 4:108-115. [PMID: 35586769 PMCID: PMC9066465 DOI: 10.35772/ghm.2022.01016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 03/22/2022] [Accepted: 03/28/2022] [Indexed: 04/29/2023]
Abstract
The aim of this study is to clarify changes in the circumstances of cancer diagnoses during the COVID-19 pandemic in Tokyo, Japan, estimated from [18F]-2-fluoro-2-deoxy-D-glucose (FDG) -positron emission tomography/ computed tomography (PET/CT) for cancer patients. Cancer diagnosis in pandemic status (PANS) was evaluated by retrospective review of the findings of FDG-PET/CT examinations performed between 11 March 2020 and 28 December 2021 for initial staging and restaging for malignancy. Evaluation of cancer diagnosis in pre-pandemic status (pPANS) was conducted similarly in FDG-PET/CT examinations performed between 4 January 2018 and 10 March 2020. Of these, patients with malignant lymphoma (ML), lung cancer, esophageal cancer, and colorectal cancer who had a pathologically proven diagnosis or clinical diagnosis following therapy of the disease were selected for analysis. Initial cancer staging was determined by the diagnostic report of FDG-PET/CT. Change in cancer stage and in the number of FDG-PET/CT examinations performed was evaluated between pPANS and PANS, and according to term of the pandemic and vaccination status. The COVID-19 epidemic influenced the number of cancer patients who underwent FDG-PET/CT. There was a marked decrease in the number of cancer patients receiving FDG-PET/CT in Terms 1-3 (March 2020 to February 2021), but it recovered in Terms 4-6 (March 2021 to December 2021). There was no significant difference between PANS and pPANS in terms of the initial stage of cancer, but Stage IV ML and Stage II esophageal cancer were more frequent in PANS. Initial staging of ML, lung cancer, and esophageal cancer revealed more advanced cancer stages in Terms 4-6 compared with Terms 1-3. The number of patients receiving FDG-PET/CT in Tokyo was influenced by the COVID-19 epidemic. Staging based on FDG-PET/CT shifted to more advanced cancer stage during the pandemic compared with pre-pandemic.
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Affiliation(s)
- Ryogo Minamimoto
- Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
- Address correspondence to:Ryogo Minamimoto, Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjyuku-ku, Tokyo 162-8655, Japan. E-mail:
| | - Masatoshi Hotta
- Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
- Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takashi Okafuji
- Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Soichiro Tsutui
- Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masaaki Tsukuda
- Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hidetsugu Nakayama
- Department of Radiation Oncology, National Cancer Center for Global Health and Medicine, Tokyo, Japan
| | - Yoshitaka Shida
- Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tsuyoshi Tajima
- Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
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Ebner B, Volz Y, Mumm JN, Stief CG, Magistro G. The COVID-19 pandemic - what have urologists learned? Nat Rev Urol 2022; 19:344-356. [PMID: 35418709 PMCID: PMC9007269 DOI: 10.1038/s41585-022-00586-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2022] [Indexed: 12/18/2022]
Abstract
On 11 March 2020, the WHO declared the coronavirus disease 2019 (COVID-19) outbreak a pandemic and COVID-19 emerged as one of the biggest challenges in public health and economy in the twenty-first century. The respiratory tract has been the centre of attention, but COVID-19-associated complications affecting the genitourinary tract are reported frequently, raising concerns about possible long-term damage in these organs. The angiotensin-converting enzyme 2 (ACE2) receptor, which has a central role in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) invasion, is highly expressed in the genitourinary tract, indicating that these organs could be at a high risk of cell damage. The detection of SARS-CoV-2 in urine and semen is very rare; however, COVID-19 can manifest through urological symptoms and complications, including acute kidney injury (AKI), which is associated with poor survival, severe structural changes in testes and impairment of spermatogenesis, and hormonal imbalances (mostly secondary hypogonadism). The effect of altered total testosterone levels or androgen deprivation therapy on survival of patients with COVID-19 was intensively debated at the beginning of the pandemic; however, androgen inhibition did not show any effect in preventing or treating COVID-19 in a clinical study. Thus, urologists have a crucial role in detecting and managing damage of the genitourinary tract caused by COVID-19.
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Affiliation(s)
- Benedikt Ebner
- Department of Urology, Ludwig-Maximilians-University, Munich, Germany
| | - Yannic Volz
- Department of Urology, Ludwig-Maximilians-University, Munich, Germany
| | - Jan-Niclas Mumm
- Department of Urology, Ludwig-Maximilians-University, Munich, Germany
| | - Christian G Stief
- Department of Urology, Ludwig-Maximilians-University, Munich, Germany
| | - Giuseppe Magistro
- Department of Urology, Ludwig-Maximilians-University, Munich, Germany.
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Lopes A, Pastore CBP, Deckers P, Halla IKMW, Dias ALR, da Mata MVM, do Nascimento Martins A, Viu MM, Lopez RVM, Yamada AD. ASO Author Reflections: Oncological Surgery during the COVID-19 Pandemic: Effectiveness of Preoperative Screening and Factors Associated with Postoperative SARS-CoV-2 Infection. Ann Surg Oncol 2022; 29:2163-2164. [PMID: 34994888 PMCID: PMC8739371 DOI: 10.1245/s10434-021-11201-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 11/30/2021] [Indexed: 11/18/2022]
Affiliation(s)
- André Lopes
- Department of Gynecology, São Camilo Oncologia, Avenida Alcantara Machado 2576, Mooca, SP, 03102-006, Brazil. .,Nucleo de Pesquisa e Ensino da Rede São Camilo, São Paulo, Brazil.
| | - Caroline B P Pastore
- Department of Gynecology, São Camilo Oncologia, Avenida Alcantara Machado 2576, Mooca, SP, 03102-006, Brazil
| | - Paula Deckers
- Department of Gynecology, São Camilo Oncologia, Avenida Alcantara Machado 2576, Mooca, SP, 03102-006, Brazil
| | - Izabela K M W Halla
- Department of Gynecology, São Camilo Oncologia, Avenida Alcantara Machado 2576, Mooca, SP, 03102-006, Brazil
| | - Ana Luiza Rezende Dias
- Department of Gynecology, São Camilo Oncologia, Avenida Alcantara Machado 2576, Mooca, SP, 03102-006, Brazil
| | | | | | | | - Rossana Veronica Mendoza Lopez
- Faculdade de Medicina, Oncology Translational Research Center, Instituto do Cancer do Estado de Sao Paulo ICESP, Universidade de Sao Paulo, Butantã, SP, Brazil
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De Jaeghere EA, Kanervo H, Colman R, Schrauwen W, West P, Vandemaele N, De Pauw A, Jacobs C, Hilderson I, Saerens M, Sundahl N, Vandecasteele K, Naert E, Lapeire L, Kruse V, Rottey S, Lemmens G, Denys HG. Mental Health and Quality of Life among Patients with Cancer during the SARS-CoV-2 Pandemic: Results from the Longitudinal ONCOVID Survey Study. Cancers (Basel) 2022; 14:1093. [PMID: 35205838 PMCID: PMC8869927 DOI: 10.3390/cancers14041093] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 01/31/2022] [Accepted: 02/15/2022] [Indexed: 01/08/2023] Open
Abstract
PURPOSE This longitudinal survey study aimed to investigate the self-reported outcome measures of COVID-19 peritraumatic distress, depression, anxiety, stress, quality of life (QOL), and their associated factors in a cohort of cancer patients treated at a tertiary care hospital during the SARS-CoV-2 pandemic. METHODS Surveys were administered at four time points between 1 April 2020 and 18 September 2020. The surveys included the CPDI, DASS-21, and WHOQOL-BREF questionnaires. RESULTS Survey response rates were high (61.0% to 79.1%). Among the 355 participants, 71.3% were female, and the median age was 62.2 years (IQR, 53.9 to 69.1). The majority (78.6%) were treated with palliative intention. An important proportion of the participants reported symptoms of COVID-19 peritraumatic distress (34.2% to 39.6%), depression (27.6% to 33.5%), anxiety (24.9% to 32.7%), and stress (11.4% to 15.7%) at any time point during the study period. We did not find clinically meaningful mental health and QOL differences during the study period, with remarkably little change in between the pandemic's first and second wave. We found no consistent correlates of mental health or QOL scores, including cancer type, therapy intention, and sociodemographic information. CONCLUSION This cohort of cancer patients showed considerable resilience against mental health and QOL deterioration during the SARS-CoV-2 pandemic.
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Affiliation(s)
- Emiel A. De Jaeghere
- Medical Oncology Department, Ghent University Hospital, 9000 Ghent, Belgium; (H.K.); (A.D.P.); (C.J.); (I.H.); (M.S.); (E.N.); (L.L.); (S.R.); (H.G.D.)
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium; (N.S.); (K.V.); (V.K.)
| | - Heini Kanervo
- Medical Oncology Department, Ghent University Hospital, 9000 Ghent, Belgium; (H.K.); (A.D.P.); (C.J.); (I.H.); (M.S.); (E.N.); (L.L.); (S.R.); (H.G.D.)
| | - Roos Colman
- Biostatistics Unit, Faculty of Medicine and Life Sciences, Ghent University, 9000 Ghent, Belgium;
| | - Wim Schrauwen
- Medical Psychology Department, Ghent University Hospital, 9000 Ghent, Belgium;
| | - Paulien West
- Faculty of Medicine and Life Sciences, Ghent University, 9000 Ghent, Belgium; (P.W.); (N.V.)
| | - Nele Vandemaele
- Faculty of Medicine and Life Sciences, Ghent University, 9000 Ghent, Belgium; (P.W.); (N.V.)
| | - Aglaja De Pauw
- Medical Oncology Department, Ghent University Hospital, 9000 Ghent, Belgium; (H.K.); (A.D.P.); (C.J.); (I.H.); (M.S.); (E.N.); (L.L.); (S.R.); (H.G.D.)
| | - Celine Jacobs
- Medical Oncology Department, Ghent University Hospital, 9000 Ghent, Belgium; (H.K.); (A.D.P.); (C.J.); (I.H.); (M.S.); (E.N.); (L.L.); (S.R.); (H.G.D.)
| | - Ingeborg Hilderson
- Medical Oncology Department, Ghent University Hospital, 9000 Ghent, Belgium; (H.K.); (A.D.P.); (C.J.); (I.H.); (M.S.); (E.N.); (L.L.); (S.R.); (H.G.D.)
| | - Michael Saerens
- Medical Oncology Department, Ghent University Hospital, 9000 Ghent, Belgium; (H.K.); (A.D.P.); (C.J.); (I.H.); (M.S.); (E.N.); (L.L.); (S.R.); (H.G.D.)
| | - Nora Sundahl
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium; (N.S.); (K.V.); (V.K.)
- Radiotherapy Department, Ghent University Hospital, 9000 Ghent, Belgium
| | - Katrien Vandecasteele
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium; (N.S.); (K.V.); (V.K.)
- Radiotherapy Department, Ghent University Hospital, 9000 Ghent, Belgium
| | - Eline Naert
- Medical Oncology Department, Ghent University Hospital, 9000 Ghent, Belgium; (H.K.); (A.D.P.); (C.J.); (I.H.); (M.S.); (E.N.); (L.L.); (S.R.); (H.G.D.)
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium; (N.S.); (K.V.); (V.K.)
| | - Lore Lapeire
- Medical Oncology Department, Ghent University Hospital, 9000 Ghent, Belgium; (H.K.); (A.D.P.); (C.J.); (I.H.); (M.S.); (E.N.); (L.L.); (S.R.); (H.G.D.)
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium; (N.S.); (K.V.); (V.K.)
| | - Vibeke Kruse
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium; (N.S.); (K.V.); (V.K.)
- Medical Oncology Department, General Hospital Sint-Niklaas, 9100 Sint-Niklaas, Belgium
| | - Sylvie Rottey
- Medical Oncology Department, Ghent University Hospital, 9000 Ghent, Belgium; (H.K.); (A.D.P.); (C.J.); (I.H.); (M.S.); (E.N.); (L.L.); (S.R.); (H.G.D.)
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium; (N.S.); (K.V.); (V.K.)
| | - Gilbert Lemmens
- Psychiatry Department, Ghent University Hospital, 9000 Ghent, Belgium;
| | - Hannelore G. Denys
- Medical Oncology Department, Ghent University Hospital, 9000 Ghent, Belgium; (H.K.); (A.D.P.); (C.J.); (I.H.); (M.S.); (E.N.); (L.L.); (S.R.); (H.G.D.)
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium; (N.S.); (K.V.); (V.K.)
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Aydın R, Bostan FS, Kabukcuoğlu K. Two wars on one front: Experiences of gynaecological cancer patients in the COVID-19 pandemic. Eur J Cancer Care (Engl) 2022; 31:e13562. [PMID: 35170125 PMCID: PMC9111480 DOI: 10.1111/ecc.13562] [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: 10/11/2021] [Revised: 12/21/2021] [Accepted: 01/26/2022] [Indexed: 11/28/2022]
Abstract
Objective The aim of this study is to explore the experiences of gynaecological cancer patients during the COVID‐19 pandemic from their own perspectives. Methods The study is a descriptive study with a qualitative design based on thematic analysis. We conducted the study with 17 women with gynaecological cancer and receiving chemotherapy in the Medical Oncology and Chemotherapy Unit of Kütahya Training and Research Hospital. The data were collected between April 2021 and May 2021 via an in‐depth individual interview form. The COREQ checklist was followed in the study. Results As a result of the interviews, we identified four main themes: the impacts of COVID‐19 on life, the impact of COVID‐19 on cancer treatment, the biggest fear during the COVID‐19 pandemic and the metaphors of struggling with cancer during the COVID‐19 pandemic. Conclusion The disruption of treatment services during the COVID‐19 pandemic and women's fear of infection by the virus led to delays in cancer diagnosis and treatment. This situation caused the women's state of health to deteriorate, and the resultant regret and sadness that they experienced had an adverse effect on their mental health. Furthermore, women's self‐isolation due to the fear of infection by the virus had a negative effect on their psychosocial health. Telehealth services should be provided for cancer patients to obtain accurate information and to easily access information about treatment processes during the pandemic, and telepsychological hotlines and peer support groups should be established to improve the psychosocial health of patients.
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Affiliation(s)
- Ruveyde Aydın
- Health Sciences Faculty, Karadeniz Technical University, Trabzon, Turkey
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Gangopadhyay A. Elimination of cervical cancer as a public health problem-how shorter brachytherapy could make a difference during COVID-19. Ecancermedicalscience 2022; 16:1352. [PMID: 35510136 PMCID: PMC9023303 DOI: 10.3332/ecancer.2022.1352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Indexed: 01/09/2023] Open
Abstract
The World Health Organization has called for elimination of cervical cancer as a public health problem and has adopted strategies in this regard. However, the estimates for achieving the goals depend on the ability to provide timely treatment in a certain proportion of cases. The coronavirus disease 2019 pandemic has had a serious impact on healthcare delivery in many low and middle income countries (LMICs) with the highest burden of cervical cancer; funds and infrastructure are being reallocated to deal with the emergency, and cancer care has been seriously affected. In the absence of clear and reliable estimates, the exact extent of disruption remains unclear. It is, therefore, essential that pragmatic approaches are adopted to save lives. There has been considerable debate regarding the use of the 9 Gy × 2 fractions high dose rate brachytherapy schedule for the treatment of locally advanced cervical carcinoma. However, in LMICs with the highest global burden of locally advanced cervical cancer cases, radiation facilities have been using this fractionation schedule in many cases to deal with the overwhelming number of patients, who would have otherwise been denied timely treatment. In view of the current pandemic, and the difficulties in accessing and delivering timely healthcare, mortality owing to delayed treatment cannot be denied in LMICs, which already have underequipped healthcare facilities. Use of the shortest available fractionation schedule to provide timely treatment would serve to save more lives in regions with high incidence and mortality from the disease.
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Lopes A, Pastore CBP, Deckers P, Halla IKMW, Dias ALR, da Mata MVM, do Nascimento Martins A, Viu MM, Lopez RVM, Yamada AD. Oncological Surgery During the COVID-19 Pandemic: Effectiveness of Preoperative Screening and Factors Associated with Postoperative SARS-CoV-2 Infection. Ann Surg Oncol 2022; 29:2155-2162. [PMID: 35000079 PMCID: PMC8742686 DOI: 10.1245/s10434-021-11195-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 11/14/2021] [Indexed: 12/11/2022]
Abstract
Background Routine preoperative screening of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with reverse transcriptase-polymerase chain reaction (RT-PCR) may reduce in-hospital SARS-CoV-2 transmission. Methods This was a prospective, observational, cohort study. The endpoints were the incidence of asymptomatic patients with positive preoperative RT-PCR results and the incidence and factors associated with postoperative SARS-CoV-2 infection in patients with cancer referred for elective surgery. Patients with elective surgery between May and October 2020 were included. RT-PCR of nasopharyngeal swabs was performed preoperatively for all patients. Postoperative SARS-CoV-2 infection was assessed within 30 postoperative days. Results A total of 1636 preoperative screening RT-PCR tests were performed. Of these, 102 (6.2%) cases were positive, and 1,298 surgical procedures were analyzed. The postoperative SARS-CoV-2 infection rate was 0.9%. The length of stay (odds ratio [OR] 1.08; 95% confidence interval [CI] 1.04–1.11; p < 0.001), surgical time (OR 1.004; 95% CI 1.001–1.008; p = 0.023), intensive care unit admission (OR 7.7; 95% CI 2.03–29.28; p = 0.003), and hospital readmissions (OR 9.56; 95% CI 2.50–36.56; p = 0.001) were associated with postoperative coronavirus disease (COVID-19). Using unadjusted and adjusted logistic regression, length of stay (OR 1.08; 95% CI 1.04–1.11; p < 0.001), and readmission (OR 9.02; 95% CI 2.30–35.48; p = 0.002) were independent factors of postoperative COVID-19. Conclusions Screening patients preoperatively may reduce in-hospital SARS-CoV-2 transmission. Length of stay and readmission were independently correlated with postoperative COVID-19.
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Affiliation(s)
- André Lopes
- Department of Gynecology, São Camilo Oncologia, São Paulo, Brazil.
- Nucleo de Pesquisa e Ensino da Rede São Camilo, São Paulo, Brazil.
| | | | - Paula Deckers
- Department of Gynecology, São Camilo Oncologia, São Paulo, Brazil
| | | | | | | | | | | | - Rossana Veronica Mendoza Lopez
- Oncology Translational Research Center, Instituto do Cancer do Estado de Sao Paulo ICESP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
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Seneviratne SL, Wijerathne W, Yasawardene P, Somawardana B. OUP accepted manuscript. Trans R Soc Trop Med Hyg 2022; 116:767-797. [PMID: 35276734 PMCID: PMC8992310 DOI: 10.1093/trstmh/trac015] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 01/13/2022] [Accepted: 02/08/2022] [Indexed: 12/15/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, has currently affected >220 million individuals worldwide. The complex interplay of immune dysfunction, active malignancy, the effect of cancer treatment on the immune system and additional comorbidities associated with cancer and COVID-19 all affect the outcomes of COVID-19 in patients with cancer. We have discussed the published findings (through the end of September 2021) on the effects of cancer on the morbidity and mortality of COVID-19, common factors between cancer and COVID-19, the interaction of cancer and COVID-19 treatments, the impact of COVID-19 on cancer clinical services, immune test findings in cancer patients with COVID-19 and the long-term effects of COVID-19 on cancer survivors.
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Palliative and end-of-life care in primary care during the COVID-19 pandemic and beyond. Br J Gen Pract 2021; 72:6-7. [PMID: 34972792 PMCID: PMC8714522 DOI: 10.3399/bjgp22x718025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
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Seretis K, Boptsi E, Boptsi A, Lykoudis EG. The impact of treatment delay on skin cancer in COVID-19 era: a case-control study. World J Surg Oncol 2021; 19:350. [PMID: 34949189 PMCID: PMC8702374 DOI: 10.1186/s12957-021-02468-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 11/24/2021] [Indexed: 11/29/2022] Open
Abstract
Background The outbreak of COVID-19 pandemic led to a 2-month lockdown in Europe. Elective surgeries, including skin cancer excisions, were postponed. The purpose of this prospective case-control study was to assess the impact of the treatment delay on patients with non-melanoma skin cancer (NMSC) or melanoma operated in the first post-lockdown period. Methods A comparative study of skin cancer operations performed in a 4-month period either in 2020 or in 2019 was conducted. All data were collected from a prospectively maintained clinic database and the pathological reports. Continuous variables were compared with t test or Mann-Whitney U test according to their distribution. Categorical variables were compared with Fisher exact test. Odds ratio (OR) with 95% confidence interval (95% CI) was used to assess the risk of excising high-risk NMSC in 2020 compared with 2019. Results Skin cancer excision was performed in 158 cases in 2020 compared to 125 cases in 2019 (26.4% increase). Significantly, more SCC were excised in 2020 (p = 0.024). No significant difference for several clinical parameters regarding BCC, SCC, and melanoma was identified. However, the reconstructive method applied, following NMSC excision, was significantly different, requiring frequently either skin grafting or a flap. Conclusion These results indicate that skin cancer treatment delay, due to COVID-19 pandemic, is related to an increased incidence of SCC and more complicated methods of reconstruction. Considering the relapsing COVID-19 waves, significant skin cancer treatment delays should be avoided. Trial registration The study adhered to the STROBE statement for case-control studies.
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Affiliation(s)
- Konstantinos Seretis
- Department of Plastic Surgery, Medical School, University of Ioannina, Leoforos St. Niarchou, 45110, Ioannina, Greece.
| | - Eleni Boptsi
- Department of Plastic Surgery, Medical School, University of Ioannina, Leoforos St. Niarchou, 45110, Ioannina, Greece
| | - Anastasia Boptsi
- Department of Plastic Surgery, Medical School, University of Ioannina, Leoforos St. Niarchou, 45110, Ioannina, Greece
| | - Efstathios G Lykoudis
- Department of Plastic Surgery, Medical School, University of Ioannina, Leoforos St. Niarchou, 45110, Ioannina, Greece
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Abstract
The impact of the COVID-19 pandemic on health services in the UK and around the world cannot be understated. Cancer care services, patient and cancer research communities have been particularly affected. Screening services, treatment and clinical trials have been halted. Research laboratories have been closed or repurposed to tackle the pandemic. Despite these profound setbacks, there are ways in which the pandemic is accelerating areas of cancer research. In the context of a new cancer research exhibition planned by the Science Museum Group, Cancer Revolution: Science, innovation and hope, this essay draws out some remarkable parallels between cancer science and the remarkable research effort seeking to tackle the COVID-19 pandemic. Knowledge and therapeutic approaches from seemingly unrelated fields of medical research are opening up new possibilities to control both diseases. As the race to control COVID-19 has shown, the more research angles, disciplines and tools and people we can bring together to tackle the challenge cancer poses, the better our chances of staying ahead of this disease for more of us now and in future.
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Abdel-Rahman O. Factors associated with fatal coronavirus disease 2019 infections among cancer patients in the US FDA Adverse Event Reporting System database. Future Oncol 2021; 17:5045-5051. [PMID: 34726930 PMCID: PMC8582593 DOI: 10.2217/fon-2021-0816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Aim: To explore factors affecting coronavirus disease 2019 (COVID-19) mortality among cancer patients based on a pharmacovigilance database. Methods: US FDA Adverse Event Reporting System (FAERS) quarterly data extract files were reviewed for quarters two, three and four of 2020 (i.e., April to December). Patients with an indication related to malignancy and a reported COVID-related reaction were selected. Multivariate logistic regression analysis for factors associated with a fatal outcome was conducted. Results: A total of 2708 patients were included. The following factors were associated with fatal COVID-19 infection: older age (odds ratio [OR]: 1.03; 95% CI: 1.01-1.04), male sex (OR: 1.43; 95% CI: 1.07-1.91), non-US report source (OR: 2.46; 95% CI: 1.93-3.13), hematological malignancy (OR: 1.62; 95% CI: 1.28-2.07), potentially immunosuppressive treatment (OR: 1.83; 95% CI: 1.30-2.58) and diagnosis in quarter two versus quarter four (OR: 1.62; 95% CI: 1.27-2.07). Conclusion: Within FAERS reports, cancer patients who are older, males and receiving immunosuppressive treatment and those with hematological malignancies were at a higher risk of death because of COVID-19 infection.
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Affiliation(s)
- Omar Abdel-Rahman
- Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, Alberta T6G 1Z2, Canada
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Cavanna L, Citterio C, Toscani I. COVID-19 Vaccines in Cancer Patients. Seropositivity and Safety. Systematic Review and Meta-Analysis. Vaccines (Basel) 2021; 9:vaccines9091048. [PMID: 34579285 PMCID: PMC8473083 DOI: 10.3390/vaccines9091048] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/17/2021] [Accepted: 09/17/2021] [Indexed: 01/04/2023] Open
Abstract
Patients with cancer are among the most vulnerable groups of the COVID-19 pandemic, whereas vaccinations can represent a cornerstone in overcoming the pandemic itself. However, cancer patients were excluded from clinical trials for COVID-19 vaccinations, and thus the data on the immunogenicity and safety of COVID-19 vaccines in cancer patients are limited. In this systematic review, we assessed the seroconversion rate and the safety of COVID-19 vaccinations in cancer patients. We searched a bibliographic database up until 31 July 2021. Utilizing inclusion criteria, six studies were selected and analyzed for this meta-analysis. This included 621 cancer patients and 256 controls. Results show that patients with solid tumors show adequate antibody responses (>90%), though the antibody titers were significantly lower than those of healthy controls. Similarly, a significantly lower rate of seroconversion was registered in patients with hematologic malignances. The vaccines showed a good safety profile; no grade 3–4 adverse events were registered. This review demonstrates generally high immunogenicity from COVID-19 vaccines in patients with cancer, with better results for solid tumors than hematological malignances, and with a good safety profile.
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Affiliation(s)
- Luigi Cavanna
- Correspondence: ; Tel.: +39-0523302697; Fax: +39-0523302141
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Hewamana S, Skandarajah T, Jayasinghe C, Deshapriya S, Senarathna D, Arseculeratne G, Harischandra M, Somasundaram G, Srinivasan V, Somiah S, Munasinghe N, Hewawasam S, Ekanayake L, Wadanamby R, Galagoda G, Lin TT, Balawardena J. Blood cancer care in a resource limited setting during the Covid-19 outbreak; a single center experience from Sri Lanka. PLoS One 2021; 16:e0256941. [PMID: 34534228 PMCID: PMC8448336 DOI: 10.1371/journal.pone.0256941] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 08/18/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The Covid-19 pandemic has caused significant morbidity and mortality among patients with cancer. Most countries employed measures to prevent spread of Covid-19 infection which include shielding, quarantine, lockdown, travel restrictions, physical distancing and the use of personal protective equipment. This study was carried out to assess the change in patient attendance and the efficacy of newly implemented strategies to mitigate the impact of Covid-19 on services at the Lanka Hospital Blood Cancer Centre (LHBCC) in Colombo, Sri Lanka. METHODOLOGY Telephone consultation, infection control, personal protective measures and emergency admission policy were implemented with the aim of having a Covid-19 free ward and to prevent cross-infections. This descriptive cross-sectional study was conducted with 1399 patient episodes (in-patient care or day-case review). We analysed patients treated as in-patient as well as day-case basis between 01st April 2020 and 31st December 2020. RESULTS There were 977 day-case based episodes and 422 in-patient based episodes. There was a 14% drop in episode numbers compared to same period in 2019. There was no cross infection and no patients with Covid-19 related symptoms or positive test results entered the LHBCC during the study period. CONCLUSION Services in blood cancer care were maintained to prevent late stage presentation and adverse outcome. Measures implemented to prevent Covid-19 were effective to allow continuation of treatment. This study highlights the importance of implementing strict protocols, clinical screening, use of appropriate personal protective equipment in delivering blood cancer care during the Covid-19 pandemic. This is the only documented study relating to outcome and successful applicability of measures to prevent spread of Covid-19 infection and maintaining services among blood cancer patients in Sri Lanka.
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Affiliation(s)
- Saman Hewamana
- Clinical Haematology Unit, Lanka Hospital, Colombo, Sri Lanka
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Thet Thet Lin
- Faculty of Health and Life Sciences, Coventry University, Coventry, United Kingdom
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Mynard N, Saxena A, Mavracick A, Port J, Lee B, Harrison S, Chow O, Villena-Vargas J, Scheff R, Giaccone G, Altorki N. Lung Cancer Stage Shift as a Result of COVID-19 Lockdowns in New York City, a Brief Report. Clin Lung Cancer 2021; 23:e238-e242. [PMID: 34580031 PMCID: PMC8403338 DOI: 10.1016/j.cllc.2021.08.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 08/19/2021] [Indexed: 02/07/2023]
Abstract
Introduction The COVID-19 pandemic reached New York City in early March 2020 resulting in an 11-week lockdown period to mitigate further spread. It has been well documented that cancer care was drastically affected as a result. Given New York City's early involvement, we attempted to identify any stage shift that may have occurred in the diagnoses of non-small cell lung cancer (NSCLC) at our institution as a result of these lockdowns. Patients and Methods We conducted a retrospective review of a prospective database of lung cancer patients at our institution from July 1, 2019 until March 31, 2021. Patients were grouped by calendar year quarter in which they received care. Basic demographics and clinical staging were compared across quarters. Results Five hundred and fifty four patients were identified that underwent treatment during the time period of interest. During the lockdown period, there was a 50% reduction in the mean number of patients seen (15 ± 3 vs. 28 ± 7, P = .004). In the quarter following easing of restrictions, there was a significant trend towards earlier stage (cStage I/II) disease. In comparison to quarters preceding the pandemic lockdown, there was a significant increase in the proportion of patients with Stage IV disease in the quarters following phased reopening (P = .026). Conclusion After a transient but significant increase in Stage I/II disease with easing of restrictions there was a significant increase in patients with Stage IV disease. Extended longitudinal studies must be conducted to determine whether COVID-19 lockdowns will lead to further increases in the proportion of patients with advanced NSCLC.
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Affiliation(s)
- Nathan Mynard
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY
| | - Ashish Saxena
- Department of Medicine, Division of Hematology & Medical Oncology, Weill Cornell Medicine, New York, NY
| | - Alexandra Mavracick
- Department of Medicine, Division of Hematology & Medical Oncology, Weill Cornell Medicine, New York, NY
| | - Jeffrey Port
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY
| | - Benjamin Lee
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY
| | - Sebron Harrison
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY
| | - Oliver Chow
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY
| | | | - Ronald Scheff
- Department of Medicine, Division of Hematology & Medical Oncology, Weill Cornell Medicine, New York, NY
| | - Giuseppe Giaccone
- Department of Medicine, Division of Hematology & Medical Oncology, Weill Cornell Medicine, New York, NY
| | - Nasser Altorki
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY.
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Maresca G, Siddiqui S, Wardlaw K, Royle J. The aftereffects of the UK national lockdown – could the reduction in urgent referrals, diagnostic and surgical capacities result in increased cancer morbidity and mortality? JOURNAL OF CLINICAL UROLOGY 2021. [DOI: 10.1177/20514158211029129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background: The COVID-19 pandemic has cause major disruption to daily life in the United Kingdom in 2020. The national lockdown and mobilization of healthcare resources to areas with increased demand has resulted in a historical shift in referral, diagnostic and surgical capabilities in most healthboards. This regional, retrospective study aimed to shed light on the potential consequences of the UK national lockdown, the resultant decrease in referrals and diagnostic capacity on surgical services and patients during the recovery phase. Methods: Urgent referrals for suspected (USC) prostate cancer ( N =1430) from primary care in the north-east of Scotland and the number of diagnostic prostate biopsies performed in the region were reviewed to assess trends between January 2018 and December 2020. The data was anonymized and charted to highlight the differences between the period of national lockdown and other times. Results: The number of USC referrals for prostate cancer dropped significantly between March 2020 and June 2020 (a mean of 25 per month from 45 per month in the same period in 2018 and 2019). The number of diagnostic procedures also decreased significantly, with 74 fewer biopsies having been performed during the lockdown period compared with the same period in 2019. Conclusions: The shifts in USC referrals and diagnostics during the lockdown period have led to a backlog which may put patients at risk of cancer stage migration, leading to increased morbidity and mortality. This study indicates that reestablishment of surgical services should take priority during the recovery phase. Level of evidence: 3
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Affiliation(s)
| | - Saad Siddiqui
- Department of Urology, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Kevin Wardlaw
- Department of Urology, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Justine Royle
- Department of Urology, Aberdeen Royal Infirmary, Aberdeen, UK
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COVID-19 and Malignancy: Exploration of the possible genetic and epigenetic interlinks and overview of the vaccination scenario. Cancer Treat Res Commun 2021; 28:100425. [PMID: 34171559 PMCID: PMC8213508 DOI: 10.1016/j.ctarc.2021.100425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 06/12/2021] [Accepted: 06/14/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Malignancy is one of the prime global causes of mortality. Cancer Patients suffering from SARS-CoV-2 have demonstrated higher rates of severe complications exacerbating towards death. Possible genetic and epigenetic alterations may exist in cancer patients which have the potential to contribute towards their increased vulnerability towards COVID-19. METHOD An exhaustive literature search using 'COVID-19', 'SARS-CoV-2', 'Cancer', 'Malignancy', 'Relationships', Interlinks', 'Genetic', 'Epigenetic', 'Epidemiological studies', 'Clinical Studies', 'Vaccination', 'Vaccine scenario' were conducted in PubMed and EMBASE till 2nd June 2021. RESULT In this narrative review, 17 epidemiological studies were listed which focused on clinical parameters of several malignancy patient cohorts who contracted COVID-19. Besides, genetic and epigenetic alterations seen among cancer patients are also discussed which may plausibly increase the vulnerability of cancer patients to SARS-CoV-2 infection. Also, global vaccination scenario among malignant patients along with the necessity to prioritize them in the vaccination campaigns are also elaborated. CONCLUSION Genetic and epigenetic modifications present in ACE2, TMPRSS2, IL-6 and several cytokines require more in-depth research to elucidate the shared mechanisms of malignancy and SARS-CoV-2.
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Trapani D, Curigliano G. COVID-19 vaccines in patients with cancer. Lancet Oncol 2021; 22:738-739. [PMID: 34087120 PMCID: PMC8169039 DOI: 10.1016/s1470-2045(21)00250-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 12/31/2022]
Affiliation(s)
- Dario Trapani
- European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Giuseppe Curigliano
- European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy; Department of Oncology and Hematology, University of Milan, Milan, Italy.
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Venables ZC, Ahmed S, O Bleiker T, Broggio J, Kwiatkowska M, Levell NJ, Millington GWM, Paley L, Payne E, M Proby C, Vernon S, McPhail S. The impact of the COVID-19 pandemic on skin cancer incidence and treatment in England, 2020. Br J Dermatol 2021; 185:460-462. [PMID: 33937975 PMCID: PMC8239907 DOI: 10.1111/bjd.20409] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/23/2021] [Accepted: 04/23/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Z C Venables
- Norfolk and Norwich University Hospital, Norwich, UK.,National Cancer Analysis and Registration Service, Public Health England, London, UK
| | - S Ahmed
- British Association of Dermatologists, London, UK
| | - T O Bleiker
- British Association of Dermatologists, London, UK.,University Hospital of Derby and Burton NHS Foundation Trust, Derby, UK
| | - J Broggio
- National Cancer Analysis and Registration Service, Public Health England, London, UK
| | - M Kwiatkowska
- National Cancer Analysis and Registration Service, Public Health England, London, UK.,British Association of Dermatologists, London, UK
| | - N J Levell
- Norfolk and Norwich University Hospital, Norwich, UK
| | - G W M Millington
- Norfolk and Norwich University Hospital, Norwich, UK.,British Association of Dermatologists, London, UK
| | - L Paley
- National Cancer Analysis and Registration Service, Public Health England, London, UK
| | - E Payne
- National Cancer Analysis and Registration Service, Public Health England, London, UK
| | - C M Proby
- Ninewells Hospital & Medical School, University of Dundee, Dundee, UK
| | - S Vernon
- National Cancer Analysis and Registration Service, Public Health England, London, UK
| | - S McPhail
- National Cancer Analysis and Registration Service, Public Health England, London, UK
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50
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Curigliano G, Eggermont AMM. Adherence to COVID-19 vaccines in cancer patients: promote it and make it happen! Eur J Cancer 2021; 153:257-259. [PMID: 34147290 PMCID: PMC8293865 DOI: 10.1016/j.ejca.2021.05.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 05/17/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Giuseppe Curigliano
- European Institute of Oncology, IRCCS, Milan, Italy; Department of Oncology and Hematology, University of Milan, Milan, Italy
| | - Alexander M M Eggermont
- Princess Máxima Center, Utrecht, Netherlands; University Medical Center Utrecht, Utrecht, Netherlands.
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