BackgroundWe compared the new outpatient clinic referrals during the first 10 months of the COVID-19 pandemic with the year before.MethodsWe compared baseline characteristics of the 2208 new referrals in 2020 (n=922) and 2019 (n=1286) with Χ2 and Mann-Whitney U tests and calculated ORs with binary logistic regression. To evaluate the expected changes in the cancer survival secondary to stage migration, we used the 5-year survival data of Survival, Epidemiology and End Results (SEER) Program 2010–2016.ResultsThe percentage of patients with inoperable or metastatic disease was significantly increased during the pandemic (49.8% vs 39%, OR: 1.553, 95% CI: 1.309 to 1.843, p<0.001). We observed a significant decrease in the percentage of patients diagnosed via the screening methods (18.8% vs 28.7%, OR: 1.698, 95% CI: 1.240 to 2.325, p=0.001). The 90-day mortality after the cancer diagnosis was significantly higher during the pandemic (10.5% vs 6.6%, OR: 1.661, 95% CI: 1.225 to 2.252, p=0.001). Due to the increased advanced-stage disease rate at first referral, significant decreases in 5-year survival rates were expected for breast cancer (−8.9%), colorectal cancer (−11.1%), cervix cancer (−10.3%) and melanoma (−7%).ConclusionWe think that collaborative efforts are paramount to prevent the pandemic of late cancer diagnoses and ensure patient safety during the pandemic.
BackgroundIt is known that genetic and environmental factors play a role in the pathogenesis of spondyloarthritis (SpA). [1] It can be thought that spouses living in the same house are exposed to similar environmental factors.ObjectivesThis study aimed to investigate whether common living space increases the frequency of SpA development in unrelated spouses of SpA patients.MethodsBetween November 2021 and June 2022, 680 SpA patients who applied to the Hacettepe University rheumatology outpatient clinic were included. Patients were divided into ankylosing spondylitis (AS), non-radiographic SpA, and peripheral SpA. The patients were asked whether their spouses had SpA, and if they had SpA diagnosis, they were called to the outpatient clinic, and their diagnosis was confirmed. The family history of the patients and their use of bDMARDs were also noted. It was also checked whether the patients whose spouses had SpA findings fulfilled the AS criteria.Results680 SpA patients were evaluated. There were 582(85.6%) AS, 72(10.6%) nr AxSpA, and 26 only peripheral SpA (3.8%). 49.4% of the patients were male, and the mean age was 45.6 (10.4). The mean follow-up period of the patients was 10.6 (7.9) years. Of all patients, 468 (55.1%) were using a bDMARD at the time of evaluation. 12 SpA patients stated that their spouses had SpA. In the review of these patients, it was found that four patients did not have SpA, and one of them had PsA. Spouses of patients with nr AxSpA and peripheral SpA did not have AS/SpA AS was detected in the spouses of 7 patients. The incidence of AS in the entire SpA patient group was calculated as 7/695 (1.01% (0.4-2.1)). The incidence of AS in spouses of AS patients are 7/582 (1.20% (0.5-2.5)) calculated. 2 of 7 wives were cousins’ children. The incidence of AS in unrelated spouses of AS patients are 5/580 (0.86% (0.3-2)). Only one of the spouses with AS knew her spouse’s diagnosis at the time of marriage, while the other six were diagnosed after marriage. The median time for these patients to be diagnosed after marriage is 22 (7-32) years.ConclusionIn the Turkish population, the frequency of AS was 0.49%, and the frequency of SpA was 1.05%. [2] The incidence of AS in the spouses of SpA patients has increased approximately two times compared to the average Turkish population. A 2.4-fold increased risk was found in AS patients. This situation may be related to environmental factors that play a role in the pathogenesis of SpA disease. However, the fact that half of the patients were using bDMARDs suggests that they were analyzed in the group with the potential for more severe disease. The results require confirmation in more extensive studies.References[1]Hwang, M.C., L. Ridley, and J.D. Reveille,Ankylosing spondylitis risk factors: a systematic literature review.Clinical Rheumatology, 2021.40(8): p. 3079-3093.[2]Onen, F., et al.,Prevalence of ankylosing spondylitis and related spondyloarthritides in an urban area of Izmir, Turkey.The Journal of rheumatology, 2008.35(2): p. 305-309.Acknowledgements:NIL.Disclosure of InterestsNone Declared.
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