Impact of the COVID-19 Pandemic on Colorectal Cancer Care in the Netherlands: A Population-based Study

Meijer, Joyce; Elferink, M.A.G.; Hoeve, Jolanda C. van; Buijsen, Jeroen; Erning, Felice N. van; Nagtegaal, Irıs D.; Tanis, Pieter J.; Vink, Geraldine R.; Wumkes, M.; Hingh, Ignace H. J. T. de; Siesling, Sabine

doi:10.1016/j.clcc.2022.02.005

Cited by 16 publications

(31 citation statements)

References 10 publications

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“…Also for breast cancer treatment in the Netherlands significant differences in chemotherapy, mastectomy with immediate reconstruction and primary hormonal treatment are reported [ 20 ]. Previous research based on data from 25 hospitals in the Netherlands found minimal effects during the 1 st peak of 2020 [ 10 ]. The current nationwide data confirm these findings and therefore the setbacks in treatment of CRC during the pandemic was limited in the Netherlands.…”

Section: Discussionmentioning

confidence: 99%

“…In the second part of 2020, a catch-up in CRC diagnoses was observed since the Dutch government decided to expand the screening colonoscopy capacity up to 120% [ 9 ]. Previous analyses, with data available from 25 hospitals until June 2020 (week 26), found a limited impact of the COVID-19 pandemic on CRC care in the Netherlands for the first half of 2020 [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Limited impact of the COVID-19 pandemic on colorectal cancer care in the Netherlands in 2020

Meijer

Elferink²,

Vink³

et al. 2022

Int J Colorectal Dis

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Purpose The COVID-19 pandemic had a major impact on the health services worldwide. We aimed to investigate the impact of the pandemic on colorectal cancer (CRC) care in the Netherlands in 2020. Methods CRC patients, diagnosed in 2018–2020 in the Netherlands, were selected from the Netherlands Cancer Registry (NCR). The year 2020 was divided in four periods reflecting COVID-19 developments in the Netherlands (pre-COVID, 1st peak, recovery period, 2nd peak) and compared with the same periods in 2018/2019. Patient characteristics and treatment were compared using the Chi-squared test. Median time between diagnosis and treatment, and between (neo)adjuvant therapy and surgery were analyzed by the Mann–Whitney U test. Results In total, 38,021 CRC patients were diagnosed in 2018/2019 (n = 26,816) and 2020 (n = 11,205). Median time between diagnosis and initial treatment decreased on average 4 days and median time between neoadjuvant radiotherapy and surgery in clinical stage II or III rectal cancer patients increased on average 34 days during the three COVID-19 periods compared to the same periods of 2018/2019. The proportion of colon cancer patients that underwent elective surgery significantly decreased with 3.0% during the 1st peak. No differences were found in the proportion of patients who received (neo)adjuvant therapy, systemic therapy, or no anti-cancer treatment. Conclusion Only minor changes in the care for CRC patients occurred during the COVID-19 pandemic, mostly during the 1st peak. In conclusion, the impact on CRC care in the Netherlands was found to be limited. However, long-term effects cannot be precluded.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Limited impact of the COVID-19 pandemic on colorectal cancer care in the Netherlands in 2020

Meijer

Elferink²,

Vink³

et al. 2022

Int J Colorectal Dis

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“…Clinicians must treat cancer patients in accordance with their individual characteristics, the involved organ(s), the tumor stage, and the available adjuvant treatments. Although some studies have indicated an increase in T4 stage cancer during the pandemic, most have reported no significant upstaging in terms of the TNM classification ( Table 3 ) [ 8 28 33 57 58 59 60 61 62 63 ]. A hasty or obstinate selection of surgical resection is thus unnecessary in positive COVID-19 cases if other treatment modalities are available.…”

Section: Resultsmentioning

confidence: 99%

Surgical safety in the COVID-19 era: present and future considerations

Kim

Park

2022

Ann Surg Treat Res

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The impacts of coronavirus disease 2019 (COVID-19) have been globally paradigm shifting in all aspects. Surgeons have experienced unprecedented changes regarding operation schedules, preparations before surgery, and the precautions needed both during and after surgery. Many medical centers simultaneously reported a decrease in their numbers of surgeries, whether they were elective or emergent, or for cancerous or benign resections. However, accumulated surgical outcomes from the last 2 years of experience presented postoperative morbidity and mortality data that were comparable to the pre-pandemic era, whether in elective or urgent settings. Although COVID-19 showed a significant association with postoperative morbidity and mortality, the majority of noninfected patients could be treated successfully with stringent mitigation protocols. Initially recommended to be avoided at the start of the pandemic, minimally invasive surgery seems to be safe and feasible according to reported surgical outcomes. Numerous sets of guidelines have now been produced from medical societies and adhering to the basic precautions has been found to be practicable. It is crucial that health care systems and surgical staff remain vigilant and attentive to the ever-changing situation in this pandemic in order to provide optimal medical support to their patients.

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“…The clinical presentation was significantly affected by COVID-19. Meijer et al [ 62 ] reported a reduction of patients presenting with stage I and stage II CRC from 29.5% and 26.6% to 20.0% and 25.5%, respectively, after the onset of COVID-19 pandemic. They also noticed an increase of patients with stage III and stage IV from 22.2% and 19.0% to 26.8% and 26.2%, respectively[ 16 , 62 ].…”

Section: Clinical Presentation Of Colorectal Cancermentioning

confidence: 99%

“…Meijer et al [ 62 ] reported a reduction of patients presenting with stage I and stage II CRC from 29.5% and 26.6% to 20.0% and 25.5%, respectively, after the onset of COVID-19 pandemic. They also noticed an increase of patients with stage III and stage IV from 22.2% and 19.0% to 26.8% and 26.2%, respectively[ 16 , 62 ]. These changes were attributed to the delays in screening and diagnosis of CRC that was caused by the COVID-19 pandemic[ 17 , 55 , 62 ].…”

Section: Clinical Presentation Of Colorectal Cancermentioning

confidence: 99%

Clinical presentation, management, screening and surveillance for colorectal cancer during the COVID-19 pandemic

Akbulut¹,

Hargura²,

Garzali³

et al. 2022

WJCC

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Management of colorectal cancer (CRC) was severely affected by the changes implemented during the pandemic, and this resulted in delayed elective presentation, increased emergency presentation, reduced screening and delayed definitive therapy. This review was conducted to analyze the impact of the coronavirus disease 2019 (COVID-19) pandemic on management of CRC and to identify the changes made in order to adapt to the pandemic. We performed a literature search in PubMed, Medline, Index Medicus, EMBASE, SCOPUS, Reference Citation Analysis ( ) and Google Scholar using the following keywords in various combinations: Colorectal cancer, elective surgery, emergency surgery, stage upgrading, screening, surveillance and the COVID-19 pandemic. Only studies published in English were included. To curtail the spread of COVID-19 infection, there were modifications made in the management of CRC. Screening was limited to high risk individuals, and the screening tests of choice during the pandemic were fecal occult blood test, fecal immunochemical test and stool DNA testing. The use of capsule colonoscopy and open access colonoscopy was also encouraged. Blood-based tests like serum methylated septin 9 were also encouraged for screening of CRC during the pandemic. The presentation of CRC was also affected by the pandemic with more patients presenting with emergencies like obstruction and perforation. Stage migration was also observed during the pandemic with more patients presenting with more advanced tumors. The operative therapy of CRC was altered by the pandemic as more emergencies surgeries were done, which may require exteriorization by stoma. This was to reduce the morbidity associated with anastomosis and encourage early discharge from the hospital. There was also an initial reduction in laparoscopic surgical procedures due to the fear of aerosols and COVID-19 infection. As we gradually come out of the pandemic, we should remember the lessons learned and continue to apply them even after the pandemic passes.

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Impact of the COVID-19 Pandemic on Colorectal Cancer Care in the Netherlands: A Population-based Study

Cited by 16 publications

References 10 publications

Limited impact of the COVID-19 pandemic on colorectal cancer care in the Netherlands in 2020

Limited impact of the COVID-19 pandemic on colorectal cancer care in the Netherlands in 2020

Surgical safety in the COVID-19 era: present and future considerations

Clinical presentation, management, screening and surveillance for colorectal cancer during the COVID-19 pandemic

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