Has the COVID-19 pandemic changed the clinical picture and tumour stage at the time of presentation of patients with colorectal cancer? A retrospective cohort study

Cano-Valderrama, Óscar; Sánchez-Santos, Raquel; Vigorita, Vincenzo; Paniagua, Marta; Flores, Erene; Garrido, Lucia; Facal, Cristina; Ruano, Alejandro; San-Ildefonso, Alberto; Moncada, Enrique

doi:10.1016/j.ciresp.2022.02.001

Cited by 12 publications

(6 citation statements)

References 26 publications

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“…It is possible that the overall stage of presenting cancer may have progressed. Several international studies have suggested the progression of colorectal cancer [9,35,36]. Colorectal cancer could progress if the time from the positive fecal occult blood test to colonoscopy exceeds 10 months [37][38][39][40] or if the time from diagnosis to surgery exceeds 3 months [41,42].…”

Section: Discussionmentioning

confidence: 99%

Changes in the Number of Gastrointestinal Cancers and Stage at Diagnosis with COVID-19 Pandemic in Japan: A Multicenter Cohort Study

Kuzuu,

Misawa,

Ashikari

et al. 2023

Cancers

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This retrospective cohort study compared the number of newly diagnosed patients, stage at diagnosis, and detection process of gastrointestinal cancers based on hospital-based cancer registry data at two tertiary Japanese hospitals. The pre-COVID-19 period was from January 2017 to February 2020, with phase 1 (midst of COVID-19 pandemic) from March to December 2020 and phase 2 (the transition period to the “new normal”) from January to December 2021. Each month, the number of patients diagnosed with esophageal, gastric, colorectal, pancreatic, liver, and biliary tract cancers were aggregated, classified by stage and detection process, and compared, including a total of 6453 patients. The number of colorectal Stage 0-II patients decreased significantly in phase 1 and increased in phase 2. The total number of colorectal cancer patients returned to pre-COVID-19 levels (mean monthly patients [SD]: 41.61 [6.81] vs. 36.00 [6.72] vs. 46.00 [11.32]). The number of patients with gastric cancer Stage I significantly decreased in phase 2 following phase 1. The number of gastric cancer patients decreased significantly from pre-COVID-19 levels (30.63 [6.62] vs. 22.40 [5.85] vs. 24.50 [4.15]). During phase 2, the number of patients diagnosed after screening with colorectal cancer increased significantly, whereas that with gastric cancer remained considerably lower. The number of Stage III colorectal and gastric cancer patients increased significantly from the pre-COVID-19 levels. Thus, gastric cancer may not be optimally screened during phases 1 and 2. There was a significant increase in patients with Stage III colorectal and gastric cancers from the pre-COVID-19 period; hence, the stage at diagnosis may have progressed.

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Section: Discussionmentioning

confidence: 99%

Changes in the Number of Gastrointestinal Cancers and Stage at Diagnosis with COVID-19 Pandemic in Japan: A Multicenter Cohort Study

Kuzuu,

Misawa,

Ashikari

et al. 2023

Cancers

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“…Despite the increase observed in Spain, and considering that the last 5 months of the 2020 data collection were conducted during the COVID-19 pandemic, restrictions in screening activities may have influenced the probability of undergoing screening during that period, limiting the percentage of uptakers and delaying CRC diagnosis. Moreover, the impact of the screening programmes cancellation could be longer than the period they were closed, because program's restart was progressive and many people could have decided not to participate in the programmes to prevent unnecesary virus exposure ( 24 ). Some researchers have examined the effect of the cancellation of these CRC screening programmes on CRC.…”

Section: Discussionmentioning

confidence: 99%

Uptake patterns and predictors of colorectal cancer screening among adults resident in Spain: A population-based study from 2017 to 2020

Cruz

Cebrino

2023

Front. Public Health

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BackgroundAlthough population screening has improved the early diagnosis of colorectal cancer (CRC), most cases are diagnosed in symptomatic patients. This study aimed to estimate the prevalence and evolution over time of uptake patterns to fecal immunochemical test (FIT) as a screening test for CRC among individuals aged 50–69 in Spain, and to determine the predictive factors for uptake patterns to this type of screening based on sociodemographic, health, and lifestyle characteristics.MethodsA cross-sectional study with 14,163 individuals from the 2017 Spanish National Health Survey and the 2020 European Health Survey was performed, including as the main variable uptake pattern to FIT screening within the last 2 years, with which we analyzed sociodemographic factors, health status and lifestyle habits.Results38.01% of participants had undergone FIT in the previous 2 years, and from 2017 to 2020, a significant increase in the uptake rate for CRC was observed (2017: 32.35%, 2020: 43.92%, p < 0.001). The positive predictors to FIT uptake pattern included factors such as being between 57 and 69 years, having a higher educational level or a higher social class, having at least one chronic illness, frequent contact with the primary care physician, alcohol consumption and physical activity, while immigration and smoking habit were negative predictors.ConclusionIn Spain, although the evolution of FIT uptake pattern over time is positive, the prevalence of FIT uptake is still low (38.01%), not reaching the level considered as acceptable in the European guidelines. Moreover, there are disparities in CRC screening uptake among individuals.

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“…As such, we reported the same experience by not prolonging the interval between diagnosis and surgery for the time period analyzed over a mean time of 15 days. However, several reports, from Spain, Japan, and other countries [ 29 , 30 , 31 , 32 ] described a generalized increase in stage III and IV tumors during the pandemic. We could not find any differences in stage at presentation nor in histopathological data between groups ( Table 2 , Table 3 and Table 4 ), but the subgroup analysis showed, only for left colon tumors, an increase of almost double for stage II cancers and a drop in stage I.…”

Section: Discussionmentioning

confidence: 99%

Influence of COVID-19 Pandemic on Colorectal Cancer Presentation, Management and Outcome during the COVID-19 Pandemic

Pirozzi

Siragusa

Baldini

et al. 2023

JCM

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The aim of the study was to investigate whether the COVID-19 pandemic and related measures had an influence on colorectal cancer (CRC) presentation, management, and outcomes; it was a retrospective monocentric study. CRC patients undergoing surgery during the Covid-19 pandemic (1 March 2020–28 February 2022) (group B) were compared with patients operated on in the previous two years (1 March 2018–29 February 2020) in the same unit (group A). The primary outcome was to investigate whether there were differences in concern regarding the stage at presentation, as a whole and after dividing groups based on cancer location (right colon cancer, left colon cancer, rectal cancer). Secondary outcomes included differences in the number of patients admitted from emergency departments and emergency surgeries between periods, and differences in the postoperative outcomes. A subanalysis within the pandemic group was conducted on the same outcomes, dividing the aforementioned group based on pandemic trends. Two hundred and eighty (280) were operated on during the study period: 147 in group A and 133 in group B. Stage at presentation was similar between groups; however, the subgroups analysis showed that in the pandemic group, the number of early-stage left colon cancer occurrences almost halves, yet not significantly. Emergency department referral was more common in group B (p-value: 0.003); in group B, they also had longer operations and there was a more frequent use of ostomy. No differences in the number of postoperative complications nor in the postoperative outcomes were found. Patients with CRC were more frequently referred through the emergency department during the COVID-19 pandemic and left-sided cancers appear to be generally diagnosed at a more advanced stage. Postoperative outcomes showed that high specialized colorectal units can deliver standard high-level treatment under high-pressure external conditions.

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Has the COVID-19 pandemic changed the clinical picture and tumour stage at the time of presentation of patients with colorectal cancer? A retrospective cohort study

Cited by 12 publications

References 26 publications

Changes in the Number of Gastrointestinal Cancers and Stage at Diagnosis with COVID-19 Pandemic in Japan: A Multicenter Cohort Study

Changes in the Number of Gastrointestinal Cancers and Stage at Diagnosis with COVID-19 Pandemic in Japan: A Multicenter Cohort Study

Uptake patterns and predictors of colorectal cancer screening among adults resident in Spain: A population-based study from 2017 to 2020

Influence of COVID-19 Pandemic on Colorectal Cancer Presentation, Management and Outcome during the COVID-19 Pandemic

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