Dramatic Changes in Oncology Care Pathways During the COVID-19 Pandemic: The French ONCOCARE-COV Study

Brügel, Mathias; Carlier, Claude; Essner, C.; Debreuve‐Theresette, Adeline; Beck, Marie Françoise; Merrouche, Yacine; Bouché, Olivier

doi:10.1002/onco.13578

Cited by 43 publications

(59 citation statements)

References 10 publications

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“…With particular relevance to our study, it should be noted that an observational Taiwanese cancer registry study 34 , based on 39,000 newly identified CRC cases, reports that the risk of death increases significantly relative to the delay between diagnosis and treatment: to an interval ≤ 30 days, for 31–150 days: HR 1.51; (95% CI 1.43 to 1.59); for ≥151 days: HR 1.64; (95% CI 1.54 to 1.76). The French ONCOCARE-COV study confirmed a reduction in terms of CRC FIT screening (−86%), CRC biomolecular somatic analyses (−59%), and new patients files discussed in multidisciplinary tumor board meeting (−39%) during the 3-month lockdown period in 2020 compared with the same trimester in 2019 31 .…”

Section: Discussionmentioning

confidence: 86%

“…While the lockdown was undoubtedly a necessity, it led to unintended consequences in the diagnosis of various cancers. While the pandemic has dramatically affected all aspects of the cancer care pathway those especially affected are screening, diagnosis and surgical treatment 31,32,4 . For instance, De Vincentiis et al have reported that the number of cancer diagnoses in Italy decreased by 39% in the first semester of 2020, compared to the average number recorded in 2018 and 2019 4 .…”

Section: Discussionmentioning

confidence: 99%

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The tumor burden of metastatic colorectal cancer patients at initial diagnosis, pre- versus post-Covid-19 lockdown

Pastor

Pisareva

et al. 2021

Preprint

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Background: The COVID-19 pandemic led to a significant reduction in the provision of screening, case identification and hospital referrals to cancer patients. To our knowledge, no study has yet correlated quantitatively the consequences of these limitations for cancer patient management. This study evaluates the implications of such reductions for patients newly diagnosed with metastatic colorectal cancer (mCRC) in both the pre- and post-lockdown periods. Methods: We examined 80 newly identified mCRC patients from 18 different clinical centers. These cases come from the screening procedure of a clinical trial which is using circulating DNA (cirDNA) analysis to determine their RAS and BRAF status. Results: The tumor burden as evaluated by the median total plasma cirDNA concentration showed a statistically higher level in patients diagnosed post-lockdown compared to those diagnosed pre-lockdown (119.2 versus 17.3 ng/mL; p<0.0001). In order to link tumor burden to survival, we compared the survival of these mCRC patients with previous studies in which cirDNA was examined in the same way (median survival, 16.2 months; median follow up, 48.7 months, N=135). Given the poor survival rate of mCRC patients with high cirDNA levels (14.7 vs 20.0 and 8.8 vs 19.3 months median survival when dichotomizing the cohort by the median cirDNA concentration 24.4 and 100 ng/mL, respectively), our study points to the potential deleterious consequences of the COVID-19 pandemic. Conclusions: Recognizing that our exploratory study offers a snapshot of an evolving situation, our observations nonetheless clearly highlight the need to determine actions which would minimize delays in diagnosis during the ongoing and future waves of COVID-19.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

The tumor burden of metastatic colorectal cancer patients at initial diagnosis, pre- versus post-Covid-19 lockdown

Pastor

Pisareva

et al. 2021

Preprint

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“…A general reduction in overall cancer care in several countries in the same period has been observed. Indeed, in the UK, urgent referrals and chemotherapy for any cancer, including oropharynx cancer, decreased by 70% and 40%, respectively, 25 while reductions by 9% in chemotherapy, 16% in radiotherapy, and 30% in surgery were observed in France 26 . Among patients with cancer under treatment in the Netherlands, treatment or follow‐up was postponed or cancelled in 11% of individuals and changed into phone/video counselling in 18% 27 .…”

Section: Figurementioning

confidence: 99%

“…The data from June were the most up to date when this study was carried out. Data on hospitalizations that occurred between April and June of 2016, 2017, 2018 and 2019 were also gathered from SIH-SUS for comparison, by Brazilian State of patients' residences-Brazil is divided into 26 States and one Federal District. To obtain the hospitalization rates, we divide the monthly number of hospitalizations due to oral and oropharyngeal cancer in each State by its population and multiply the result by 100 000.…”

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confidence: 99%

The impact of the COVID‐19 pandemic on hospitalizations for oral and oropharyngeal cancer in Brazil

Cunha

Antunes

Martins

et al. 2021

Comm Dent Oral Epid

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Timely diagnosis and treatment of oral and oropharyngeal cancers are central for the patient's survival. Our objective was to document the impact of the COVID‐19 pandemic on the rate of hospitalizations due to these cancers in Brazil's National Health System (SUS). The number of hospitalizations by these cancers during the first periods of the pandemic—and between the same period of 2016 to 2019—was retrieved from the SUS Hospital Information System. We compared hospitalization rates between pre‐ and pandemic periods, by State. The hospitalization rate for oral and oropharyngeal cancer during the pandemic was lower than that of the same period of previous years. The decline between 2019 and 2020 was of 49.3%, reaching 60% in the North. The reduction in hospitalization during an extended period suggests that oral and oropharyngeal cancer care will be postponed, with potentially detrimental impact on survival.

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“…The impact of the reorganization of healthcare systems during the first wave of the COVID-19 pandemic was major on cancer care pathways [5] , [6] , [7] , [8] . The French ONCOCARE-COV study confirmed a reduction in terms of colon cancer screening (−86%), histopathological (−48%) and biomolecular (somatic and germinal) (−69%) analyses, oncology announcement consultations (−54%), oncogeriatric evaluations (−86%) and new patients files discussed in multidisciplinary tumor board meeting (MTBM) (−39%) [5] . The decrease in cancer treatment was also significant concerning surgery (−30%) and to a lesser extent for radiotherapy (−16%) and chemotherapy (−9%); all clinical research trials were stopped for 3 months [5] .…”

mentioning

confidence: 99%

Management of digestive cancers during the COVID-19 second wave: A French intergroup point of view (SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO, ACHBT, SFR)

Tougeron

Michel

Lièvre

et al. 2021

Digestive and Liver Disease

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Introduction:The COVID-19 pandemic has major impact of healthcare systems, including cancer care pathways. The aim of this work is to discuss in a multidisciplinary approach the therapeutic and/or strategies adaptations for patients treated for a digestive cancer during the European second wave of COVID-19 pandemic. Methods: A collaborative work was performed by several French societies to answer how to preserve digestive cancer care with no loss of chance during the second wave of COVID-19. In this context, all recommendations are graded as expert's agreement according to level evidence found in literature until October 2020 and the experience of the first wave of the COVID-19 pandemic. Results: As far as possible, no therapeutic modification should be carried out. If necessary, therapeutic adjustments may be considered if they do not constitute a loss of chance for patients. Considering the level of evidence all therapeutic modifications need to be discussed in multidisciplinary tumor board meeting and with patient consent. By contrast to first wave cancer prevention, cancer screening, supportive care and clinical trials should be continued. Conclusion: Recommendations proposed could limit cancer excess mortality due to the COVID-19 pandemic but should be adapted according to the situation in each hospital.

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Dramatic Changes in Oncology Care Pathways During the COVID-19 Pandemic: The French ONCOCARE-COV Study

Cited by 43 publications

References 10 publications

The tumor burden of metastatic colorectal cancer patients at initial diagnosis, pre- versus post-Covid-19 lockdown

The tumor burden of metastatic colorectal cancer patients at initial diagnosis, pre- versus post-Covid-19 lockdown

The impact of the COVID‐19 pandemic on hospitalizations for oral and oropharyngeal cancer in Brazil

Management of digestive cancers during the COVID-19 second wave: A French intergroup point of view (SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO, ACHBT, SFR)

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